UDP, CICS want cancer answers

Buoyed by last week’s passage of anti-smoking legislation, the Cayman Islands Cancer Society has now set its sights on the establishment of a nation-wide cancer registry to document the extent of cancer in the Cayman Islands.


Mr. Bush

It comes after Leader of the Opposition McKeeva Bush in September called for a nationwide cancer study during a private members motion in the Legislative Assembly, pointing to knowledge gaps about the prevalence and causes of cancer in Cayman.

CICS Chief Operating Officer Christine Sanders said her organisation is bombarded with questions about the extent of cancer in the Cayman Islands but she said not enough information is known about its prevalence here.

‘There are so many unanswered questions about cancer in the Cayman Islands including the perception that there is a higher than normal rate of cancer here and that there may be environmental causes associated with this,’ she said

‘Hopefully such a registry will help provide the information needed to answer these questions.’

During his private member’s motion, Mr. Bush said it is no secret that many people in the community have from time to time expressed concerns about what they perceive to be a high rate of cancer in these islands given its population size.

‘We certainly cannot fault them for this perception,’ he said.

‘The more we know about what is causing this disease among our people and the more we know who is at risk, the better prepared we will be to deal with it,’ he said.

Mr. Bush said people regularly express concern about whether there is a link between cancer and environmental factors such as the island’s water source; mosquito spraying; an ‘unhealthy garbage dump’ and building materials formerly used in some schools.

‘We have to get beyond mere questions, fearful speculation and the anxiety that stems from lack of scientific knowledge,’ he said.

Mr. Bush acknowledged that a legislative framework may have to be established to allow for the type of cancer registry the CICS is proposing. But cancer registries exist in other countries and there is no reason why government cannot act to create the same here, he said.

Ms Sanders pointed to a private-public partnership established in Belize in November 2007 as one possibility.

There, government agencies, healthcare providers and NGO’s partnered to establish a cancer registry as a part of a comprehensive cancer control programme that includes surveillance, screening, therapy and palliative care.

The registry contains a file on all cancer cases occurring within Belize. Under the system, general information about patients and the clinical and pathological characteristics of the cancers is collected continuously and systematically.

The registry provides data for analysis, information to promote research, cancer prevention, early diagnosis and effective treatment.

Mr. Bush detailed to the house some of the problems that have contributed to a knowledge gap about cancer in the Cayman Islands.

‘As I understand it, there are two main particularities: One, a significant number of local residents do not see a doctor here. They develop a medical problem and they go off island for diagnosis and treatment, or they see a primary physician here, but then are referred overseas,’ he said.

‘In many cases, unless persons are insured by Government or seen at the George Town Hospital, any potential cancer cases are not captured as part of our local data.

‘The second issue is that we have a large expatriate population here and it is entirely possible that persons within this grouping may emigrate here with a predisposition to certain cancers,’ he continued.

‘We know that some types of cancer take many years to develop and if members of this group should later be diagnosed with the disease, then hospitals cannot tell whether there were local factors at play or whether they had been incubating the disease for some time.’

Mr. Bush pointed out that a cancer study tabled in the Legislative Assembly in 2003 by the Chief Medical Officer reported that cancer incidence and mortality rates in the Cayman Islands were one-third to one-quarter of those found in developed countries such as the US and the United Kingdom. It further found that the incidence of the most common male and female cancers in Cayman were similar to those found throughout the Caribbean.

But he said a more comprehensive study is now needed.

‘To us here in the islands, when we experience it around our family, around our friends, and when we see what is happening in the community, we say ‘well they can have their statistics but this is high for us’.’

‘We can help to prevent what is preventable in our own special circumstances and treat what can be treated.’

Mr. Bush said he expected to hear that the study he was proposing was a tall order and that there was little small communities could do to overcome a global phenomenon such as cancer.

‘That is not something we have to accept. We do not have to accept that,’ he said.

Government members voted in favour of Mr. Bush’s motion but they are yet to outline any plan to take the proposals further.