Abstract B46: Cancer incidence and mortality rates and trends in Trinidad and Tobago
Authors: Warner Wayne A. , Llanos Adana A.M. , Lee Tammy Y. , Williams Tanisha M. , Badal Kimberly M. , Roach Veronica , Slovacek Simeon , Toriola Adetunji T. , Roach Allana , Martin Damali 
Published: May 2016

Abstract
Background: Consistent with observations from various developing regions of the world, cancer incidence and mortality rates have increased in the past two decades, and continue to increase in the Caribbean nation of Trinidad and Tobago (TT). The aim of this study was to describe patterns of incidence and mortality for the five leading cancers among men and women in TT.
Methods: Cancer surveillance data collected between January 1995 and December 2007, by the Dr. Elizabeth Quamina Cancer Registry for Trinidad and Tobago were analyzed. Sex-specific, age-standardized cancer incidence and mortality rates (standardized to the World Standard Population) were calculated (per 100,000) for each year.
Results: Between 1995 and 2007, there were 25,027 incident cases and 15,279 cancer deaths reported in TT. Cancer incidence and mortality rates among nationals of African ancestry were significantly higher than other ethnic/race groups (East Indians, mixed ancestry). The leading incident cancers among men were prostate, lung, colon, stomach, and hematologic cancers. Prostate cancer incidence and mortality rates fluctuated substantially and in any given year, prostate cancer incidence rates were more than 3 times that of the other leading cancers among men. Prostate cancer mortality rates increased fairly steadily throughout the study period. Incidence and mortality rates for cancers of the lung & bronchus, colon, stomach, and hematologic cancers remained stable during this time period. Among women, the leading incident cancer sites were breast, cervical, endometrial, colon, and ovarian. Breast cancer incidence and mortality rates increased steadily from 1995-2007. Cervical cancer incidence rates decreased during the study period while the mortality rates mortality rates almost doubled during the same time period. Incidence and mortality rates of endometrial, colon and ovarian cancers remained stable during this time period. Cancer incidence and mortality rates varied substantially, by geography (as shown across the catchment areas of the five Regional Health Authorities [RHAs] in TT). By RHA, average incidence rates were highest in areas covered by the Tobago RHA (188.3 per 100,000), followed by the Northwest RHA (NWRHA), which includes the capital, Port-of-Spain (170.8 per 100,000). Overall, average mortality rates were also highest in areas covered by the NWRHA (106.3 per 100,000).
Conclusions: These findings indicate that there are significant disparities in cancer incidence and mortality by geography and ancestry in TT. The differences in the top cancer sites in TT compared to United States and other countries as well as the increasing cancer burden highlights the need for increased cancer research in the Caribbean. Our findings also highlight the need for further studies including planned molecular, genetic, and environmental studies, to further understand risk factors related to these differences or disparities in cancer burden in TT. These and other similar efforts will aid TT in strategies for increased cancer surveillance and creation of cancer prevention and control programs and policies.
Citation Format: Wayne A. Warner, Adana A.M. Llanos, Tammy Y. Lee, Tanisha M. Williams, Kimberly M. Badal, Veronica Roach, Ret., Simeon Slovacek, Adetunji T. Toriola, Allana Roach, Damali Martin. Cancer incidence and mortality rates and trends in Trinidad and Tobago. [abstract]. In: Proceedings of the Eighth AACR Conference on The Science of Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; Nov 13-16, 2015; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2016;25(3 Suppl):Abstract nr B46.