Abstract
Breast cancer (BC) is the most common newly diagnosed cancer among women in Trinidad and Tobago (TT) and BC mortality rates are among the highest in the world. Globally, racial/ethnic trends in BC incidence, mortality and survival have been reported. However, such investigations have not been conducted in TT, which has been noted for its rich diversity. In this study, we investigated associations among ancestry, geography and BC incidence, mortality and survival in TT. Data on 3767 incident BC cases, reported to the National Cancer Registry of TT, from 1995 to 2007, were analyzed in this study. Women of African ancestry had significantly higher BC incidence and mortality rates (Incidence: 66.96; Mortality: 30.82 per 100,000) compared to women of East Indian (Incidence: 41.04, Mortality: 14.19 per 100,000) or mixed ancestry (Incidence: 36.72, Mortality: 13.80 per 100,000). Geographically, women residing in the North West Regional Health Authority (RHA) catchment area followed by the North Central RHA exhibited the highest incidence and mortality rates. Notable ancestral differences in survival were also observed. Women of East Indian and mixed ancestry experienced significantly longer survival than those of African ancestry. Differences in survival by geography were not observed. In TT, ancestry and geographical residence seem to be strong predictors of BC incidence and mortality rates. Additionally, disparities in survival by ancestry were found. These data should be considered in the design and implementation of strategies to reduce BC incidence and mortality rates in TT.
Highlights
As the most commonly diagnosed malignancy among women worldwide, breast cancer (BC) is clearly a major global health concern
There were substantial ‘unspecified’ data on tumor grade (78% overall), women of mixed ancestry were more frequently diagnosed with poorly differentiated tumors and least likely to be diagnosed with well-differentiated tumors, compared to women of African or Indian ancestry (P < 0.01)
Analysis of ancestral and geographic differences in BC incidence and mortality rates is an essential component of understanding the epidemiologic landscape of BC in Trinidad and Tobago (TT)
Summary
As the most commonly diagnosed malignancy among women worldwide, breast cancer (BC) is clearly a major global health concern. Studies are limited among many developing countries, where incidence and mortality are projected to continually increase in the few decades [2,3,4,5]. This is pronounced in developing countries of the Caribbean where population growth, aging, increasing life expectancy [5], and the adoption of “westernized” lifestyles, are identified as possible contributing factors to the increasing incidence [3, 6, 7]. Lack of access to adequate comprehensive breast care, including mammography and timely, appropriate treatment and followup care, may contribute to increases in BC mortality [8, 9]
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