A situational analysis of breast cancer early detection services in Trinidad and Tobago

Kimberly Badal; Fidel Rampersad; Wayne A. Warner; Adetunji T. Toriola; Hamish Mohammed; Harold Alexis Scheffel; Rehanna Ali; Murrie Moosoodeen; Siva Konduru; Adaila Russel; Rajini Haraksingh

doi:10.1007/s10552-017-0937-4

A situational analysis of breast cancer early detection services in Trinidad and Tobago

Kimberly Badal^*, Fidel Rampersad, Wayne A. Warner, Adetunji T. Toriola, Hamish Mohammed, Harold Alexis Scheffel, Rehanna Ali, Murrie Moosoodeen, Siva Konduru, Adaila Russel, Rajini Haraksingh

^*Corresponding author for this work

NIS: STI Surveillance

Research output: Contribution to journal › Article › peer-review

2 Citations (Scopus)

Abstract

Purpose: A situational analysis of breast cancer (BC) early detection services was carried out to investigate whether Trinidad and Tobago (T&T) has the framework for successful organized national screening. Methods: An online survey was designed to assess the availability, accessibility, quality control and assurance (QC&A), and monitoring and evaluation (M&E) mechanisms for public and private BC early detection. A focus group with local radiologists (n = 3) was held to identify unaddressed challenges and make recommendations for improvement. Results: Major public hospitals offer free detection services with wait times of 1–6 months for an appointment. Private institutions offer mammograms for TTD$240 (USD$37) at minimum with same day service. Both sectors report a lack of trained staff. Using 1.2 mammograms per 10,000 women ≥40 years as sufficient, the public sector’s rate of 0.19 mammograms per 10,000 women ≥40 years for screening and diagnosis is inadequate. Program M&E mechanisms, QC&A guidelines for machinery use, delays in receipt of pathology reports, and unreliable drug access are further unaddressed challenges. Conclusion: T&T must first strengthen its human and physical resources, implement M&E and QC&A measures, strengthen cancer care, and address other impediments to BC early detection before investing in nationally organized BC screening.

Original language	English
Pages (from-to)	33-42
Number of pages	10
Journal	Cancer Causes and Control
Volume	29
Issue number	1
DOIs	https://doi.org/10.1007/s10552-017-0937-4
Publication status	Published - 1 Jan 2018

Bibliographical note

Funding Information:
Acknowledgments The project was supported by the Caribbean Cancer Research Initiative and Washington University School of Medicine Institute for Public Heath, Public Health Cubed (PH3) Grant, and Washington University School of Medicine (GSAS/CGFP Fund 94028C) (W.A.W.).

Funding Information:
The project was supported by the Caribbean Cancer Research Initiative and Washington University School of Medicine Institute for Public Heath, Public Health Cubed (PH3) Grant, and Washington University School of Medicine (GSAS/CGFP Fund 94028C) (W.A.W.). The authors declare that they have no competing interest.

Publisher Copyright:
© 2017, Springer International Publishing AG.

Keywords

Breast cancer
Early detection
Health service evaluation
Primary prevention
Screening
Situational analysis
Trinidad and Tobago

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1007/s10552-017-0937-4

Cite this

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title = "A situational analysis of breast cancer early detection services in Trinidad and Tobago",

abstract = "Purpose: A situational analysis of breast cancer (BC) early detection services was carried out to investigate whether Trinidad and Tobago (T&T) has the framework for successful organized national screening. Methods: An online survey was designed to assess the availability, accessibility, quality control and assurance (QC&A), and monitoring and evaluation (M&E) mechanisms for public and private BC early detection. A focus group with local radiologists (n = 3) was held to identify unaddressed challenges and make recommendations for improvement. Results: Major public hospitals offer free detection services with wait times of 1–6 months for an appointment. Private institutions offer mammograms for TTD$240 (USD$37) at minimum with same day service. Both sectors report a lack of trained staff. Using 1.2 mammograms per 10,000 women ≥40 years as sufficient, the public sector{\textquoteright}s rate of 0.19 mammograms per 10,000 women ≥40 years for screening and diagnosis is inadequate. Program M&E mechanisms, QC&A guidelines for machinery use, delays in receipt of pathology reports, and unreliable drug access are further unaddressed challenges. Conclusion: T&T must first strengthen its human and physical resources, implement M&E and QC&A measures, strengthen cancer care, and address other impediments to BC early detection before investing in nationally organized BC screening.",

