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.

In Antigua and Barbuda, prostate cancer is known for its epidemiological burden; however, its economic burden on the healthcare system is unknown. This study aimed to assess the economic burden of prostate cancer in Antigua and Barbuda from the healthcare provider’s perspective. To conduct this prevalence-based cost-of-illness study, we used patient data abstracted from records at key study sites for the period of 2017–2021 to establish a yearly prevalence. Top-down and bottom-up approaches were used to estimate the direct medical cost. The cost was computed at the 2021 price level and converted to United States dollars (USD). The total annual direct medical cost for prostate cancer was estimated at USD 1.8 million (ranging between USD 1.4 million and USD 2.3 million). Stages II and III disease accounted for a combined greater share of the cost. The direct medical unit cost for screening, diagnosing, and treating a prostate cancer patient was USD 126,388.98. The top contributors to this cost were surgery (USD 20,913.42), renal complications/renal failure (USD 20,674.86), and hormonal therapy (USD 31,824.00). The results of this study provide evidence of the economic burden of prostate cancer in Antigua and Barbuda. Our findings appear reasonable. Besides contributing to further economic research, they will be useful for policy development, resource allocation, and cost containment measures.

Cervical cancer remains a significant public health issue globally. In Antigua and Barbuda, cervical cancer is ranked among the top five most common cancers in terms of incidence and mortality among females. There is no evidence that the costs of diagnosing, treating, and managing this cancer have been studied before in Antigua and Barbuda. From the providers’ perspective, this study aimed to estimate costs associated with cervical cancer in Antigua and Barbuda. The prevalence-based cost-of-illness methodology was used to assess patient data abstracted from four study sites for the period 2017–2021, and to derive the annual prevalence. Top-down and bottom-up costing approaches were used to estimate direct medical costs. Costs were computed using the 2021 price level and converted to United States Dollars (USD). Total annual direct medical costs of cervical cancer were estimated at USD 0.24 million (ranging between USD 0.19 million and USD 0.30 million). Major cost drivers were treatment (USD 112,863.76), post-treatment side-effects care (USD 67,406.57), and the diagnostic process (USD 26,238.58). The overall direct medical unit costs for managing a case were estimated at USD 115,822.09. Our study reflects the current estimates for managing cervical cancer and provides evidence to complement cervical cancer prevention and cost containment measures in Antigua and Barbuda.

Colorectal cancer burden is a threat to health systems in several countries. As the cost of diagnosing, treating, and managing this cancer is unknown in Antigua and Barbuda, this study aimed to estimate its direct medical cost in this country. We used the prevalence-based cost-of-illness methodology to study data on patients diagnosed with colorectal cancer between 2017 and 2021. Data record abstraction was carried out to determine the five-year prevalence, and a top-down and bottom-up approach was employed to estimate the direct medical costs for colorectal cancer care components. All costs were computed at 2021 price levels and are reported in United States dollars. The total annual direct medical costs for colorectal cancer were estimated at USD 1.14 million (ranging between USD 0.85 million and USD 1.42 million). Major cost drivers were treatment (USD 613,650.01) and post-treatment side-effects care (USD 402,234.50). The overall estimated direct medical unit costs were USD 139,295.58, with the main drivers being surgery (USD 43,467.10), other complications of treatment (USD 28,469.21), and immunotherapy (USD 19,200.00). This study provides evidence of the economic burden of colorectal cancer in Antigua and Barbuda. The estimates of annual direct medical costs are substantial. Our findings could help in the development of health policy and aid in resource allocation related to local colorectal cancer management.

Understanding cancer survival is important for countries such as Antigua and Barbuda, where female breast, cervical, colorectal, and prostate cancers are burdensome to the healthcare system. This study therefore aimed to estimate the survival probabilities of patients diagnosed with these cancers between 2017 and 2021. A retrospective analytical study design was used to evaluate cancer cases abstracted from medical records at key study sites. Estimates of observed survival probabilities were determined using a Kaplan–Meier analysis. Significant differences between survival curves were assessed using the log-rank test. Hazard ratios were calculated using Cox regression. A p-value < 0.05 indicated significance. A total of 391 diagnosed cases were included in this study (2017–2021): female breast cancer accounted for 42%, cervical cancer accounted for 10%, colorectal cancer accounted for 20%, and prostate cancer accounted for 28%. Overall, the mean age of the participants was 61.5 (±12.9) years; 62% were female, 73% were aged > 55 years, 56% were from St. John’s, and 82% were alive at the end of 2021. The median overall survival (years) was 4.8 for female breast cancer, 4.1 for cervical cancer, 4.5 for colorectal cancer, and not reached for prostate cancer. The cancer-specific overall observed 5-year survival probabilities were 44.9% for female breast cancer, 10.8% for cervical cancer, 19.6% for colorectal cancer, and 69.0% for prostate cancer. Significant associations between disease stage and overall survival were observed in female breast and colorectal cancers. This study provides important evidence for the 5-year observed survival probabilities of the studied cancers. Healthcare improvements that support cancer survival are required.

In South Africa, prostate, breast, and cervical cancers are prioritised under the National Cancer Strategic Framework (2017-2022), while oesophageal cancer remains a major public health concern in the Eastern Cape Province. This study describes the incidence patterns and temporal trends of breast, cervical, prostate, and oesophageal cancers in the Eastern Cape from 1998 to 2021. Cancer incidence data were obtained from the Eastern Cape Population-Based Cancer Registry for 1998-2021. Population denominators were derived from the 2001 and 2011 national censuses, with intercensal and postcensal estimates used to generate annual age- and sex-specific populations. Age-standardised incidence rates were calculated using direct standardisation to the World Standard Population. Temporal trends were analysed using Joinpoint regression models. A total of 10 240 cancer cases were recorded, with a median age at diagnosis of 61.6 years (IQR: 50.7-71.0). Of the 10 240, oesophageal cancer accounted for 40.1% (4 108), followed by cervical cancer 36.4% (3 732), breast cancer 13.0% (1 327), and prostate cancer 10.5% (1 073). Incidence rates increased significantly for prostate cancer 9.6% (95% CI: 6.9%-12.4%), breast cancer 4.1% (95% CI: 2.4%-5.4%), and cervical cancer 3.8% (95% CI: 1.7%-5.8%). In contrast, oesophageal cancer incidence declined significantly in both sexes -3.0% (95% CI: -4.4% to -3.1%). Prostate, breast, and cervical cancer incidence has increased substantially in the Eastern Cape over the past two decades, while oesophageal cancer incidence decreased significantly. Strengthened cancer surveillance and targeted control strategies are needed in this predominantly rural setting.