Bovell Andre A N, Ramaliba Thendo, Goodwin Sekeena O, Phillip Joycelyn C, Ncayiyana Jabulani, Ginindza Themba G
Discipline of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu- Natal, Durban, South Africa.
Business Intelligence Unit, National Health Laboratory Service, Johannesburg, South Africa.
BMC Cancer. 2025 Jan 13;25(1):72. doi: 10.1186/s12885-025-13459-8.
Globally, estimates of cancer cases and deaths have increased since 2018, particularly in Latin America and Caribbean countries. In Antigua and Barbuda, understanding the burden of common cancers such as female breast, cervical, colorectal and prostate cancers is critical. This study aimed to assess the incidence, trends, and patterns of these four cancers from 2017 to 2021.
Using a retrospective observational study design, information on these cancers was abstracted from medical records at four key study sites in Antigua and Barbuda. Estimates of age-specific and age-standardized incidence were determined using direct standardization. The KeyFitz method was used to derive standard errors and confidence intervals. Derived estimates were employed to analyze trends and Joinpoint regression modeling was used to determine annual percentage change.
Between 2017 and 2021, 391 cases of female breast (41.7%), cervical (10.2%), colorectal (20.2%) and prostate (27.9%) cancers were diagnosed. Overall mean age at presentation was 61.5 (± 12.9) years, ranging from 24 to 94 years, age-standardized incidence rate 65.2 (95% CI: 58.7-71.6) per 100,000 population. Age-standardized incidence rate for female breast cancer was 49.9 (95% CI: 42.2-57.8), annual percentage change in incidence a low of -0.2%. Prostate cancer had the second highest age-standardized incidence rate at 41.6 (95% CI: 33.8-49.4), annual percentage change showed a gradual but steady increase at 21.7%. Per cancer types, variations in age-standardized incidence rates were noted across age-groups, year-of-presentation, and parishes. Collectively, there was an 8.1% (95% CI: -14.9-37.6) annual percentage change increase in age-standardized incidence rates between 2017 and 2021. Incident cases, age-standardized incidence rates, and trends per cancer type are expected to gradually increase during 2022-2030 (average annual percentage increase is 3.4%).
This study is a first step in providing reasonable evidence on the incidence, trends, and patterns of four common cancers in Antigua and Barbuda. Female breast and prostate cancers were the dominant cancer types in terms of incidence, age-standardized incidence and predicted increasing incidence trends. Variableness in cancer-specific age-standardized rates across parishes and years of presentation were observed. Besides research, this study has importance for instituting cancer prevention and control measures, including surveillance and healthy lifestyles initiatives.
自2018年以来，全球癌症病例和死亡人数估计有所增加，尤其是在拉丁美洲和加勒比国家。在安提瓜和巴布达，了解女性乳腺癌、宫颈癌、结直肠癌和前列腺癌等常见癌症的负担至关重要。本研究旨在评估2017年至2021年这四种癌症的发病率、趋势和模式。
采用回顾性观察研究设计，从安提瓜和巴布达四个主要研究地点的医疗记录中提取这些癌症的信息。使用直接标准化方法确定年龄别发病率和年龄标准化发病率估计值。采用KeyFitz方法推导标准误差和置信区间。利用推导的估计值分析趋势，并使用Joinpoint回归模型确定年度百分比变化。
2017年至2021年期间，共诊断出391例女性乳腺癌（41.7%）、宫颈癌（10.2%）、结直肠癌（20.2%）和前列腺癌（27.9%）。总体就诊时的平均年龄为61.5（±12.9）岁，范围为24至94岁，年龄标准化发病率为每10万人口65.2（95%CI：58.7-71.6）。女性乳腺癌的年龄标准化发病率为49.9（95%CI：42.2-57.8），发病率的年度百分比变化低至-0.2%。前列腺癌的年龄标准化发病率第二高，为41.6（95%CI：33.8-49.4），年度百分比变化呈逐渐但稳定的上升趋势，为21.7%。按癌症类型划分，不同年龄组、就诊年份和教区的年龄标准化发病率存在差异。总体而言，2017年至2021年期间年龄标准化发病率的年度百分比变化增加了8.1%（95%CI：-14.9-37.6）。预计2022年至2030年期间，每种癌症类型的发病病例、年龄标准化发病率和趋势将逐渐增加（平均年度百分比增长为3.4%）。
本研究是为安提瓜和巴布达四种常见癌症的发病率、趋势和模式提供合理证据的第一步。就发病率、年龄标准化发病率和预测的发病率上升趋势而言，女性乳腺癌和前列腺癌是主要的癌症类型。观察到不同教区和就诊年份的癌症特异性年龄标准化率存在差异。除了研究之外，本研究对于制定癌症预防和控制措施，包括监测和健康生活方式倡议具有重要意义。
