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 - 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.
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 -