A nationwide analysis of incidence and outcome of breast cancer in the country of Surinam, during 1994–2003

Abstract

In this study, we describe the incidence, treatment, and outcome of breast cancer (BC) during the period 1994-2003 in the South-American country of Surinam and compare these with those of BC in the Netherlands. Pathology reports and hospital charts from all BC cases diagnosed between 1994 and 2004 were retrieved from Surinam's single pathology laboratory and its five hospitals. Data on demographics, tumor characteristics, treatment, and follow-up were gathered. We compared our data to BC statistics of first generation immigrants from Surinam to the Netherlands. 421 patients were diagnosed with BC during the study period. The age-adjusted incidence rate was 26 per 100,000 compared to 65/100,000 in first generation Surinamese women in the Netherlands. The majority had a fairly advanced stage at presentation, with 60% of tumors larger than 2 cm, and 41.6% with lymph node involvement. Because of the absence of radiotherapy facilities, local treatment in most patients was radical mastectomy. Adjuvant hormonal therapy (51.6%) was administered more frequently than adjuvant chemotherapy (20.3%). A significant number of patients were lost to follow-up, resulting in a median follow-up duration of only 23 months. The 5-year overall survival was 79%. BC incidence in Surinam is low compared to that in the western world, but the advanced stage at diagnosis, the low utilization of systemic adjuvant therapy, and the inadequate follow-up may lead to poor outcomes. A number of steps are underway to improve the level of cancer care in Surinam.

Childhood Cancer in the Republic of Suriname (1980 Through 2008)

“…Several investigators have reported on various aspects of the epidemiology of adult malignancies -particularly carcinomas -in Suriname [24][25][26][27]. Up till now, no comprehensive data are available on the occurrence of cancer in Surinamese newborns, infants, young children, adolescents, and young adults.…”

Social determinants of breast cancer in the Caribbean: a systematic review

“…p  > 0.05. Proportions and CI obesity: Hispanic white (43.5%, 26.5–61.4), Hispanic black (35.6%, 23.0–48.2), nonhispanic black immigrant (44.3%, 37.9–50.7), nonhispanic black USVI-born (38.8%, 29.9–47.7).van Leeuwaarde, 2011 [70]Registry-based/(all)PopulationSuriname/Ethnicity I /Proportions and incidence rates (per 100,000 per year) of breast cancer: Creole (37.2%, 35.7), Maroons (1.9%, 2.2), Hindu (29.4%, 18.2), Javanese (17.9%, 20.8), Chinese (1.9%, not given), mixed (7.4%, 10.1), Dutch (1.4%, not given), other (2.9%, not given). Note these proportions also reflect the ethnography of the general Suriname population.Varona, 2011 [45] (a)Cross-sectional22,85115+PopulationCubaIncome – perception of economic situationAge Alc //Proportions and CI of females consuming alcohol in past 30 days across age group: 15–19 (11.4%, 8.9–13.9), 20–39 (14.6%, 13.2–15.9), 40–59 (9.3%, 8.0–10.5), >59 (2.7%, 1.8–3.6).Education Alc Proportions and CI of females consuming alcohol in past 30 days: primary school (4.8%, 3.8–5.7), middle school (10.7%, 9.4–12.1), high school (13.9%, 12.4–15.4), university (13.2%, 10.8–15.7).Ethnicity Alc Proportions and CI of females consuming alcohol in past 30 days: white (8.2%, 7.3–9.0), mestizo (14.7%, 12.9–16.5), black (14.9%, 12.3–17.6).Income Alc Proportions and CI of females consuming alcohol in past 30 days: excellent (8.4%, 2.3–14.6), good (11.8%, 10.0–13.6), fair (10.2%, 9.2–11.1), poor (9.2%, 7.4–10.9), very poor (10.9%, 7.6–14.1).Marital status Alc Proportions and CI of females consuming alcohol in past 30 days: unmarried (14.1%, 12.3–16.0), married or cohabiting (10.0%, 9.0–10.9), divorced or separated (12.0%, 9.9–14.0), widowed (2.5%, 1.4–3.7).Occupation Alc Proportions and CI of females consuming alcohol in past 30 days: manager (18.8%, 13.8–23.7), administrator (14.7%, 10.5–18.8), upper-level technician (13.1%, 10.1–16.1), middle-level technician (12.6%, 10.0–16.1), labourer (14.0%, 10.5–17.2), service worker (16.0%, 13.2–18.8).

• (a) - Articles are components of larger studies: (Block, [40]) - Grenada Heart Project [100] ; ((Blum, [41]), (Ohene, [44])) - Caribbean Youth Health Survey [101]; (Brathwaite, [47]) - 2001 Bahamas Living Conditions Survey [102] ; ((Nam, [55]), (Kim, [42])) – [Health, Wellbeing and Aging] [103]; (Dubois, [49]) - Jamaica Youth Risk and Resiliency Behaviour Survey of 2007 [104] ; (Ferguson, [50]) - Jamaica Birth Cohort [105] ; (Laborde, [53]) - Behavioral Risk Factor Surveillance System [

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“…There were 75 inequality relationships reported: 59 on breast cancer risk factors, 13 on breast cancer frequency, and 3 on breast cancer outcomes.

Fig. 2Summary of 75 inequality relationships from 34 articles between a social determinant and review endpoint [40–70, 72, 73]. Legend: Age and limited breastfeeding cells do not separate youth and adult samples as the studies have combined these age groups in their samples

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“…Summary of 75 inequality relationships from 34 articles between a social determinant and review endpoint [40–70, 72, 73]. Legend: Age and limited breastfeeding cells do not separate youth and adult samples as the studies have combined these age groups in their samples…”

“…The proportion of risk of bias classifications of the 75 relationships among each of the 5 risk of bias domains [40–70, 72, 73]…”