Age-specific incidence of cancer in Kingston and St Andrew, Jamaica, 1998 - 2002 / Incidencia específica por edad en relación con el cáncer en Kingston y en Saint Andrew, Jamaica, 1998 - 2002

A total of 4737 cancers were recorded in Kingston and St Andrew during the period 1998 - 2002: 2387 in males and 2350 in females. Age standardized rates per 100 000 per year (ASR) were 188.6 and 144.2 for males and females respectively. In males, the leading sites for cancer were prostate (873 cases), bronchus (269 cases) and large bowel (176 cases) while in females, the leading sites were breast (639 cases), cervix uteri (318 cases) and large bowel (218 cases). The number of new cases has remained relatively stable, compared to the previous five-year period (1993-1997), but the ASR for females has fallen from 156.7 to 144.2 per 100 000 per year and that for males has increased from 176.7 to 188.6 per 100 000 per year. The leading sites of cancer for both males and females have also been maintained in the same order but there was a moderate increase in prostate cancer (ASR 56.4 vs 65.5 per 100 000 per year) and a moderate decrease in cervical cancer (ASR 25.2 vs 19 per 100 000 per year). The incidence of cancer of the female breast has remained relatively stable (ASR 43.2 vs 40.1 per 100 000 per year). In both males and females, colon cancer incidence rates remain high at ASR of 9.9 per 100 000 per year in males and 9.4 per 100 000 per year in females. These data support the continuation of existing programmes for prevention and control of cancers of the prostate, lung, breast and cervix uteri and the introduction of new programmes specifically for cancers of the large bowel in the Jamaican population.

En el periodo 1998-2002, se registraron un total de 4737 cánceres en Kingston y Saint Andrew: 2387 en varones y 2350 en hembras. Las tasas ajustadas por edad (TAE) por cada 100 000 por año fueron 188.6 y 144.2 para los varones y las hembras respectivamente. En los varones, el cáncer estuvo localizado principalmente en la próstata (873 casos), los bronquios (269 casos) y el intestino grueso (176 casos), en tanto que en las hembras, los lugares principales fueron las mamas (639 casos), el cuello del útero (318 casos) y el intestino grueso (218 casos). El número de nuevos casos ha permanecido relativamente estable, en comparación con el periodo quinquenal anterior (1993-1997), pero la TAE para las hembras descendió de 156.7 a 144.2 por cada 100 000 por año, mientras que el de los varones aumentó de 176.7 a 188.6 por cada 100 000 por año. También se han mantenido los lugares principales de cáncer en el mismo orden tanto para varones como para hembras, pero hubo un aumento moderado en el cáncer de la próstata (TAE 56.4 frente a 65.5 por cada 100 000 por año) y una disminución moderada en el cáncer cervical (TAE 25.2 frente a 19 por cada 100 000 por año). La incidencia de cáncer de mamas en hembras, ha permanecido relativamente estable (TAE 43.2 frente a 40.1 por cada 100 000 por año). Las tasas de incidencia del cáncer permanecen altas a TAE 9.9 por cada 100 000 por año en varones y hembras, en los varones y 9.4 por cada 100 000 por año en las hembras. Estos datos apoyan la continuación de los programas existentes destinados específicamente a la prevención y el control de los cánceres de próstata, pulmón, mamas y cuello del útero, así como la introducción de nuevos programas para los cánceres de intestino grueso en la población jamaicana.

Trends in incidence and histological subtypes of lung cancer, Kingston and St Andrew, Jamaica, 1968-1997 / Tendencias en la incidencia y subtipos histológicos de cáncer pulmonar en Kingston y St Andrew, Jamaica, 1968­1997

Several scientific publications have reported a progressive shift in the distribution of the histologic subtypes of lung carcinoma in the latter decades of the 20th century, with adenocarcinoma now surpassing squamous cell carcinoma as the most commonly diagnosed morphologic pattern. A 30-year review (1968-1997) of lung cancer cases registered in the Jamaica cancer registry shows a similar trend among males in Kingston and St Andrew with a progressive increase in the documented cases of adenocarcinoma relative to squamous cell carcinoma. Similar changes were not observed in females.

Varias publicaciones científicas han reportado un desplazamiento progresivo en la distribución de los subtipos histológicos del carcinoma pulmonar en las últimas décadas del siglo 20. En las mismas se evidencia que, en el presente, el adenocarcinoma supera al carcinoma celular escamoso como patrón morfológico más comúnmente diagnosticado. Una revisión de 30 años (1968–1997) de casos de cáncer pulmonar registrados en el registro de cáncer de Jamaica, muestra una tendencia similar entre los hombres en Kingston y Saint Andrew, con un aumento progresivo en los casos documentados de adenocarcinoma en relación con el carcinoma celular escamoso. No se observaron cambios similares en las mujeres.

