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. 2018 Jul;29(7):685-697.
doi: 10.1007/s10552-018-1038-8. Epub 2018 May 17.

The burden of prostate cancer in Trinidad and Tobago: one of the highest mortality rates in the world

Wayne A Warner  1   2   3 , Tammy Y Lee  4 , Fang Fang  5 , Adana A M Llanos  6 , Smriti Bajracharya  7 , Vasavi Sundaram  8 , Kimberly Badal  9 , Vandana Devika Sookdeo  10 , Veronica Roach  11 , Marjorie Lamont-Greene  11 , Camille Ragin  12   13   14   15 , Simeon Slovacek  3 , Krishan Ramsoobhag  16 , Jasmine Brown  17 , Timothy R Rebbeck  18   19 , Ravi Maharaj  10 , Bettina F Drake  20   21
Affiliations

The burden of prostate cancer in Trinidad and Tobago: one of the highest mortality rates in the world

Wayne A Warner et al. Cancer Causes Control. 2018 Jul.

Abstract

Purpose: In Trinidad and Tobago (TT), prostate cancer (CaP) is the most commonly diagnosed malignancy and the leading cause of cancer deaths among men. TT currently has one of the highest CaP mortality rates in the world.

Methods: 6,064 incident and 3,704 mortality cases of CaP occurring in TT from January 1995 to 31 December 2009 reported to the Dr. Elizabeth Quamina Cancer population-based cancer registry for TT, were analyzed to examine CaP survival, incidence, and mortality rates and trends by ancestry and geography.

Results: The age-standardized CaP incidence and mortality rates (per 100,000) based on the 1960 world-standardized in 2009 were 64.2 and 47.1 per 100,000. The mortality rate in TT increased between 1995 (37.9 per 100,000) and 2009 (79.4 per 100,000), while the rate in the US decreased from 37.3 per 100,000 to 22.1 per 100,000 over the same period. Fewer African ancestry patients received treatment relative to those of Indian and mixed ancestry (45.7%, 60.3%, and 60.9%, respectively).

Conclusions: Notwithstanding the limitations surrounding data quality, our findings highlight the increasing burden of CaP in TT and the need for improved surveillance and standard of care. Our findings highlight the need for optimized models to project cancer rates in developing countries like TT. This study also provides the rationale for targeted screening and optimized treatment for CaP to ameliorate the rates we report.

Keywords: Cancer in populations of African ancestry; Cancer incidence; Cancer mortality; Cancer survival; Caribbean; Geography; Prostate cancer; Trinidad and Tobago.

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Conflict of interest statement

The authors declared that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Patient selection algorithm
Fig. 2
Fig. 2
Prostate cancer rates, trends, and survival trends, Trinidad and Tobago, 1995–2009. a Trends in prostate cancer rates, Trinidad and Tobago, 1995–2009. Source: TT Cancer Registry and WHO Cancer Mortality Database. Rates are age adjusted to the 1960 world standard population. b Comparative prostate cancer trend analyses of Trinidad and Tobago and USA, 1995–2009: Incidence. Rates are age adjusted to the 2000 US standard population. c Comparative prostate cancer trend analyses of Trinidad and Tobago and USA, 1995–2009: Mortality. Rates are age adjusted to the 2000 US standard population. d Prostate cancer incidence and mortality rates in Trinidad and Tobago by ancestry, 1995–2009. Rates are age adjusted to the 1960 world standard population. e Prostate cancer survival probability by geography based on residence within Regional Health Authority catchment area. f Prostate cancer survival probability by ancestry
Fig. 3
Fig. 3
Prostate cancer mortality-to-incidence (M/I) rate ratio in World Health Organization (WHO) regions and select countries. Data source Incidence: Globocan; mortality: WHO Mortality database. *Data source Trinidad and Tobago Cancer Registry
Fig. 4
Fig. 4
Geospatial maps of prostate cancer incidence and mortality rates in Trinidad and Tobago 1995–2009: top panel, left to right—age-standardized incidence rates for all Regional Health Authorities and Corporations, and bottom panel, left to right—age-standardized mortality rates for all Regional Health Authorities and Corporations. Rates are age adjusted to the 1960 world standard population
See this image and copyright information in PMC

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