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

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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.

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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.).

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Authors and Affiliations

  1. Caribbean Cancer Research Initiative, San Fernando, Trinidad and Tobago

    Kimberly Badal, Rehanna Ali & Rajini Haraksingh

  2. Department of Life Science, Faculty of Science and Technology, The University of the West Indies, St. Augustine, Trinidad and Tobago

    Kimberly Badal, Rehanna Ali, Adaila Russel & Rajini Haraksingh

  3. Faculty of Medical Sciences, The University of the West Indies, St. Augustine, Trinidad and Tobago

    Fidel Rampersad

  4. Department of Cell Biology and Physiology, Medical Oncology, Siteman Cancer Center, Washington University School of Medicine, Saint Louis, MO, USA

    Fidel Rampersad & Wayne A. Warner

  5. Division of Public Health Sciences, Washington University School of Medicine, Saint Louis, MO, USA

    Adetunji T. Toriola

  6. Department of HIV and STIs, National Infection Service, Public Health England, London, UK

    Hamish Mohammed

  7. Department of Geography, York University, Toronto, Canada

    Harold-Alexis Scheffel

  8. San Fernando General Hospital, San Fernando, Trinidad and Tobago

    Murrie Moosoodeen

  9. Sangre Grande General Hospital, Sangre Grande, Trinidad and Tobago

    Siva Konduru

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  1. Kimberly Badal
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Correspondence to Kimberly Badal.

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Badal, K., Rampersad, F., Warner, W.A. et al. A situational analysis of breast cancer early detection services in Trinidad and Tobago. Cancer Causes Control 29, 33–42 (2018). https://doi.org/10.1007/s10552-017-0937-4

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