From Antigua Barbuda Business Focus

The Trinidad-based Caribbean Public Health Agency (CARPHA) has reported that cancers are the second leading cause of death in the region; even as it acknowledged that nearly one half of cancers are preventable or treatable if detected early.

CARPHA said that among females, breast cancer is the main cause of death, followed by cervical cancer. Prostate cancer is ranked as the leading cause of cancer death among males, with lung cancer being the second main cause of cancer death. Lung cancer also contributes to a high number of deaths among women. Colon cancer is the fifth leading cause of death in the region, with an almost equal number of deaths among males and females.

Cervical cancer is one of the most preventable, yet it claims the lives of approximately 2,500 women, CARPHA said.

“There are common modifiable risk factors that contribute to the development of cancers. These include tobacco use, unhealthy diets, physical inactivity and harmful use of alcohol,” said CARPHA’s Executive Director Dr James Hospedales.

“Research has shown that a reduction in the modifiable risk factors in the population will contribute to a reduction of cancer cases and as a consequence deaths and costs from the disease in our region.”

Dr Hospedales said cancer prevention and control is certainly not beyond the Caribbean.

“Collaborative, multisectoral, multidisciplinary action supported by good data is urgently needed to impact this problem in our region. Let us use World Cancer Day 2015 to mark the start of concerted actions in our countries for reducing the scourge of cancer in our Caribbean!”

The agency explained it has been supporting member states in identifying the risk factors for chronic diseases including cancer in the population and that results from such surveys have shown high levels of tobacco use in some countries especially among males; low levels of physical activity, overwhelming levels of overweight and obesity; high levels of harmful use of alcohol particularly among men and extremely low levels of intake of fruits and vegetable.

It said that the theme for World Cancer Day 2015 (February 4) “Not Beyond Us” and that countries are still being urged to employ proactive approaches to fight against cancer with a strong message which stresses that solutions do exist and are within our reach to reduce the disease burden and cost impact.

“In this regard, countries are encouraged to implement and enforce proven policies and interventions which will impact on the reduction of the development of chronic diseases and their risk factors in the population.”

CARPHA said it will continue to support and guide countries in the identification of suitable interventions for impacting behavior change in the population, thereby reducing the risks for cancer.

The health agency is also actively working with partners regionally and internationally including non-governmental organizations to reduce risk factors and chronic diseases in the region. In addition, CARPHA is collaborating with institutions and agencies within the Caribbean Community (CARICOM) region to impact trade agreements and influence the availability and access to healthy foods.

“Crucially, to improve cancer prevention and control, requires strengthening of information data about cancer, particularly cancer registries.

“In this regard, CARPHA is working with the National Cancer Institute (NCI), the International Agency for Research on Cancer (IARC), and the Centre for Disease Control (CDC) to be a cancer registry hub for the Caribbean to strengthen existing cancer registries in the Member States,” the Trinidad-based agency said.

ANTIGUA AND BARBUDA CANCER RANK BY TYPE

AGE-STANDARDIZED DEATH RATE

PER 100,000 POPULATION

Rate World Rank
1 Breast Cancer 29.78 2 (poor)
2 Prostate Cancer 24.81 5 (poor)
3 Colon-Rectum Cancers 13.61 47
4 Ovary Cancer 8.47 1 (poor)
5 Lung Cancers 8.26 119
6 Uterin Cancer 6.75 2 (poor)
7 Other Neoplasms 5.71 17 (poor)
8 Cervical Cancer 5.44 95
9 Liver Cancer 5.21 107
10 Lymphomas 4.79 109
11 Oesophagus Cancer 4.63 53
12 Stomach Cancer 4.3 143 (good)
13 Leukemia 3.95 94
14 Pancreas Cancer 3.37 96
15 Bladder Cancer 3.11 68
16 Oral Cancer 2.68 98
17 Skin Cancers 0.42 163 (good)
Latest WHO data (2010)

OUR DATA: We use the most recent data from these primary sources: WHO, World Bank, UNESCO, CIA and individual country databases for global health and causes of death.

