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      The cancer epidemic in the Caribbean region: Further opportunities to reverse the disease trend

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          Summary

          Cancer incidence has been rising in the Caribbean and is expected to have significant adverse implications for the health of people in the region and health systems in this decade. While developed countries, for the most part, enjoy the benefits of advanced technologies and adaptive systems in cancer control and management, a different experience confronts a large segment of the Caribbean population. The region has experienced some success in enhancing cancer services, however, there is a need to address gaps in several areas through nationally and regionally tailored initiatives. This Review complements previous publications on the challenges, actions, and progress towards cancer prevention and care in Caribbean countries but also further outlines potential positive impacts that can be derived from addressing gaps pertaining to cancer education, data management, screening and risk assessment, navigation services, gender factors, and resource development. The proposed approaches encapsulate concepts of health theories that are applicable across the ecological domains. When implemented in combination, the proposals may effectively contribute to reducing the cancer burden in the region.

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          Lung cancer in China: challenges and interventions.

          Jun She, Ping Yang, Qunying Hong … (2013)
          In 2008, lung cancer replaced liver cancer as the number one cause of death among people with malignant tumors in China. The registered lung cancer mortality rate increased by 464.84% in the past 3 decades, which imposes an enormous burden on patients, health-care professionals, and society. We performed a systematic review of the published data on lung cancer in China between 1990 and 2011 to analyze the incidence and mortality rates, economic burden, and risk factors of cancer and the effectiveness of interventions. Lung cancer incidence varies within China. People in eastern China, especially women, likely have a higher risk of developing lung cancer than those in western China. The crude mortality rates from lung cancer in 2008 were 47.51 per 100,000 men and 22.69 per 100,000 women. The crude mortality rate was highest in Shanghai (76.49 per 100,000 men and 35.82 per 100,000 women) and lowest in Tibet (25.14 per 100,000 men) and Ningxia (12.09 per 100,000 women). Smoking and environmental pollution are major risk factors for lung cancer in China. Continuous efforts should be concentrated on education of the general public regarding lung cancer to increase prevention and early detection. Specific interventions need to be implemented to reduce smoking rates and environmental risk factors. Standardized treatment protocols should be adapted in China.
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            Increased cancer burden among pesticide applicators and others due to pesticide exposure.

            Michael Alavanja, Matthew Ross, Matthew Bonner (2013)
            A growing number of well-designed epidemiological and molecular studies provide substantial evidence that the pesticides used in agricultural, commercial, and home and garden applications are associated with excess cancer risk. This risk is associated both with those applying the pesticide and, under some conditions, those who are simply bystanders to the application. In this article, the epidemiological, molecular biology, and toxicological evidence emerging from recent literature assessing the link between specific pesticides and several cancers including prostate cancer, non-Hodgkin lymphoma, leukemia, multiple myeloma, and breast cancer are integrated. Although the review is not exhaustive in its scope or depth, the literature does strongly suggest that the public health problem is real. If we are to avoid the introduction of harmful chemicals into the environment in the future, the integrated efforts of molecular biology, pesticide toxicology, and epidemiology are needed to help identify the human carcinogens and thereby improve our understanding of human carcinogenicity and reduce cancer risk. Copyright © 2013 American Cancer Society, Inc.
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              Underutilization of cervical cancer prevention services in low and middle income countries: a review of contributing factors

              Fresier Chidyaonga-Maseko, Maureen Chirwa, Adamson Muula (2015)
              This review aims at identifying barriers to utilization of cervical cancer prevention services in low- and middle-income countries. An electronic search was conducted using the following key words, HPV vaccination, screening, barriers, utilization and low and middle income/developed countries. Using the Garrard (1999) Matrix method approach, a modified matrix was designed and used as a data collection tool and data related to each category listed on the tool were entered into a matrix containing columns reflecting the categories. Constant comparative analysis was used to identify thematic categories. 31 articles published between 2001 and 2014 were yielded from the search. Analysis of the contents of the articles showed that the underutilization of cervical cancer screening services in low and middle-income countries is the result of barriers in accessing and utilizing of the prevention services. Though not mutually exclusive, the barriers were categorized in three categories; individual, community and health system related. Individual barriers include lack of awareness and knowledge about risk factors and prevention of cervical cancer. Age, marital status, diffidence, social economic status, cultural and religious belief of the women also determine the women's' willingness to utilize the services. In some communities there is stigma attached to discussing reproductive health issues and this limits the young women's awareness of cervical cancer and its prevention. Understanding individual, community and health system barriers that hinder women's utilization of cervical cancer prevention services is very crucial in designing effective cervical cancer control programs in low- and middle-income countries.
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                Author and article information

                Contributors
                Lindonne Glasgow
                Journal
                Journal ID (nlm-ta): Lancet Reg Health Am
                Journal ID (iso-abbrev): Lancet Reg Health Am
                Title: Lancet Regional Health - Americas
                Publisher: Elsevier
                ISSN (Electronic): 2667-193X
                Publication date PMC-release: 14 June 2022
                Publication date Collection: September 2022
                Publication date (Electronic): 14 June 2022
                Volume: 13
                Electronic Location Identifier: 100295
                Affiliations
                [a ]St. George's University, True Blue, St. George's, Grenada
                [b ]Ministry of Health, Tanteen, St. George's, Grenada
                Author notes
                [* ]Corresponding author at: Department of Public Health & Preventive Medicine, St. George's University, P.O. Box 7, True Blue, St. George, Grenada. lglasgow@ 123456sgu.edu
                Article
                Publisher Item ID: S2667-193X(22)00112-0 Publisher ID: 100295
                DOI: 10.1016/j.lana.2022.100295
                PMC ID: 9903961
                PubMed ID: 36777319
                SO-VID: 722c2a93-e204-46a4-b1b1-c876574095b7
                Copyright © © 2022 The Author(s)
                License:

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                Categories
                Subject: Review

                Keywords: cancer,oncology,caribbean,cancer prevention,cancer education,patient support,cancer screening,patient navigation
                Data availability:
                Keywords: cancer, oncology, caribbean, cancer prevention, cancer education, patient support, cancer screening, patient navigation

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