Heterogeneity in head and neck cancer incidence among black populations from Africa, the Caribbean and the USA: Analysis of cancer registry data by the AC3.

BACKGROUND: Africa and the Caribbean are projected to have greater increases in Head and neck cancer (HNC) burden in comparison to North America and Europe. The knowledge needed to reinforce prevention in these populations is limited. We compared for the first time, incidence rates of HNC in black populations from African, the Caribbean and USA. METHODS: Annual age-standardized incidence rates (IR) and 95% confidence intervals (95%CI) per 100,000 were calculated for 2013-2015 using population-based cancer registry data for 14,911 HNC cases from the Caribbean (Barbados, Guadeloupe, Trinidad & Tobago, N = 443), Africa (Kenya, Nigeria, N = 772) and the United States (SEER, Florida, N = 13,696). We compared rates by sub-sites and sex among countries using data from registries with high quality and completeness. RESULTS: In 2013-2015, compared to other countries, HNC incidence was highest among SEER states (IR: 18.2, 95%CI = 17.6-18.8) among men, and highest in Kenya (IR: 7.5, 95%CI = 6.3-8.7) among women. Nasopharyngeal cancer IR was higher in Kenya for men (IR: 3.1, 95%CI = 2.5-3.7) and women (IR: 1.5, 95%CI = 1.0-1.9). Female oral cavity cancer was also notably higher in Kenya (IR = 3.9, 95%CI = 3.0-4.9). Blacks from SEER states had higher incidence of laryngeal cancer (IR: 5.5, 95%CI = 5.2-5.8) compared to other countries and even Florida blacks (IR: 4.4, 95%CI = 3.9-5.0). CONCLUSION: We found heterogeneity in IRs for HNC among these diverse black populations; notably, Kenya which had distinctively higher incidence of nasopharyngeal and female oral cavity cancer. Targeted etiological investigations are warranted considering the low consumption of tobacco and alcohol among Kenyan women. Overall, our findings suggest that behavioral and environmental factors are more important determinants of HNC than race.

Sinonasal malignancies: incidence and histological distribution in Jamaica, 1973-2007.

PURPOSE: To determine the histological distribution and trends in incidence of sinonasal malignancies in Jamaica. METHODS: Cases of all sinonasal malignancies diagnosed between 1973 and 2007 were extracted from the archives of the Jamaica Cancer Registry. Data recorded for each case included age at diagnosis, sex, year of diagnosis, topography, and histology. Data were used to calculate frequencies, age-specific incidence rates, and age-standardized incidence rates (ASRs). Linear regression analysis was used to determine significance of trends in incidence rates; p values of ≤0.05 were significant. RESULTS: Sinonasal malignancies were commoner in males (male: female ratio, 1.1:1), and the median ages were 62 (males) and 66 years (females). Most were located in either the maxillary sinus (61.3%) or nasal cavity (24.3%). The commonest histological types were squamous cell carcinoma (SCC) (55.9%) and non-Hodgkin's lymphoma (17.1%), which were predominantly of T-cell immunophenotype, in both the nasal cavity and sinuses. There was no documentation in registry data regarding separation into NK/T and peripheral T-subtypes. The ASRs in males and females were consistently less than 1.5 per 100,000 per year. In males, there was a significant decrease in SCC ASR (p = 0.014) over time. CONCLUSIONS: The age, gender, and anatomical and histological distribution patterns of sinonasal malignancies in Jamaica are similar to those reported internationally, and the low ASRs are in keeping with previous global reports. Broader local immunohistochemistry panels are warranted for further delineation of sinonasal T-cell lymphomas. Investigation into factors contributing to the decreasing incidence of sinonasal SCC is also required.

Factors affecting prostate cancer screening behaviour in a discrete population of doctors at the University Hospital of the West Indies, Jamaica.

To determine the knowledge, attitudes and practices of Jamaican male medical consultants regarding prostate cancer screening in three departments within the University Hospital of the West Indies. The research design was a cross-sectional quantitative survey utilising a self administered questionnaire. All 36 male consultants between 40 and 70 years from the Departments of Surgery Radiology Anaesthesia and Intensive Care, Obstetrics and Gynaecology/Child Health, and Medicine participated in the survey. Bivariate analyses were used to determine the relationship between the three constructs with P < 0.05 taken as statistically significant. The majority (97%) of the respondents were aware that prostate cancer among Jamaicans account for one of the highest incidences in the world and 85% believed that screening for prostate cancer should begin at age 40 years. Approximately two-fifths (44.4%) reported that they usually encourage their patients to be screened. Nearly all (97%) of the respondents agreed that performing both the prostate specific antigen (PSA) test and digital rectal examination (DRE) are more effective in assessing for the presence of prostate cancer. Just over one-third (36%) found the DRE embarrassing and 41% had never had a DRE. The results showed a significant positive correlation (r = 0.374, P = 0.032) between knowledge and attitude, and an even stronger correlation between attitude and prostate cancer screening practice (r = 0.395, P = 0.025). However there was no direct correlation between knowledge and practice. Physicians' knowledge of prostate cancer does not predict their personal prostate cancer screening behaviour. Knowledge of prostate cancer is not enough to result in screening behavior of men in Jamaica.