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Cancer Causes & Control

, Volume 28, Issue 11, pp 1251–1263 | Cite as

Gynecologic cancer mortality in Trinidad and Tobago and comparisons of mortality-to-incidence rate ratios across global regions

  • Adana A. M. Llanos
  • Wayne A. Warner
  • Silvana Luciani
  • Tammy Y. Lee
  • Smriti Bajracharya
  • Simeon Slovacek
  • Veronica Roach
  • Marjorie Lamont-Greene
Original paper

Abstract

Purpose

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.

Methods

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).

Results

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.

Conclusions

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.

Keywords

Caribbean Trinidad and Tobago Cervical cancer Ovarian cancer Endometrial cancer Mortality Mortality-to-incidence rate ratio 

Notes

Acknowledgments

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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Copyright information

© Springer International Publishing AG 2017

Authors and Affiliations

  • Adana A. M. Llanos
    • 1
    • 7
  • Wayne A. Warner
    • 2
  • Silvana Luciani
    • 3
  • Tammy Y. Lee
    • 4
  • Smriti Bajracharya
    • 5
  • Simeon Slovacek
    • 4
  • Veronica Roach
    • 6
  • Marjorie Lamont-Greene
    • 6
  1. 1.Department of Epidemiology, Rutgers School of Public Health and Division of Population Science, Rutgers Cancer Institute of New JerseyRutgers UniversityNew BrunswickUSA
  2. 2.Oncology Division, Department of Cell Biology and Physiology, Siteman Cancer CenterWashington University School of MedicineSt. LouisUSA
  3. 3.Cancer Prevention and ControlPan American Health OrganizationWashington, DCUSA
  4. 4.Division of Applied and Advanced Studies in EducationCalifornia State UniversityLos AngelesUSA
  5. 5.Center for Public Health Systems Science, George Warren Brown School of Social WorkWashington UniversitySt. LouisUSA
  6. 6.Dr. Elizabeth Quamina Cancer RegistryMt. HopeTrinidad and Tobago
  7. 7.Department of EpidemiologyRutgers School of Public HealthPiscatawayUSA

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