Gynecologic cancer mortality in Trinidad and Tobago and comparisons of mortality-to-incidence rate ratios across global regions
To examine the factors associated with gynecologic cancer mortality risks, to estimate the mortality-to-incidence rate ratios (MIR) in Trinidad and Tobago (TT), and to compare the MIRs to those of select countries.
Data on 3,915 incident gynecologic cancers reported to the National Cancer Registry of TT from 1 January 1995 to 31 December 2009 were analyzed using proportional hazards models to determine factors associated with mortality. MIRs for cervical, endometrial, and ovarian cancers were calculated using cancer registry data (TT), GLOBOCAN 2012 incidence data, and WHO Mortality Database 2012 data (WHO regions and select countries).
Among the 3,915 incident gynecologic cancers diagnosed in TT during the study period, 1,795 (45.8%) were cervical, 1,259 (32.2%) were endometrial, and 861 (22.0%) were ovarian cancers. Older age, African ancestry, geographic residence, tumor stage, and treatment non-receipt were associated with increased gynecologic cancer mortality in TT. Compared to GLOBOCAN 2012 data, TT MIR estimates for cervical (0.49 vs. 0.53), endometrial (0.61 vs. 0.65), and ovarian cancers (0.32 vs. 0.48) were elevated. While the Caribbean region had intermediate gynecologic cancer MIRs, MIRs in TT were among the highest of the countries examined in the Caribbean region.
Given its status as a high-income economy, the relatively high gynecologic cancer MIRs observed in TT are striking. These findings highlight the urgent need for improved cancer surveillance, screening, and treatment for these (and other) cancers in this Caribbean nation.
KeywordsCaribbean Trinidad and Tobago Cervical cancer Ovarian cancer Endometrial cancer Mortality Mortality-to-incidence rate ratio
Support was provided by Washington University School of Medicine (GSAS/CGFP Fund 94028C) (WAW), and by the Cancer Center Support Grant Number P30CA072720 from the National Cancer Institute (through a New Investigator Award awarded to AAML). We acknowledge the assistance of Stephan Samuell, Central Statistical Office in Trinidad & Tobago. The contents of this manuscript are solely the responsibility of the authors and do not necessarily represent the official views of the affiliating organizations.
Compliance with Ethical Standards
Conflict of interest
Authors have no conflicts of interest to disclose.
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