We use the CDC, NIH and individual state and county databases for verification and supplementation for USA data.

IMAGE: cancer-word-cloud

Related from The Cayman Islands Cancer Society

On Tuesday, 10 February 2015 the Ministry of Health held a press conference to launch the 30 day public consultation period for the draft Cancer Registry Bill, 2015. This Bill would provide for the automatic reporting of cancers diagnosed in the Cayman Islands to the national cancer registry. With the passing of this Bill physicians will be mandated to report basic cancer and demographic information to the registry for the purpose of conducting research into the causes and management of cancer in the Cayman Islands.

Confidentiality is of the highest importance, and great measures have been taken to ensure the confidentiality of those registered. Names of registrants are not entered into the registry and all data is coded. As such, it is impossible for the personal details of individuals to be exposed as they are not kept in the database. The cancer registry is not part of the government’s internal IT system, nor is it networked in any way to other data management systems. The registry can only be accessed with a user name and password which are changed regularly. In the unlikely event that someone would access the database the identities of individuals would not be available since no names or other identifying information is entered into the registry.

Currently, there is almost no information about cancer trends in this country. It is still unclear how many people are diagnosed with cancer in the Cayman Islands every year, which types of cancer are most common, or whether we are seeing higher rates of cancer here than in other countries. In addition to answering these questions, the registry also hopes to use this data to identify potential environmental concerns which may contribute to cancer incidence.

The World Health Organization estimates that cancer rates could increase 50% by the year 2020. Because of this anticipated rise in cancer the WHO encourages all nations to have cancer registries providing reliable data. By far, the most reliable data comes from registries which require automatic reporting from physicians.

According to a 2007 publication from the International Agency for Research on
Cancer, of the 225 population-based cancer registries on five continents, more than half have mandated reporting through either legislation or administrative order. The UK has had mandatory reporting in place since 1993 and is known for having one of the most comprehensive registries in the world. By passing this Bill, the Cayman Islands will simply be adopting best practices as recommended by the World Health Organization as have well over a hundred other cancer registries worldwide.

We would like to thank the cancer survivors, and families of cancer victims, who have already registered with us. We are grateful for all the support this Bill has received from the public, the medical community, and government officials. The Cayman Islands Cancer Society fully supports this Bill and we will continue to be a strong advocate for the automatic reporting of cancers to the national registry. We believe in this initiative and the goal of advancing our knowledge about how this disease impacts our community.

Regards, Cayman Islands Cancer Society Board of Directors

Below, is a list of population-based cancer registries which currently have automatic/mandatory reporting in place as a result of legislation (a law requiring physicians to report). This list does NOT include those registries worldwide which have mandatory reporting in place due to administrative order. This list compiles information from The International Agency for Research on Cancer, the African-Caribbean Cancer Consortium, and EUROCARE. There are a total of 84 registries listed below (in approx. 30 countries). For a more comprehensive list of cancer registries worldwide, which includes registries using both automatic/mandatory and voluntary reporting, follow this link to IARC’s website http://www.iarc.fr/en/publications/pdfs-online/epi/sp160/ (chapter 2).

You will see each state in the U.S. listed below (with a few exceptions). This is because each state in the U.S. has a mandatory registry which reports to the Center for Disease Control. Only states with mandatory reporting in place due to legislation are listed, not those with mandatory reporting in place due to administrative order.

USA

USA, Alabama
USA, Alaska
USA, Arizona
USA, California
USA, California, Greater San Francisco Bay Area
USA, California, Los Angeles County
USA, Colorado
USA, Connecticut
USA, District of Columbia
USA, Georgia
USA, Georgia, Atlanta
USA, Hawaii
USA, Idaho
USA, Illinois
USA, Indiana
USA, Kentucky
USA, Louisiana
USA, Louisiana, New Orleans
USA, Maine
USA, Massachusetts
USA, Michigan
USA, Michigan, Detroit
USA, Missouri
USA, Montana
USA, New Jersey
USA, New York State
USA, Ohio
USA, Oklahoma
USA, Oregon
USA, Pennsylvania
USA, Rhode Island
USA, SEER
USA, South Carolina
USA, Texas
USA, Vermont
USA, Washington
USA, Washington, Seattle
USA, West Virginia