keywords = "Breast cancer, Early detection, Health service evaluation, Primary prevention, Screening, Situational analysis, Trinidad and Tobago",

author = "Kimberly Badal and Fidel Rampersad and Warner, {Wayne A.} and Toriola, {Adetunji T.} and Hamish Mohammed and Scheffel, {Harold Alexis} and Rehanna Ali and Murrie Moosoodeen and Siva Konduru and Adaila Russel and Rajini Haraksingh",

note = "Funding Information: Acknowledgments The project was supported by the Caribbean Cancer Research Initiative and Washington University School of Medicine Institute for Public Heath, Public Health Cubed (PH3) Grant, and Washington University School of Medicine (GSAS/CGFP Fund 94028C) (W.A.W.). Funding Information: The project was supported by the Caribbean Cancer Research Initiative and Washington University School of Medicine Institute for Public Heath, Public Health Cubed (PH3) Grant, and Washington University School of Medicine (GSAS/CGFP Fund 94028C) (W.A.W.). The authors declare that they have no competing interest. Publisher Copyright: {\textcopyright} 2017, Springer International Publishing AG.",

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AU - Toriola, Adetunji T.

AU - Mohammed, Hamish

AU - Scheffel, Harold Alexis

AU - Ali, Rehanna

AU - Moosoodeen, Murrie

AU - Konduru, Siva

AU - Russel, Adaila

AU - Haraksingh, Rajini

N1 - Funding Information: Acknowledgments The project was supported by the Caribbean Cancer Research Initiative and Washington University School of Medicine Institute for Public Heath, Public Health Cubed (PH3) Grant, and Washington University School of Medicine (GSAS/CGFP Fund 94028C) (W.A.W.). Funding Information: The project was supported by the Caribbean Cancer Research Initiative and Washington University School of Medicine Institute for Public Heath, Public Health Cubed (PH3) Grant, and Washington University School of Medicine (GSAS/CGFP Fund 94028C) (W.A.W.). The authors declare that they have no competing interest. Publisher Copyright: © 2017, Springer International Publishing AG.

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Y1 - 2018/1/1

N2 - Purpose: A situational analysis of breast cancer (BC) early detection services was carried out to investigate whether Trinidad and Tobago (T&T) has the framework for successful organized national screening. Methods: An online survey was designed to assess the availability, accessibility, quality control and assurance (QC&A), and monitoring and evaluation (M&E) mechanisms for public and private BC early detection. A focus group with local radiologists (n = 3) was held to identify unaddressed challenges and make recommendations for improvement. Results: Major public hospitals offer free detection services with wait times of 1–6 months for an appointment. Private institutions offer mammograms for TTD$240 (USD$37) at minimum with same day service. Both sectors report a lack of trained staff. Using 1.2 mammograms per 10,000 women ≥40 years as sufficient, the public sector’s rate of 0.19 mammograms per 10,000 women ≥40 years for screening and diagnosis is inadequate. Program M&E mechanisms, QC&A guidelines for machinery use, delays in receipt of pathology reports, and unreliable drug access are further unaddressed challenges. Conclusion: T&T must first strengthen its human and physical resources, implement M&E and QC&A measures, strengthen cancer care, and address other impediments to BC early detection before investing in nationally organized BC screening.

AB - Purpose: A situational analysis of breast cancer (BC) early detection services was carried out to investigate whether Trinidad and Tobago (T&T) has the framework for successful organized national screening. Methods: An online survey was designed to assess the availability, accessibility, quality control and assurance (QC&A), and monitoring and evaluation (M&E) mechanisms for public and private BC early detection. A focus group with local radiologists (n = 3) was held to identify unaddressed challenges and make recommendations for improvement. Results: Major public hospitals offer free detection services with wait times of 1–6 months for an appointment. Private institutions offer mammograms for TTD$240 (USD$37) at minimum with same day service. Both sectors report a lack of trained staff. Using 1.2 mammograms per 10,000 women ≥40 years as sufficient, the public sector’s rate of 0.19 mammograms per 10,000 women ≥40 years for screening and diagnosis is inadequate. Program M&E mechanisms, QC&A guidelines for machinery use, delays in receipt of pathology reports, and unreliable drug access are further unaddressed challenges. Conclusion: T&T must first strengthen its human and physical resources, implement M&E and QC&A measures, strengthen cancer care, and address other impediments to BC early detection before investing in nationally organized BC screening.

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A situational analysis of breast cancer early detection services in Trinidad and Tobago

Abstract

Bibliographical note

Keywords

UN SDGs

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