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

作者：Badal Kimberly; Rampersad Fidel; Warner Wayne A; Toriola Adetunji T; Mohammed Hamish; Scheffel Harold Alexis; Ali Rehanna; Moosoodeen Murrie; Konduru Siva; Russel Adaila; Haraksingh Rajini

来源：Cancer Causes & Control, 2018, 29(1): 33-42.

DOI：10.1007/s10552-017-0937-4

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

Purpose 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.
Methods 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.
Results 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.
Conclusion 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.

• 出版日期2018-1