title: Prostate cancer trends in Barbados: An analysis of the Barbados Urologic Diseases Survey database.
abstract: OBJECTIVE
  To describe the burden and trend of prostate cancer (CaP) in the Caribbean island of Barbados.
  
  
  METHODS
  All urologic pathology reports in Barbados between 1990 and 2009 were entered into the Barbados Urologic Diseases Survey (BUDS) database. All new cases of CaP were identified and the database was used to assess trends in CaP epidemiology over the study period.
  
  
  RESULTS
  3066 new cases of CaP were identified between 1990 and 2009. The world age-standardized rate increased steadily from 71.8 (95% CI 57.8-88.4) per 100,000 in 1990 to 112.4 (95% CI 94.0-133.7) per 100,000 in 2009, with a peak rate of 148.9 (95% CI 127.0-172.8) in 2004. The cumulative risk up to 74 years of age also increased from 11.1% in 1990 to 23.8% in 2009 with a peak of 29.9% in 2004. The mean age at diagnosis decreased from 73.1 years in 1990 to a nadir of 66.2 years in 2009. The rate of high-grade cancer (Gleason score ≥ 8) and intermediate-grade cancer (Gleason score=7) at presentation rose between 2000 and 2009 while the rate of low-grade cancer (Gleason score ≤ 6) decreased.
  
  
  CONCLUSIONS
  Barbados suffers an unusually high burden of CaP with a trend towards more aggressive disease over the last decade. The results are important as they highlight the utility of the BUDS initiative in epidemiologic evaluation, but should be looked at cautiously due to a lack of specific details regarding screening practices in this population.
authors.affiliation: Department of Genitourinary Oncology, Moffitt Cancer Center, Tampa, FL, USA. Electronic address: jemtage@health.usf.edu.
authors.forename: Justin B
authors.initials: JB
authors.lastname: Emtage
authors.affiliation: Department of Genitourinary Oncology, Moffitt Cancer Center, Tampa, FL, USA.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Poch
authors.affiliation: Healthy Caribbean Coalition, St. Michael, Barbados.
authors.forename: Maisha T
authors.initials: MT
authors.lastname: Hutton
authors.affiliation: School of Clinical Medicine and Research, Department of Urology, Queen Elizabeth Hospital, St. Michael, Barbados.
authors.forename: Jerry B
authors.initials: JB
authors.lastname: Emtage
mesh_terms: D000328:Adult; D000368:Aged; D001460:Barbados / Q000453:epidemiology; D017281:Cost of Illness; D016208:Databases, Factual; D006801:Humans; D008297:Male; D008875:Middle Aged; D011471:Prostatic Neoplasms / Q000453:epidemiology*
keywords: Barbados; Caribbean; Incidence; Prevalence; Prostatic neoplasms; Urologic neoplasms