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A first look at cancer incidence rates and trends in Bermuda over the 10-year period 2007-2016

Explore the cancer incidence rates and trends in Bermuda from 2007 to 2016, comparing global data, with insights on high rates and factors influencing them. Collaboration between IARC Caribbean Cancer Registry Hub and Bermuda National Tumour Registry.

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A first look at cancer incidence rates and trends in Bermuda over the 10-year period 2007-2016

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  1. A first look at cancer incidence rates and trends in Bermuda over the 10-year period 2007-2016 Sarah Crooks IARC Caribbean Cancer Registry Hub Caribbean Public Health Agency (CARPHA) Trinidad and Tobago NAACCR /IACR Combined Annual Conference June 11 – 13, 2019 Vancouver, BC, Canada

  2. The IARC Caribbean Cancer Registry Hub • One of six regional IARC Hubs worldwide • Became operational in 2015 • Based at the Caribbean Public Health Agency (CARPHA), in Port of Spain, Trinidad & Tobago • Operations managed by 3 CARPHA staff members with technical and financial support provided by multiple partners (NCI, NAACCR, IARC, CDC, PAHO) • MISSION: To improve the availability, use and dissemination of high-quality cancer data to inform cancer control in the Caribbean region

  3. Bermuda • One of 6 British Overseas Territory in the Caribbean • Associate Member of the Caribbean Community (CARICOM) • Located in the North Atlantic Ocean roughly 1000km east of North Carolina • Consists of approximately 138 islands, 7 of which are populated and connected by bridges • 20.5 square mile land area • Population: 61,695 (2016) • A high-income country with over 98% population-wide health insurance coverage and one of the highest per capita health expenditure rates worldwide

  4. Bermuda National Tumour Registry • A population-based cancer registry • Located in the King Edward VII Memorial Hospital • Established in 1979 • Data accepted into CI5 VI Katura Horton-Perinchief Manager, Bermuda National Tumour Registry September 2008 - present

  5. Methods • A “Data Use Agreement” between the Bermuda National Tumour Registry and the IARC Caribbean Cancer Registry Hub was completed and signed • Time Period: 2007-2016 • Data Sources: • Incidence data - Bermuda National Tumour Registry • Population estimates - Department of Statistics • Software: CanReg 5.00.43, Excel, SEER*Stat • Analyses: • Cancer incidence rates and trends generated for the 10 year period • ASR for the combined period 2014-2016 were compared to worldwide GLOBOCAN 2018 estimates

  6. Age-standardized incidence rates, All cancers ASR for 2014-2016 for Bermuda were 63% higher for men and 41% higher for women compared to GLOBOCAN 2018 Worldwide ASR for all cancers.

  7. Comparing ASR, All Cancers

  8. Among women in Bermuda: • the ASR for breast cancer, colorectal cancer, melanoma of the skin and Non-Hodgkins lymphoma are each roughly double the worldwide estimates • Rates for lung cancer, liver cancer, leukemia and cervical cancer were lower than worldwide estimates

  9. Among men: • Prostate cancer rates were roughly three times higher in Bermuda than worldwide • Colorectal cancer rates were twice as high in Bermuda than worldwide • Rates for liver cancer and leukemia were lower in Bermuda than worldwide estimates

  10. Determining the reasons underlying the disproportionately high incidence rates for some cancers in Bermuda requires further investigation and clinical/epidemiological research. • Likely contributing factors: • Relatively high national health care financing which may influence health seeking behavior and result in increased screening and detection of cancers • High prevalence of chronic disease risk factors in the population

  11. Next Steps • The IARC Caribbean Cancer Registry Hub will continue to work with the Bermuda National Tumour Registry to explore some of the key differences and interesting trends observed for Bermuda • Broaden analyses: incorporate more recent data, include smoothing and/or Joinpoint analyses • Include stakeholders from the Ministry of Health: National Epidemiologist, Chief Medical Officer of Health • Generate internal reports and a manuscript for publication • Work with IARC to provide the requested technical support to assist the Bermuda National Tumour Registry in submitting their data to the next CI5

  12. Authors • Sarah Crooks • Programme Coordinator, IARC Caribbean Cancer Registry Hub • CARPHA, Trinidad & Tobago • Glennis Andall-Brereton • Principal Investigator, IARC Caribbean Cancer Registry Hub • CARPHA, Trinidad & Tobago Katura Horton-Perinchief Manager Bermuda National Tumour Registry • Brenda Edwards • Senior Advisor, Office of the Director, Division of Cancer Control and Population Sciences, NCI • Damali Martin • Global Health Coordinator, Epidemiology & Genomics Research Program, Division of Cancer Control and Population Sciences, NCI Gerri Nott Tumour Registrar Bermuda National Tumour Registry • Rachel Hanisch • Division of Cancer Control and Population Sciences NCI • Les Mery • Global Programme Manager, Cancer Surveillance Unit, IARC

  13. Thank you Any questions?

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