Abstract
Prostate cancer mortality in the Caribbean region is among the highest in the world and prostate cancer is the most common cancer in Trinidad and Tobago. There is a two-tiered healthcare system in Trinidad and Tobago, and prostate cancer related issues account for a significant percentage of urologists’ workload. Delivery of care is sometimes constrained by limited financial resources. Prostate-specific antigen testing is widely available but there is no national guideline. Treatment options available include active surveillance, radical prostatectomy, external beam radiotherapy and brachytherapy. Patients have access to androgen deprivation, chemotherapy and palliative care for the management of advanced disease. Generally, the infrastructure for treatment in Trinidad and Tobago is satisfactory but would benefit from further investments in technology and human resources.
Highlights
Trinidad and Tobago, a twin island English speaking republic, are the southernmost islands of the Caribbean, located about 11 km off the north-eastern coast of Venezuela
The following article details the current situation with regard to prostate cancer screening, treatment and outcomes in Trinidad and Tobago
Even though the prostate cancer screening remains a topic for hot debate, there is no doubt that prostate-specific antigen (PSA) screening has resulted in a substantial downward migration of prostate cancer stage over the past two decades in the United States [5]
Summary
Trinidad and Tobago, a twin island English speaking republic, are the southernmost islands of the Caribbean, located about 11 km off the north-eastern coast of Venezuela. 37.6% of the country’s inhabitants are Indo-Trinidadians while the second largest group, the Afro-Trinidadians and Tobagonians, account for about 36.3%. Tobago comprises approximately 300 km or 6% of the surface area of the country and is unique in that 95% of the population are of African descent [1]. According to data from the Elizabeth Quamina National Cancer Registry of Trinidad and Tobago, prostate cancer accounted for 22% of all cancers in the country, making this the commonest cancer overall as well as the commonest cancer in men. Afro-Trinidadians had higher Gleason scores, prostate-specific antigen (PSA) values and an increased risk of mortality [3]. Recent work at the San Fernando General Hospital (SFGH) reported that prostate cancer was three times as common among Afro-Trinidadians compared to Indo-Trinidadians. The following article details the current situation with regard to prostate cancer screening, treatment and outcomes in Trinidad and Tobago
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