Prostate Cancer in the Caribbean.

Prostate cancer (PC) is one of the principal causes of cancer death worldwide. The mortality rate for PC in the Caribbean is higher than in many developed countries, and there is a difference in the incidence among the various Caribbean nations. Besides surveillance and screening, these factors increase concerns about genetic and other risk factors causing PC incidence. PC research is limited in scope and regularity in the Caribbean, creating a literature gap. This literature review aims to examine the PC situation in the Caribbean to highlight where further studies are needed. This review includes all available studies on PC in the specified Caribbean population from 1958 to 2023 utilising the keywords "Prostate Cancer and Caribbean" on PubMed, Scopus, and ScienceDirect databases. The information is then structured by Caribbean countries and by seven themes. These themes are PC incidence and mortality, demographics, clinicopathology, genetics, non-genetic risks, diagnosis and treatment, and PC control. The findings demonstrated that countries with low resources are burdened by more severe illnesses with worse PC outcomes. Furthermore, territories with national cancer registries seemed to have enhanced methods for PC management. In conclusion, this review is significant because it provides initial support for researchers, administrators, and planners for PC healthcare. Additionally, it gives an opportunity for further epidemiological analyses that can supply more significant insights into the PC situation in the Caribbean. Further research should focus on prevention strategies and the standardisation of treatment procedures to enhance surveillance and improve patient outcomes.

Epidemiology of Cervical Cancer in the Caribbean.

Cervical cancer (CvC) is considered a preventable disease; however, in the Caribbean, it is still one of the fourth most common causes of death in women. Efforts to overcome obstacles to the treatment and control of this preventable disease are being made by several countries within the Caribbean. However, no health issue can be readily managed without first acquiring an understanding of the dynamics relating to its severity of impact reaching the target population, its clinical pathology, and the availability of treatment and/or preventative measures to control or halt its progression. To assess the status of CvC in the Caribbean, a review of the literature was conducted using PubMed. The Caribbean was defined in the review as comprising nations and islands whose coastlines are touched by the Caribbean Sea. This led to an assessment of the available literature on CvC for 33 Caribbean territories. The review showed a lack of published information on CvC and highlights the need for greater research. This also serves as a template for subsequent investigations.

Perception of Survivorship Needs Among Breast Cancer Patients in Trinidad and Tobago.

The perception of survivorship among the cancer communities of the Caribbean is largely unknown. This study focused on determining the perception and interest in cancer survivorship among breast cancer (BC) patients in Trinidad and Tobago, as a preliminary, to introducing a pilot survivorship program and evaluating its impact on this patient population. Participants were given a questionnaire to determine needs, expectations and interest in survivorship care. Baseline measurable outcomes reported in this article include the following: 1. Participants' satisfaction with their medical care follow-up plan (if any), 2. Participants' satisfaction with the amount of information provided by healthcare providers, and 3. Participants' satisfaction with their physician's overall concern about their well-being, ranked on a 5-point Likert scale. Participants also reported on the advice/ guidelines provided by their physicians, after surgery and/or on completion of treatment, what they did to cope with BC, and their expectations of what could have been done to improve the quality of care received. A second questionnaire was then used to measure the level of interest in participating in a Cancer Survivorship Program (CSP) with components such as: nutrition, psychosocial development, spiritual well-being, and yoga and mindfulness. The level of interest was ranked by participants on a 5-point Likert scale. Fifteen themes emerged from participants' responses to the first questionnaire. Nutrition stood out as the module of highest interest, followed by psychosocial development among BC patients.

Breast Cancer in the Caribbean.

Breast cancer (BC) is one of the leading causes of death among women globally. In the Caribbean, there is a higher mortality rate compared with North American and European countries which have higher incidence rates. We conducted a literature review to examine the BC dynamic in the Caribbean and determine the areas where further investigations are needed. The PubMed database was used for identifying relevant studies using a combination of specific keyword searches. All studies focusing on BC within the defined Caribbean population were selected for this review. A total of 117 papers were included. The data were organized and presented under the following headings and reported according to the country where available: BC incidence and mortality, patient demographics, clinicopathology, genetics, behavioral risks, diagnosis and treatment, and BC control. Our review uncovered major variability in the incidence, management, etiology, and mortality of BC among Caribbean countries. Low-resource countries are burdened by more advanced disease with expected poorer BC outcomes (i.e., shorter periods of disease-free survival). Countries with established national cancer registries seem to have a better approach to the management of BC. The introduction of cancer treatment programs in association with international nonprofit groups has shown tremendous improvement in quality, accessible cancer care for patients, particularly in low- and middle-income settings. BC research is relatively limited in the Caribbean, lacking in both scope and consistency. The unique Caribbean BC population of diverse ethnicities, environmental influence, immigrants, socioeconomic status, and sociocultural practices allows an optimal opportunity for epidemiological investigations that can provide deeper insights into the status of BC.

Evaluating Cardiovascular Disease (CVD) risk scores for participants with known CVD and non-CVD in a multiracial/ethnic Caribbean sample.

BACKGROUND: Cardiovascular Disease (CVD) risk prediction models have been useful in estimating if individuals are at low, intermediate, or high risk, of experiencing a CVD event within some established time frame, usually 10 years. Central to this is the concern in Trinidad and Tobago of using pre-existing CVD risk prediction methods, based on populations in the developed world (e.g. ASSIGN, Framingham and QRISK®2), to establish risk for its multiracial/ethnic Caribbean population. The aim of this study was to determine which pre-existing CVD risk method is best suited for predicting CVD risk for individuals in this population. METHOD: A survey was completed by 778 participants, 526 persons with no prior CVD, and 252 who previously reported a CVD event. Lifestyle and biometric data was collected from non-CVD participants, while for CVD participants, medical records were used to collect data at the first instance of CVD. The performances of three CVD risk prediction models (ASSIGN, Framingham and QRISK®2) were evaluated using their calculated risk scores. RESULTS: All three models (ASSIGN, Framingham and QRISK®2) identified less than 62% of cases (CVD participants) with a high proportion of false-positive predictions to true predictions as can be seen by positive predictabilities ranging from 78% (ASSIGN and Framingham) to 87% (QRISK®2). Further, for all three models, individuals whose scores fell into the misclassification range were 2X more likely to be individuals who had experienced a prior CVD event as opposed to healthy individuals. CONCLUSION: The ASSIGN, Framingham and QRISK®2 models should be utilised with caution on a Trinidad and Tobago population of intermediate and high risk for CVD since these models were found to have underestimated the risk for individuals with CVD up to 2.5 times more often than they overestimated the risk for healthy persons.