The Changing Distribution of Colorectal Cancer in Barbados: 1985-2004

Zbar, Andrew P.; Inniss, Michael; Prussia, Patsy R.; Shenoy, R. K.

doi:10.1007/s10350-007-0238-1

Cited by 7 publications

(7 citation statements)

References 39 publications

(32 reference statements)

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“…the demographic distribution was also predictable with a peak in the 6th to 8th decades of life. this matches the age distribution for invasive CrC in the Caribbean literature (8)(9)(10)(11)(12)(13). However, it is notable that 7% of patients with neoplastic polyps were <49 years of age.…”

Section: Characteristicsupporting

confidence: 85%

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Epidemiology of neoplastic colorectal polyps in a Caribbean country

Cawich

Mahabir

Arthurs

2021

Med Int

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Screening is practiced to identify and remove neoplastic colorectal polyps prior to their transformation into colorectal cancer (CrC). the aim of the present study was to document the epidemiology of neoplastic colorectal polyps in order to obtain important data that may then be used to guide screening protocols in Jamaica. For this purpose, an audit was performed to identify all consecutive patients who had neoplastic polyps detected at a screening colonoscopy at a facility in Jamaica from January 1, 2015 to December 30, 2018. the following data were collected: Patient demographics, polyp location, polyp synchronicity and histopathological information. the results revealed that a total of 480 colonoscopies were performed over the study period. With the exclusion of 2 patients with innumerable polyps as a part of polyposis syndrome, there were a total of 92 neoplastic polyps in 68 patients. Polyps were most commonly located in the right colon (55.6%), followed by the left colon (38%) and rectum (6.5%). Upon the histological evaluation, 63 polyps were found to be benign adenomas with mild to moderate dysplastic alterations, 15 were adenomas with severe dysplasia and/or carcinoma in situ and 14 had foci of invasive carcinomas. on the whole, the present study demonstrates that ~15% of the patients screened had neoplastic polyps that were recognized as precursor lesions for CrC. the majority of these were in the right colon. these results support the call for policy makers to institute national CrC screening programs, such as the National Comprehensive Cancer Network harmonized guidelines for the Caribbean.

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Section: Characteristicsupporting

confidence: 85%

“…Previous studies have documented a 'right shift' in the Jamaican population (8)(9)(10) and in other Caribbean territories (11)(12)(13), where CrC primaries have become more prevalent in the right colon. therefore, it was predictable that the precursor neoplastic polyps were most prevalent in the right colon in the present study.…”

Section: Discussionmentioning

confidence: 99%

Epidemiology of neoplastic colorectal polyps in a Caribbean country

Cawich

Mahabir

Arthurs

2021

Med Int

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“…These data have significant implications on the present study, as it was shown that the predominant pattern was right-sided disease in 44.3% of Barbadian patients. In a previous study, Zbar et al (7) also reported a significant right-sided shift over two decades in Barbadian patients, without a decline in left-sided primaries. A right-shift was also observed in other Caribbean nations, with McFarlane et al (13) reporting right-sided lesions in 28.5% of Jamaican patients and Joachim et al (16) reporting right-sided lesions in 26.3% of patients in Martinique.…”

Section: Discussionmentioning

confidence: 81%

“…International data indicate that males have significantly more cancer-related deaths than females (9,10) and a significantly lower overall survival (9,11,12). Of note, the other Caribbean islands have reported different patterns, with published data from Jamaica (13,14), Trinidad and Tobago (15) and an older Barbadian study (7), all reflecting a female predilection. The only other Caribbean nation that reported a male preponderance was Martinique (16).…”

Section: Discussionmentioning

confidence: 99%

Colorectal cancer demographics in Barbados

Griffith

Padmore

Phillips

et al. 2021

Med Int

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Barbados is an island in the Eastern Caribbean that is reported to have the 8th highest incidence of colorectal cancer (CRC) worldwide. However, these figures are based only on estimates, and there is little available epidemiological data collected from Barbadians with CRC. The present study sought to collect epidemiologic data from patients in Barbados diagnosed with CRC. This information is considered important to shape national public health policies. For this purpose, hospital admission registers at all tertiary care facilities in Barbados were retrospectively audited over a four-year period from January 1, 2014 to December 31, 2018 to identify patients who underwent operative treatment for CRC. The following data were extracted: Age, sex, ethnicity, the location of the primary tumour and tumour stage. Descriptive statistical analyses were generated using SPSS version 21.0. The results revealed that there were 97 patients with CRC at a mean age of 64.9 years (SD ±12.2) and a male preponderance (1.3:1). The majority (93.8%) were from the African diaspora. Only 18.5% of diagnoses were made at (opportunistic) screening. Consequently, two thirds of the patients had advanced-stage disease at diagnosis. The disease staging of the patients was as follows: Stage 0 (1%), stage I (10.3%), stage II (23.7%), stage III (38.1%) and stage IV (26.8%). Right-sided primary tumours were most common (44.3%), followed by left-sided (41.2%) and rectal lesions (14.4%). Women were significantly more likely to have right-sided lesions (55 vs. 45%) and males were more likely to have rectal lesions (77 vs. 23%). On the whole, the present study highlights the need to implement a national screening programme in this high-risk population of African origin with a predominantly right-sided distribution of CRC primary tumours. This is reinforced by the fact that 10% of patients will be diagnosed before the age of 50 years with more aggressive disease.

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“…The polyp distribution was also expected as similar right-side dominant patterns have been documented in publications from the Caribbean region. [6][7][8] In our study, when screening colonoscopy found CRC, it was still in the early stages, which have a greater probability of cure and better 5-year survival compared to those with locally advanced disease, 9 and more likely to benefit from less invasive laparoscopic colectomy. 10 Most importantly, screening colonoscopy in just under 1 in 4 patients screened that identified neoplastic polyps which could be completely removed to interrupt the adenoma-carcinoma sequence.…”

Section: Discussionmentioning

confidence: 92%

Clinical yield of screening colonoscopies in Jamaica

Cawich¹,

Mahabir²,

Arthurs

2021

Trop Doct

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There is still no organised national screening programme for colorectal cancer in Jamaica. We sought to evaluate the detection of colorectal cancer precursor lesions in patients who underwent opportunistic screening over three years. Patients with colorectal polyps were selected for further study. In 431 procedures, there were 84 (19.5%) patients with colorectal polyps identified at screening colonoscopy, which gave a 19.5% sensitivity to identify patients with polyps at risk of developing colorectal cancer, 9.5% being <50 years of age. At the time of examination, 16.7% had already developed invasive adenocarcinoma. We conclude that it is time for policy makers to develop a national colorectal cancer screening programme to diagnose patients early and improve their therapeutic outcomes.

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The Changing Distribution of Colorectal Cancer in Barbados: 1985-2004

Cited by 7 publications

References 39 publications

Epidemiology of neoplastic colorectal polyps in a Caribbean country

Epidemiology of neoplastic colorectal polyps in a Caribbean country

Colorectal cancer demographics in Barbados

Clinical yield of screening colonoscopies in Jamaica

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