Factors associated with breast cancer recurrence and survival at Sangre Grande Hospital, Trinidad.

PURPOSE: The aim of this study is to determine the demographic, pathological, and treatment-related factors that predict recurrence and survival in a Trinidadian cohort of breast cancer patients. METHODS: The inclusion criteria for this study were female, over 18 years, and with a primary breast cancer diagnosis confirmed by a biopsy report occurring between 2010 and 2015 at Sangre Grande Hospital, Trinidad. Univariate associations with 5-year recurrence-free survival and 5-year overall survival were calculated using the Kaplan-Meier method for categorical variables and Cox Proportional Hazards for continuous variables. A multivariate model for prediction of recurrence and survival was determined using Cox regression. RESULTS: For the period 2010-2015, 202 records were abstracted. Five-year overall survival and recurrence-free survival rates were found to be 74.3% and 56.4%, respectively. Median times from first suspicious finding to date of biopsy report, date of surgery, and date of chemotherapy were 63 days, 125 days, and 189 days, respectively. In the univariate analysis, age (p = 0.038), stage (p < 0.001), recurrence (p = 0.035), surgery (p = 0.016), ER (p < 0.001) status, PR status (p < 0.001), and subtype (p < 0.001) were significantly associated with survival. Additionally, stage (p = 0.004), N score (p = 0.002), ER (p = 0.028) status, PR (p = 0.018) status, and subtype (p = 0.025) were significantly associated with recurrence. In the Cox multivariate model, Stage 4 was a significant predictor of survival (HR 6.77, 95% CI [0.09-2.49], p = 0.047) and N3 score was a significant predictor of recurrence (HR 4.47, 95% CI [1.29-15.54], p = 0.018). CONCLUSION: This study reports a 5-year breast cancer survival rate of 74.3%, and a recurrence-free survival rate of 56.4% in Trinidad for the period 2010-2015.

Examining HPV- and HPV vaccine-related cognitions and acceptability among US-born and immigrant hispanics and US-born and immigrant non-Hispanic Blacks: a preliminary catchment area study.

PURPOSE: Disparities in HPV vaccination exist. Therefore, we investigated the distinction and disparities in HPV- and HPV vaccine-related cognitions and acceptability among US-born African Americans (AA) and Black immigrants, and between US-born Latinas and Latina immigrants. METHODS: Secondary data analyses were conducted with 383 female adults divided into non-Hispanic Blacks-(1) AA born in the US (n = 129) and (2) Black immigrants (n = 53), and Hispanics-(3) Latinas born in the US (n = 57) and (4) Latina immigrants (n = 144). HPV-related cognitions are assessed by measuring HPV-related knowledge and HPV vaccine-related awareness, beliefs, accessibility, and acceptability. RESULTS: Black and Latina immigrants were less likely to know where they can get/refer for HPV vaccine (p = .007) than their US-born counterparts. Latina immigrants were less likely to have heard of HPV vaccine (p = .033), know where they can get more information about HPV vaccine (p = .045), and know where they can get/refer for HPV vaccine (p = .001) than US-born Latinas. Both immigrant groups (Black: p = .046; Latina: p = .044) were more likely to report cost concerns than their counterparts. US-born AA were the least likely to endorse HPV vaccine safety (31.0%) and efficacy (39.7%), whereas US-born Latinas endorsed efficacy (63.2%) but less safety (44.6%). Overall, vaccine acceptability was low across all groups. CONCLUSIONS: Group disparities in HPV vaccine cognitions emerged, but they all had notable HPV vaccine acceptability (safety and efficacy) barriers. HPV vaccine safety and efficacy were highly unfavorable in US-born AA. The HPV vaccine safety concerns are demonstrated with only 31-54% reporting that the "HPV vaccine is safe"-potentially increasing their risk of HPV vaccine negation. With regards to HPV vaccine efficacy, only 40-63% of this study population endorsed HPV vaccine efficacy. Additionally, immigrants reported greater HPV vaccine cost barriers and healthcare access concerns-increasing their risk for HPV vaccine naiveté. Therefore, our findings on HPV vaccine cognitions and acceptability can inform targeted strategies to increase vaccination among US and immigrant Hispanics and non-Hispanic Blacks who are at elevated risk for HPV-related cancers.

Nurturing Advocacy Inclusion to Bring Health Equity in Breast Cancer among African American Women.

This paper will present the multiple roles and the impact of cancer advocates. The emerging literature provides evidence for the consideration and integration of African American BC survivors as advocates in practice, policy and research relevant to cancer prevention and control. We present a practical outline for organizational assessment for the inclusion of advocates in these arenas. This assessment can be conducted by all levels of partners, including community advocacy and scientific organizations.

African-Caribbean cancer consortium for the study of viral, genetic and environmental cancer risk factors.

This is a short summary of a meeting of the "African-Caribbean Cancer Consortium", jointly organized by the University of Pittsburgh, Department of Epidemiology and the University of Pittsburgh Cancer Institute, held in Montego Bay, Jamaica as a satellite meeting at the Caribbean Health Research Council, 52nd Annual Council and Scientific meeting on May 4, 2007.