Dr. Michael Darville.
~ Report finds low screening rates ~
NASSAU, The Bahamas--Approximately one in every 500 Bahamians has been diagnosed with a cancer, according to the 2019 National Non-Communicable Disease (NCD) Risk Factor STEPS Survey, which was released on Wednesday.
“Data from the National Cancer Registry informs that the combined cancer prevalence (2019) was 182.4 per 100,000,” the report shows. “In The Bahamas, deaths from cancers (all types) have been increasing year-over-year. In 2000, the cancer mortality rate was 71.5 per 100,000, or 13.6% of deaths. In 2015, this rate stood at 111.7 per 100,000 (or 18.6%). Cancer mortality rates are not available for 2019.
“Special note is made of cervical cancer, which carries an unacceptable and disproportionately high disease burden considering 92% of [human papillomavirus – Ed.] HPV-associated cancers are preventable. In The Bahamas in 2018, the age-standardised incidence (ASI) of cervical cancer was 10.9 per 100,000, compared to an ASI of 13.1 per 100,000 for the rest of the world.
“[The World Health Organization] WHO admonishes all countries to accelerate action toward eliminating cervical cancer and to reach an incidence rate not greater than four per 100,000 population.
“A ready tool to eradicate cervical cancer is the HPV vaccine, which was introduced into the Bahamian immunisation schedule since 2015. The vaccine is documented to have exceptional protection – high efficacy and effectiveness – against HPV infection, genital warts, high-grade cervical lesions and invasive adenocarcinoma, more so when the vaccine is administered before sexual debut. The HPV virus does not only cause health problems in females, it can also cause genital, anal and oropharyngeal cancers in males.”
Breast cancer is most prevalent in The Bahamas, followed by prostate, colorectal, cervical and stomach cancer.
Cancer screening
STEPS 2019 sheds new knowledge on screening behaviours in the Bahamian population. The survey was taken between January and April 2019, and involved 2,365 participants between the ages of 18 and 69.
“Forty-three per cent of female respondents in STEPS 2019 between the ages of 45 and 69 years either never had a breast exam by a health professional or have not had one in more than two years,” the report said.
“For cervical cancer, two-thirds (67.5%) of all female respondents (18 to 69 years) had been screened for cervical cancer. For those specifically between the ages 30 and 49 years, the rate for ever screened is 76.6%.”
While the cervical cancer screening rates are the highest of all cancer screening rates in the report, the survey notes that the uptake of the HPV vaccine in The Bahamas among males and females is not as encouraging.
“The HPV vaccine was developed in 2006, and introduced into the national vaccine schedule in 2015,” the report notes. “The availability and efficacy of this vaccine means that cervical cancer can be essentially eliminated and that death from cervical cancer can be a thing of the past.
“Nearly 80% of male respondents aged 45 to 69 years never had a prostate exam – DRE or digital rectal examination. Of the 21.5% that had the exam, many report the exam was performed within the last two years. Underlying this observation may be issues related to acceptability of DRE among men as well as the existence of other clinical screening options, specifically prostate-specific antigen (PSA) blood testing.
“Regarding acceptability, a systematic review found that men – 3,029 men aged 18-89 years – are willing to participate in prostate cancer screening to prevent cancer and gain reassurance about their health, particularly when supported or prompted by their social networks or healthcare providers.
“However, to do so, they needed to mentally overcome fears of losing their masculinity and accept the intrusiveness of screening, the ambiguities about the necessity and the potential for substantial costs.”
The report says addressing the concerns and priorities of men may facilitate informed decisions about prostate cancer screening and improve patient satisfaction and outcomes.
“Colon cancer screening rate among respondents aged 45 to 69 years is 8.6% – males, 5.3% and females,12.5%. Faecal occult blood screening prevalence for the same age group is 20.8% – males, 22% and females 19.5%.”
The report points out that the data bolsters the claim that men are less likely than women to seek help from health professionals for diverse health problems. Among other recommendations, the report calls for accelerated action to scale-up HPV vaccination and screening for HPV infection and cervical cancer through effective programming, surveillance, monitoring and evaluation, as well as public awareness campaigns targeted at males and females.
During the launch of the new Wellness Unit on Thursday, Minister of Health and Wellness Dr. Michael Darville said more focus will be placed on screening, preventative care and further investments in the primary healthcare system.
“I am excited where we are going and moving forward, this new wellness unit will lead the way in convincing Bahamians everywhere to play an active role in the management of their own health,” he said. ~ The Nassau Guardian ~