Gynaecologic cancer incidence, Kingston and St Andrew, Jamaica, 1973-1997, and gynaecologic cancer mortality, Jamaica, 1999

The incidence of gynaecologic cancers in women from Kingston and St Andrew for the period 1973-1997 were reviewed by analyzing data previously published by the Jamaica Cancer Registry. Gynaecologic cancer-related mortality statistics for the entire island for 1999 were compiled from data obtained from the Registrar General's Department (RGD) and the Statistical Institute of Jamaica (STATIN). Data were compared to gynaecologic cancer statistics for women from the United States of America for 1973-1997. A total of 2862 gynaecologic cancers were registered for the years 1973-1997, which represents 26.8 of all female cancers from Kingston and St Andrew. Cervical cancer accounted for 62 of these gynaecologic cancers. The 268 cancer-related deaths (168 due to cervical cancer) registered in Jamaican women for 1999 represent approximately 15 of all female cancer-related deaths. The present incidence (27.9 per 100,000) and mortality rate (15.8 per 100,000) of cervical cancer are much higher than that documented for American women--both African Americans and Caucasians--and signify the limited success, to date, of efforts to decrease the incidence and mortality of cervical cancer by the implementation of cervical cancer screening programmes. For the time period reviewed, an increase was noted in the incidence of cancer of the corpus uteri while decreases were recorded for the incidence of choriocarcinoma, ovarian cancer and cancers arising from the vulva, vagina and fallopian tube

Progressive Epstein-Barr virus infection in a six-year-old male

Progressive Epstein-Barr virus infection is described in a six-year-old Jamaican male with no previous evidence of immune deficiency

Histopathological findings in women with postmenopausal bleeding in Jamaica

We investigated the histopathological findings in women presenting with postmenopausal bleeding in a population predominantly of African descent by conducting a six-year retrospective study of 716 gynaecological surgical specimens from 629 women accessed in the Department of Pathology, The University of the West Indies, Jamaica. Histopathological diagnoses were correlated with patients age, specimen volume, duration of bleeding and length of postmenopausal interval at presentation using t-tests and linear regression models. The mean (SD) age was 63.6 (9.3) years. The frequency of the main causes of postmenopausal bleeding was: endometrial hyperplasia (22.3); endometrial atrophy (21.3); non-diagnostic (19.9); endometrial carcinoma (9.5); cervical carcinoma (6.8); cervical polyps (4.5); endometrial sarcoma (3.5); proliferative endometrium (3.2). Mean (SD) duration of bleeding was 6.9 (12.7) months. The percentage of women with malignant lesions was two to three times greater than those reported in the United States of America and Europe subsequent to 1980. The delay between the onset of bleeding and presentation is worrisome and suggests the need for public educatio

Jamaica cancer mortality statistics, 1999

A total of 2697 cancer-related deaths were documented among Jamaicans for the year 1999, accounting for 17.7 of all deaths. Males accounted for 1466 and females for 1231. The age-adjusted cancer mortality rate was 171.7 per 100,000 for males, 122.0 per 100,000 for females and 140.5 per 100,000 for the total population. Leading cancer mortality sites for males were prostate, lung and stomach and in females, breast, cervix uteri and large bowel. Most deaths were recorded in the 55-64 and 65-74 year-age groups. Despite well-established cervical cancer screening programmes, the calculated mortality rate for cancer of the cervix uteri in Jamaican females (15.8 per 100,000) is approximately two and a half times that seen in African-American females.

Spontaneous coronary artery dissection in a thirty-two-year-old woman. A case report and a review of the literature

A case of spontaneous coronary artery dissection, an extremely rare condition, is reported in a thirty-two-year-old woman. The pathological and clinical features as well as the management of this condition are discussed. Recent postulates with regard to aetiology and pathogenesis are emphasized.

Age-specific incidence of cancer in Kingston and St Andrew, Jamaica, 1993-1997

A total of 4285 malignant neoplasms were recorded in Kingston and St. Andrew during the period 1993-1997, 2344 in females and 1941 in males. The crude incidence rate per 100,000 (CIR) for males was 121.6 and for females 129.2. Age standardized rates per 100,000 (ASR) were 156.7 and 176.7 for males and females respectively. In males, the leading sites for cancer were prostate (619 cases), bronchus (265 cases) and large bowel (144 cases) while in females the leading sites were breast (627 cases) cervix uteri (376 cases) and large bowel (204 cases). The crude and age standardized incidence rates have remained stable as compared to those for the previous five year period (1998-1992). The leading sites for both males and females have also been maintained in the same order but there was a marked increase in prostate cancer (ASR 56.4 versus 36). Invasive cervical cancer has shown no significant change in incidence (ASR 25.2 versus 26.3) but the rate for in-situ cancers has decreased (ASR 27.4 versus 43.8). The incidence of cancer of the female breast has remained relatively stable (ASR 43.2 versus 47.1). The trends exhibited by both prostate cancer and in-situ cervical cancer probably represent the influence of screening methods for prostate cancer and ablative management for low grade dysplastic lesions of the cervix uteri respectively.

Angiomyofibroblastoma: a rare but distinct entity

A case of angiomyofibroblastoma of the vulva in a 23-year-old woman is presented. Clinical, histological and immunohistochemical features as well as the differential diagnosis and prognosis of this rare but distinct entity are discussed. Only about 65 cases are documented in the literature and to our knowledge this is the first case to be reported from the Caribbean.