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The prostate cancer screening clinic in the Bahamas: a model for low- and middle-income countries

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Abstract

Purpose

Grand Bahama (pop. 51,000) is an island within the Bahamas archipelago. A local chapter of International Us TOO Prostate Cancer Support Group (UTGB) has led an annual community-based prostate cancer screening clinic in Grand Bahama each September since 2009. Features of this initiative, characteristics of attendees, and a description of found cancers were summarized to determine the clinic’s value and to guide improvements.

Method

We analyzed the established clinic from 2012 to 2015, wherein UTGB attracted corporate funding, volunteers managed clinics, and health professionals provided healthcare services. An explicit algorithm was used to sort clients by age, comorbidities, and findings from digital rectal examinations, and prostate-specific antigen (PSA) values, to determine which clients would undergo secondary assessment and prostate biopsy.

Results

Overall, 1,844 males were registered (mean age 57.6 years), and only 149 men attended on more than one occasion for a total of 1,993 clinic visit. The urologist reviewed 315 men in secondary follow-up, for elevated PSA and/or an abnormal digital rectal examination. Of these, 45 men fulfilled criteria for trans-rectal ultrasound biopsy, and there were 40 found cases of prostate cancer, for a positive-predictive value of 89%. By D’Amico risk-stratification, these 40 cases were low (10%), intermediate (40%), and high risk (50%). The urologist counseled all 40 cases and facilitated access to standard care.

Conclusion

This study suggests that low-resource countries can advance cost-effective screening clinics, apply policy guidelines, and provide services within acceptable standards of care. It is the expectation, with a sustained effort and community participation over the ensuing years, that earlier disease presentation will occur and, consequently, a concomitant decrease in the disease-specific mortality.

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Author information

Authors and Affiliations

  1. University of the West Indies, School of Clinical Medicine and Research, The Bahamas, Shirley Street, P. O. Box GT-2590, Nassau, Bahamas

    Robin Roberts

  2. Us TOO Grand Bahama Prostate Cancer Support Group, PO Box F-1070, Freeport, Grand Bahama, Bahamas

    Corydon Mitchell

  3. Rand Memorial Hospital Grand Bahama Health Services, Dept of Pathology, East Mall Drive, P.O. Box F-40071, Freeport, Grand Bahama, Bahamas

    Ana Lourdes Tancawan & Mandi Pedican

  4. The Partners Clinical Research Centre, 72 Collins Avenue, P.O. Box N-4296,, Nassau, Bahamas

    Glenn Wayne Jones

Authors
  1. Robin Roberts
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  2. Corydon Mitchell
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  3. Ana Lourdes Tancawan
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  4. Mandi Pedican
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  5. Glenn Wayne Jones
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Corresponding author

Correspondence to Robin Roberts.

Appendix

Appendix

See Table 1.

Table 1 Summary of male attendance, PSA values, and Biopsy results for 2012 to 2015
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Roberts, R., Mitchell, C., Tancawan, A.L. et al. The prostate cancer screening clinic in the Bahamas: a model for low- and middle-income countries. Cancer Causes Control 28, 1187–1193 (2017). https://doi.org/10.1007/s10552-017-0972-1

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  • DOI: https://doi.org/10.1007/s10552-017-0972-1

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