2024-11-08

Content

  • Prostate Cancer Overview
  • Epidemiology of Prostate Cancer: St Lucia
  • Role of Universal Health Coverage (UHC)
  • Project Goal & Objectives
  • Key Performance Indicators
  • Prostate Cancer KPIs
  • Review M&E Worksheet

Prostate Cancer Overview

  • Prostate cancer ranks among the most prevalent cancers in men, with approximately 1.4 million new diagnoses worldwide in 2022.

  • It is the second most common cancer affecting the male population globally.

  • About 1 in 8 men will be diagnosed with prostate cancer in their lifetime.

  • Risk factors: older ages, African/Caribbean descent, obesity, diet

Source: American Cancer Society

Top Cancers by Year - St Lucia

Prostate cancer continues to have the highest incidence in St Lucia over the past 5 years (exception:2021)

Prostate Cancer Incidence - St Lucia

  • Highest prostate cancer numbers between ages 65-69
  • Cases within the 40-44 age group in 2023

Prostate Cancer Deaths - St Lucia

Role of UHC

  • Relaunch of Men’s health clinic under UHC to include prostate cancer screening

  • Prostate-Specific Antigen (PSA) tests will be offered at phlebotomy sites in wellness centers around the island along with Digital Rectal Exams (DRE)

  • Patients with abnormal PSA levels and/or DRE will be referred to the Urology Clinic for Transrectal Ultrasounds (TRUS)

Project Goal

  • To improve early detection of prostate cancer in men aged 40 and above in St Lucia, ensuring equitable access to screening services under the universal healthcare coverage system.

Objectives

  • Increase the proportion of men aged 40+ undergoing regular prostate cancer screening.
  • Reduce the rate of late-stage prostate cancer diagnoses.
  • Improve community awareness and knowledge about prostate cancer risks and screening benefits.

Key Performance Indicators (KPIs)

  • KPIs were developed to assess the progress of UHC in meeting project goals for prostate cancer screening.

  • KPIs may not directly improve quality but they act as effective flags or alerts, that help pinpoint best practices, enable comparisons among similar services and highlight areas of improvement.

  • The primary objectives of KPIs are to:

    • Monitor progress

    • Identify areas for improvement

    • enhance accountability

    • ensure strategic alignment

Prostate Cancer Screening

Screening Participation

  • Screening coverage

  • PSA test

  • DRE test

  • Co-testing rate

Abnormal Screening Results

  • Elevated PSA Levels

  • Abnormal DRE rates

  • Patient Refusal Rate

Screening GIF

Diagnostic Procedures

  • Proportion of men with abnormal screen tests who require follow-up procedures

  • Number of patients seen by urologist within 21 days of referral

  • Proportion of men who received imaging tests

  • Biopsy referral rates

  • Positive biopsy rates

Cancer Detection & Diagnosis

  • Clinically significant cases

  • Early-stage detection

  • Late-stage detection

Operational Efficiency (Time)

  • Proportion of PSA test results available within 1 week of testing

  • Proportion of men informed of elevated PSA results 1 week (5 working days) after receiving results

  • Proportion of men informed of normal PSA results within 10 working days from receipt of results

  • Number of biopsy results available within 1 week of procedure

  • Number of men notified of biopsy results within 1 week (5 working days) of results being made available

  • Number of men treated within 4 weeks of diagnosis

  • Sample rejection rate

Diagnostic Test Accuracy

  • False Positive Rate

  • False Negative Rate

Treatment & Management

  • Gleason Scores (GS)

  • Prostate cancer treatment rate

  • Proportion of men placed in active surveillance

M&E Worksheet