title: Opportunities for reducing morbidity and mortality due to leading cancers in a developing country.
abstract: BACKGROUND
  Malignancies are a leading cause of chronic non-communicable disease deaths in Jamaica. However, little or no data is available on integration of cancer screening guidelines in clinics.
  
  
  METHODS
  A cross-sectional survey of 88 consecutive patients with diabetes mellitus (DM) and/or hypertension (HTN) was conducted at major health centers in Jamaica between September and December 2011.
  
  
  RESULTS
  Eighty percent respondents were women; 20% were men. The mean age was 57 years old. Forty persons (45.5%) had high cholesterol, 62 (71%) had DM and 62 (71%) had HTN. Of 66 women, 27% reported never having a pap smear and 66% had no pap smear within the last 12 months. 49% women over 40 years never had a mammogram and 74% did not have a mammogram in the last 12 months. Among men over 40 years old, at least 25% never had a prostate examination and 19% never had a prostate-specific antigen blood test. Most participants (>90%) received counseling about diet and exercise, but self-reported compliance with recommendations was low.
  
  
  CONCLUSIONS
  Cancer screening among chronic disease patients is suboptimal in our population. Improved implementation of guidelines for cancer in chronic disease clinics have the potential to impact on morbidity and mortality.
authors.affiliation: Kingston and St Andrew Health Department, South East Regional Health Authority, Ministry of Health, Kingston, Jamaica.
authors.forename: J P
authors.initials: JP
authors.lastname: Duncan
authors.affiliation: Kingston and St Andrew Health Department, South East Regional Health Authority, Ministry of Health, Kingston, Jamaica.
authors.forename: P
authors.initials: P
authors.lastname: Weir
authors.affiliation: Kingston and St Andrew Health Department, South East Regional Health Authority, Ministry of Health, Kingston, Jamaica.
authors.forename: S
authors.initials: S
authors.lastname: Strachan
authors.affiliation: Epidemiology Research Unit, Tropical Medicine Research, University of the West Indies, Kingston, Jamaica.
authors.forename: M
authors.initials: M
authors.lastname: Tulloch-Reid
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D003906:Developing Countries; D055088:Early Detection of Cancer / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D061213:Mortality, Premature; D009369:Neoplasms / Q000401:mortality*; D011795:Surveys and Questionnaires
keywords: cancer; chronic disease; screening