ASIA

Israel
Korea
Kuwait
Philippines
Turkey, Antalya
Turkey, Izmir

Europe

Austria
Austria, Tyrol
Austria, Vorarlberg
Croatia
Czech Republic
Finland
Germany, Brandenburg
Germany, Free State of Saxony
Germany, Hamburg
Germany, Mecklenburg-Western Pomerania
Germany, Munich
Germany, Saarland
Latvia
Malta
Norway
Poland, Cracow
Poland, Kielce
Poland, Warsaw City
Portugal, Porto
Portugal, South Region
Russia, St. Petersburg
Serbia
Slovenia
Spain, Albacete
Spain, Zaragoza
Sweden
Switzerland, Ticino
United Kingdom

Oceania

Australian Capital Territory
Australia, New South Wales
Australia, Northern Territory
Australia, Queensland
South Australia
Australia, Tasmania
Australia, Victoria
Western Australia
French Polynesia
New Zealand

Caribbean

Martinique
Barbados

Facts on minimum data sets for cancer registries

1) In a publication from the International Agency for Research on Cancer ( part of the WHO), Planning and Developing Population-based Cancer Registries in Low and Middle Income Settings, the minimum recommended data set for cancer registries includes 1) name, 2) sex, 3) DOB, 4) address, 5) ethnic group, 6) incidence date, 7) basis of diagnosis, 8) topography, 9) morphology, 10) behavior, and 11) source of information (hospital record #, name of physician.
2) The European Network of Cancer Registries goes a bit further and suggests the minimum data set include the above information and also the telephone number of the patient, laterality, stage of cancer, initial therapy received, and date of death. This info is taken from the above IARC publication.

Facts about the CanReg5 database
1) CanReg5 is a database specifically designed to store, check, and analyze cancer registry data.
2) It was developed by the International Agency for Research on Cancer, which is part of the WHO.
3) CanReg5 is currently available in 8 languages, and is used by cancer registries all over the world.
4) Accessing our CanReg 5 database requires 2 sets of user names and passwords which are HIPAA compliant and change regularly.

Issues of confidentiality
1) The registry computer is not networked to any other computers and is stored in a locked office accessible only to the Registrar. The database requires 2 user names and passwords, which change regularly, and are only known to the Registrar. The passwords are HIPAA compliant ( a minimum of 8 characters, utilizing both alpha and numeric characters, upper and lower case letters).
2) Names are never entered into the registry. Names are collected on data forms for the sole purpose of making sure the same person isn’t registered twice. They serve no other purpose.
3) All data submitted by physicians will be faxed to a locked office only accessible by the cancer registrar.

Mandatory reporting worldwide
1) In 2007 the International Agency for Research on Cancer (part of WHO) in collaboration with the International Association of Cancer Registries published, Cancer Incidence in Five Continents, Vol. IX . This report covered the continents of Africa, the Americas (north, central, and south), Asia, Europe, and Oceania (Australia, French Polynesia, New Zealand, and Hawaii). According to this report there are 225 population based (did not report on hospital based) cancer registries with reliable statistics to report. Of these 225 registries more than half have mandatory reporting in place due to legislation or administrative order. This includes the United States and the United Kingdom.
2) Martinique was the first Caribbean country to adopt mandatory reporting in 1981.

Cancer registries in the Caribbean
1) At the moment there are about a dozen active cancer registries in the Caribbean. Many of them also use CanReg5. Some of the other Caribbean countries with active registries are
a) Cuba (which has had a population-based cancer registry since 1964),
b) Martinique (Mandatory reporting since 1981)
c) Trinidad and Tobago
d) Jamaica
e) Guyana
f) Netherland Antilles (Curacao, Aruba, Bonaire, Saba, St. Eustatius, and St. Maarten)
g) Barbados (Mandatory reporting)
h) Guadalupe
i) Bahamas
j) Puerto Rico (Mandatory reporting)
k) U.S. Virgin Island
l) Cayman Islands