Cancer Causes & Control

, Volume 29, Issue 1, pp 33–42 | Cite as

A situational analysis of breast cancer early detection services in Trinidad and Tobago

  • Kimberly BadalEmail author
  • Fidel Rampersad
  • Wayne A. Warner
  • Adetunji T. Toriola
  • Hamish Mohammed
  • Harold-Alexis Scheffel
  • Rehanna Ali
  • Murrie Moosoodeen
  • Siva Konduru
  • Adaila Russel
  • Rajini Haraksingh
Original paper



A situational analysis of breast cancer (BC) early detection services was carried out to investigate whether Trinidad and Tobago (T&T) has the framework for successful organized national screening.


An online survey was designed to assess the availability, accessibility, quality control and assurance (QC&A), and monitoring and evaluation (M&E) mechanisms for public and private BC early detection. A focus group with local radiologists (n = 3) was held to identify unaddressed challenges and make recommendations for improvement.


Major public hospitals offer free detection services with wait times of 1–6 months for an appointment. Private institutions offer mammograms for TTD$240 (USD$37) at minimum with same day service. Both sectors report a lack of trained staff. Using 1.2 mammograms per 10,000 women ≥40 years as sufficient, the public sector’s rate of 0.19 mammograms per 10,000 women ≥40 years for screening and diagnosis is inadequate. Program M&E mechanisms, QC&A guidelines for machinery use, delays in receipt of pathology reports, and unreliable drug access are further unaddressed challenges.


T&T must first strengthen its human and physical resources, implement M&E and QC&A measures, strengthen cancer care, and address other impediments to BC early detection before investing in nationally organized BC screening.


Breast cancer Trinidad and Tobago Screening Early detection Health service evaluation Situational analysis Primary prevention 



The project was supported by the Caribbean Cancer Research Initiative and Washington University School of Medicine Institute for Public Heath, Public Health Cubed (PH3) Grant, and Washington University School of Medicine (GSAS/CGFP Fund 94028C) (W.A.W.).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no competing interest.


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Copyright information

© Springer International Publishing AG 2017

Authors and Affiliations

  • Kimberly Badal
    • 1
    • 2
    Email author
  • Fidel Rampersad
    • 3
    • 4
  • Wayne A. Warner
    • 4
  • Adetunji T. Toriola
    • 5
  • Hamish Mohammed
    • 6
  • Harold-Alexis Scheffel
    • 7
  • Rehanna Ali
    • 1
    • 2
  • Murrie Moosoodeen
    • 8
  • Siva Konduru
    • 9
  • Adaila Russel
    • 2
  • Rajini Haraksingh
    • 1
    • 2
  1. 1.Caribbean Cancer Research InitiativeSan FernandoTrinidad and Tobago
  2. 2.Department of Life Science, Faculty of Science and TechnologyThe University of the West IndiesSt. AugustineTrinidad and Tobago
  3. 3.Faculty of Medical SciencesThe University of the West IndiesSt. AugustineTrinidad and Tobago
  4. 4.Department of Cell Biology and Physiology, Medical Oncology, Siteman Cancer CenterWashington University School of MedicineSaint LouisUSA
  5. 5.Division of Public Health SciencesWashington University School of MedicineSaint LouisUSA
  6. 6.Department of HIV and STIs, National Infection ServicePublic Health EnglandLondonUK
  7. 7.Department of GeographyYork UniversityTorontoCanada
  8. 8.San Fernando General HospitalSan FernandoTrinidad and Tobago
  9. 9.Sangre Grande General HospitalSangre GrandeTrinidad and Tobago

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