Cancer in Belize: Characteristics of patients presenting to a public oncology clinic.

Abstract

e19000 Background: Belize is a middle-income country in Central America with significant inequality. To date, data on the oncologic burden of disease has been imputed from mortality data. The first-ever public oncology program was started in 2018, which allowed us to analyze the presenting characteristics of patients with cancer. Methods: 284 patients were seen at the Karl Heusner Memorial Hospital (KHMH) oncology clinic between April 2018 and July 2019. We performed a retrospective chart review and extracted patient characteristics to understand the burden of cancer in Belize. Results: Of 284 patients seen, 63% had a confirmed pathologic diagnosis of cancer and the remaining were clinically suspected to have cancer. 56% were female and the median age was 55. Breast, cervix, colon, and prostate were the most common types of cancer seen. Breast and cervical cancers disproportionately affected young women with a median age at presentation of 51 and 45 respectively. 28% of patients presented with Stage IV disease. 43% of patients were deemed candidates only for comfort care. Conclusions: The burden of oncologic disease in Belize is significant and represents a wide variety of cancers. Breast and cervical cancers disproportionately affect young women in Belize. A significant proportion of patients presented with late stage disease, likely due to the lack of screening programs and cancer awareness in the country. Addressing the country’s cancer burden will require strengthening local pathology and surgical oncology capabilities, establishing a public chemotherapy treatment program, and referring patients to radiation oncology in nearby countries.