Cancer battle: The career of Colombian singer Soraya was taking off when she was diagnosed with breast cancer and now she is working on beating the disease and creating awareness in the Latin community in the US. *MCT photo
Cancer battle: The career of Colombian singer Soraya was taking off when she was diagnosed with breast cancer and now she is working on beating the disease and creating awareness in the Latin community in the US. *MCT photo

When I returned home to Bermuda seven years ago, among the things that surprised me was how much people talked about cancer.

It is Bermuda’s second leading cause of death, and this supported the widely-held perception that cancer was more prevalent in Bermuda than in other countries.

As we know, however, widely-held perceptions are often only that: perceptions.

So a couple of years later when a local study compared cancer incidence rates in Bermuda with those of the US, no one should have been entirely surprised of the findings: that the rate of cancer was broadly similar for both countries.

The 2004 study Cancer in Bermuda was a good reminder that anecdotal accounts — even in tiny Bermuda — don’t always reflect the real numbers.

Health in Review

Earlier this year the Bermuda Health Council (BHeC) and the Department of Health jointly published the seminal report Health in Review: An international comparative analysis of Bermuda health system indicators.

The report follows a model developed by the Organization for Economic Cooperation and Development (OECD), benchmarking Bermuda against high-income countries on 76 different indicators; among them, cancer. And the findings support those of the 2004 cancer study.

This article summarizes some of the cancer findings in the Health in Review report.

Cancer mortality overall

The number of people dying of cancer went down between 2000 and 2007. The rates varied between different types of cancer, but overall mortality decreased. In addition, people are less likely to die of cancer in Bermuda, compared to other high-income countries.

Bermuda’s overall cancer mortality ranks eigth out of the 30 countries compared, and well below the OECD average.

More men die of cancer than women.

Lung cancer

Lung cancer paints a different picture, however. we seem to do okay for women, but not so well for men.

In men, mortality from lung cancer is comparatively high in Bermuda, and we’re among the poorest four performers compared to other countries. Lung cancer mortality among women is on par with the OECD average, and lower than the US, Canada and UK. But for men we rank with the Czech Republic, Slovak Republic, Poland and Hungary.

Prostate cancer

Bermuda’s prostate cancer mortality is higher than all of the OECD countries.

There are few known risk factors for prostate cancer, but black men have a much greater risk of being diagnosed or dying from prostate cancer than men of other races/ethnicities. Bermuda’s comparatively high rate may be due to the higher proportion of black men in our population.

Breast cancer

Breast cancer mortality, however, has been declining over the past decade, and is lower in Bermuda than in most high-income countries.

We are among the best performers, sharing fifth place with Norway.

This is likely due, in part, to the high take-up of mammography screening, a practice in which Bermuda ranks second compared to other countries.

Cervical cancer

Cervical cancer is not a common cause of death in Bermuda, but is among the cancers most effectively controlled by screening. Bermuda’s cervical cancer mortality is lower than the OECD average, and, like breast cancer, our screening rates are very high.

This is one area where Bermuda shows exemplary performance.

Although high-income women are more likely to be screened for cervical cancer than lower-income women overall, this disparity is reduced in women aged 25-64.

In fact, in this age group, low-income women report almost the same rate of screening, as high-income women in the next-highest OECD countries.

Adding value

One of the key functions of BHeC is to make available such information to the public. This is vital to identifying the strengths and weaknesses in our health system, and it’s essential for developing policy solutions.

After all, if we produce policies based on anecdotes and perceptions, we are bound to miss the target. A sound evidence base is the vital element that makes all the difference.

Both reports discussed here are available on the Bermuda Health Council web site at www.bhec.bm.  You will find “Health in Review” under Reports & Publications, and “Cancer in Bermuda” under Health Statistics.