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Difficulties in Accessing Cancer Care in a Small Island State: A Community-Based Pilot Study of Cancer Survivors in Saint Lucia

Developing robust systems for cancer care delivery is essential to reduce the high cancer mortality in small island developing states (SIDS). Indigenous data are scarce, but community-based cancer research can inform care in SIDS where formal research capacity is lacking, and we describe the experie...

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Autores principales: Auguste, Aviane, Jones, Glenn, Phillip, Dorothy, St. Catherine, James, Dos Santos, Elizabeth, Gabriel, Owen, Radix, Carlene
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8124473/
https://www.ncbi.nlm.nih.gov/pubmed/33947123
http://dx.doi.org/10.3390/ijerph18094770
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author Auguste, Aviane
Jones, Glenn
Phillip, Dorothy
St. Catherine, James
Dos Santos, Elizabeth
Gabriel, Owen
Radix, Carlene
author_facet Auguste, Aviane
Jones, Glenn
Phillip, Dorothy
St. Catherine, James
Dos Santos, Elizabeth
Gabriel, Owen
Radix, Carlene
author_sort Auguste, Aviane
collection PubMed
description Developing robust systems for cancer care delivery is essential to reduce the high cancer mortality in small island developing states (SIDS). Indigenous data are scarce, but community-based cancer research can inform care in SIDS where formal research capacity is lacking, and we describe the experiences of cancer survivors in Saint Lucia in accessing health services. Purposive and snowball sampling was used to constitute a sample of survivors for interviews. Subjects were interviewed with a questionnaire regarding socio-demographics, clinical characteristics, health services accessed (physicians, tests, treatment), and personal appraisal of experience. We recruited 50 survivors (13 men, 37 women). Only 52% of first presentations were with general practitioners. The mean turnaround for biopsy results in Saint Lucia was three times longer than overseas (p = 0.0013). Approximately half of survivors commenced treatment more than one month following diagnosis (median of 32 days, IQR 19–86 days), and 56% of survivors traveled out-of-country for treatment. Most survivors (60%) paid for care with family/friends support, followed by savings and medical insurance (38% each). In conclusion, cancer survivors in Saint Lucia are faced with complex circumstances, including access-to-care and health consequences. This study can guide future research, and possibly guide practice improvements in the near term.
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spelling pubmed-81244732021-05-17 Difficulties in Accessing Cancer Care in a Small Island State: A Community-Based Pilot Study of Cancer Survivors in Saint Lucia Auguste, Aviane Jones, Glenn Phillip, Dorothy St. Catherine, James Dos Santos, Elizabeth Gabriel, Owen Radix, Carlene Int J Environ Res Public Health Article Developing robust systems for cancer care delivery is essential to reduce the high cancer mortality in small island developing states (SIDS). Indigenous data are scarce, but community-based cancer research can inform care in SIDS where formal research capacity is lacking, and we describe the experiences of cancer survivors in Saint Lucia in accessing health services. Purposive and snowball sampling was used to constitute a sample of survivors for interviews. Subjects were interviewed with a questionnaire regarding socio-demographics, clinical characteristics, health services accessed (physicians, tests, treatment), and personal appraisal of experience. We recruited 50 survivors (13 men, 37 women). Only 52% of first presentations were with general practitioners. The mean turnaround for biopsy results in Saint Lucia was three times longer than overseas (p = 0.0013). Approximately half of survivors commenced treatment more than one month following diagnosis (median of 32 days, IQR 19–86 days), and 56% of survivors traveled out-of-country for treatment. Most survivors (60%) paid for care with family/friends support, followed by savings and medical insurance (38% each). In conclusion, cancer survivors in Saint Lucia are faced with complex circumstances, including access-to-care and health consequences. This study can guide future research, and possibly guide practice improvements in the near term. MDPI 2021-04-29 /pmc/articles/PMC8124473/ /pubmed/33947123 http://dx.doi.org/10.3390/ijerph18094770 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Auguste, Aviane
Jones, Glenn
Phillip, Dorothy
St. Catherine, James
Dos Santos, Elizabeth
Gabriel, Owen
Radix, Carlene
Difficulties in Accessing Cancer Care in a Small Island State: A Community-Based Pilot Study of Cancer Survivors in Saint Lucia
title Difficulties in Accessing Cancer Care in a Small Island State: A Community-Based Pilot Study of Cancer Survivors in Saint Lucia
title_full Difficulties in Accessing Cancer Care in a Small Island State: A Community-Based Pilot Study of Cancer Survivors in Saint Lucia
title_fullStr Difficulties in Accessing Cancer Care in a Small Island State: A Community-Based Pilot Study of Cancer Survivors in Saint Lucia
title_full_unstemmed Difficulties in Accessing Cancer Care in a Small Island State: A Community-Based Pilot Study of Cancer Survivors in Saint Lucia
title_short Difficulties in Accessing Cancer Care in a Small Island State: A Community-Based Pilot Study of Cancer Survivors in Saint Lucia
title_sort difficulties in accessing cancer care in a small island state: a community-based pilot study of cancer survivors in saint lucia
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8124473/
https://www.ncbi.nlm.nih.gov/pubmed/33947123
http://dx.doi.org/10.3390/ijerph18094770
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