Cancer is one of the leading causes of death in the Caribbean, with up to a fifth of deaths attributed to the disease. Due to a number of challenging factors, such as the geographical spread of the Caribbean Islands, limited health care resources, and the absence of a plan for cancer control, providing effective cancer treatment is difficult. In many cases, patients lack access to cancer screenings, diagnostics, and treatment. Researchers conducted an analysis of the lack of cancer control in the Caribbean islands to shed light on this issue and published their findings in The Lancet Oncology.

The researchers reported that there are several reasons for lack of cancer control in the Caribbean: large debt burdens, financial pressures that reduce public investments, and lack of financial funding to reach a public health-expenditure of at least 6% of gross domestic product. In larger Caribbean islands, such as The Bahamas, Jamaica, and the Dominican Republic, among others, health care resources are more readily available compared with smaller islands. People living on the smaller islands experience obstacles to receiving treatment on the larger islands; travel between the islands is very expensive and difficult, therefore leaving these patients with few options for receiving optimal care. Improving universal health coverage is one of the first steps to taking back control of the cancer burden. The islands depend on private funding primarily in order to take care of health costs. Because of this reliance on private funding, patients must pay large out-of-pocket costs that many cannot afford. The lack of health care personnel also poses a huge problem; many Caribbean countries do not reach the World Health Organization recommendation of 25 health care providers per 10,000 people.

Non-communicable diseases (NCDs) are highly prevalent in the Caribbean and also contribute to the growing cancer burden. Despite government declarations of stopping NCDs, little progress has been made in preventing them. Community events are held on Caribbean Wellness Day to spread awareness of good health habits to promote living a healthy life in an attempt to decrease NCDs.

The researchers recommend the following for cancer control in the Caribbean islands: policy and planning solutions to be adopted by the Caribbean Community Council for Human and Social Development to implement these strategies, improved risk reduction, cancer prevention, and early diagnosis strategies by putting certain legislation, regulations, and public policies in place, and providing access to quality treatment for cancer by investing in properly training and educating health care providers.

"Much work needs to be done to reproduce examples of good practice across the region, and to implement new evidence-based solutions to improve care across the cancer continuum, including palliative care," conclude the study authors. "The region offers many examples of innovative action to build capacity and positively affect cancer outcomes; these examples include improving cancer surveillance through establishment of a Caribbean cancer registry hub, development of regional resource-stratified treatment guidelines, improved access to care for childhood cancers, and progressive models of supportive and palliative care."

For More Information

Spence D, Dyer R, Andall-Brereton G, et al (2019). Cancer control in the Caribbean island countries and territories: some progress but the journey continues. Lancet Oncol. [Epub ahead of print] DOI:10.1016/S1470-2045(19)30512-1

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