Barbados’ good lung cancer rating a secret

With smokers in the minority among its population, Barbados has for a long time been carrying one of the lowest rates lung cancer deaths, but no one knew, Dr Clive Landis has said.

The deputy principal of the University of the West Indies, Cave Hill Campus, made this revelation Tuesday night during the question and answer segment which followed a presentation by UWI Chancellor Sir George Alleyne.

Sir George Alleyne
Sir George Alleyne

Sir George had earlier spoken about how inadequate data collection and public information sharing systems were crippling the work of health workers in the Caribbean.

And in support of the Chancellor, Professor Landis said, “Even when we do something good, we often don’t have the monitoring to actually know that we’ve done something good.”

He pointed out that Barbados was classified as “a low smoking jurisdiction”, in which less than ten per cent of the population smokes.

However, Dr Landis said it was only when the cancer registry was set up in the Chronic Disease Research Centre that “we realized that uniquely, in any country that has reported, lung cancer was not in the top five.

“So we are the only country, that has reported, that doesn’t have lung cancer in the top five.

“Admittedly we didn’t know that.

“So we couldn’t even tell that we had done something fantastic,” he told last night’s gathering.

The cancer registry was established in 2010.

Responding to a question from the floor, Sir George had compared the task of obtaining medical data in Barbados to “pulling teeth”.

“Even some basic information is not available, routine information in clinics, in tertiary care centres,” Sir George said, recalling his experience during joint research project with Dr Henry Fraser.

“We tried to do a study years ago on tourism in Barbados. It’s like pulling teeth in getting basic information on something as simple as that about admissions and what people are admitted for,” he said, arguing that “the reason [information] is not valued is because the health systems are open systems, and the system encourages you not to change it . . . by making you ignorant of the part of the system that is most likely to change the performance of the system”.

“A lot of what you call routine information is not collected, and what is worse, even when it is collected, it is not used to modify what happens in the system,” Sir George said.

However, while stressing the importance of up-to-date information to health practitioners, he noted that one in five people now had diabetes in Barbados.

“If you knew that [before now], do you think that you would altar some of the practices that you put in place?” he asked, while suggesting, “you would see that it is part of your responsibility to make a greater attempt at keeping people less fat.”

Bemoaning the low priority placed on information, Sir George said during his lecture presentation, “I would argue here as I have argued elsewhere that the most important entry point for strengthening the health system to deal with non-communicable diseases is through the strengthening of the information subsystem.

“This is not to deny the importance of the specific interventions, but unless there is an adequate information subsystem there will be inadequate feedback on the outputs and therefore inadequate efforts to modulate the other components of the system,” he insisted.

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