TY - JOUR
T1 - A situational analysis of breast cancer early detection services in Trinidad and Tobago
AU - Badal, Kimberly
AU - Rampersad, Fidel
AU - Warner, Wayne A.
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 - Publisher Copyright:
© 2017, Springer International Publishing AG.
PY - 2018/1/1
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.
KW - Breast cancer
KW - Early detection
KW - Health service evaluation
KW - Primary prevention
KW - Screening
KW - Situational analysis
KW - Trinidad and Tobago
UR - http://www.scopus.com/inward/record.url?scp=85027365192&partnerID=8YFLogxK
U2 - 10.1007/s10552-017-0937-4
DO - 10.1007/s10552-017-0937-4
M3 - Article
C2 - 28801763
AN - SCOPUS:85027365192
SN - 0957-5243
VL - 29
SP - 33
EP - 42
JO - Cancer Causes and Control
JF - Cancer Causes and Control
IS - 1
ER -