Currently accepted at: JMIR Research Protocols
Date Submitted: Jan 6, 2026
Date Accepted: Jun 3, 2026
This paper has been accepted and is currently in production.
It will appear shortly on 10.2196/90930
The final accepted version (not copyedited yet) is in this tab.
Overseas Care and Cancer Survivorship in Small Island Developing States of the Eastern Caribbean (CaSIDEC): Protocol for a multi-country mixed-methods study
ABSTRACT
Background:
Small Island Developing States (SIDS) make up worldwide, 65 million people. SIDS have some of the highest rates of cancer mortality burden in the developing world. Disparities in cancer mortality could be attributed to reliance on services overseas which is a common feature across SIDS due to limited resources for comprehensive cancer care on-island. Overseas travel for cancer care, remains largely understudied in SIDS, and epidemiological data on the impact on patient outcomes are lacking.
Objective:
We aim to investigate the association with overseas travel for care and known determinants of cancer survivorship (treatment delays, lifestyle and social support) in Caribbean SIDS.
Methods:
We will establish a cohort of 900 cancer survivors residing in the islands of Antigua, Dominica, Grenada, Saint Kitts, Saint Lucia and Saint Vincent. Eligible participants will be adult cancer survivors and having accessed health services in their island of residence due to cancer. Sites for recruitment will be cancer support groups and hospitals/clinics. Surveys will be conducted face-to-face. For every country visited for diagnosis and/or treatment, we will record the services accessed, and motives for the choice of country. In-depth interviews (n=24) and focus groups (n~54 participants) will be conducted with cancer survivors and caregivers to learn about overseas travel and social support systems. Open-ended questions and prompts will assess aspects of the day-to-day logistics and travel arrangements, experience living overseas. We will use an inductive thematic analysis approach to identify and interpret patterns.
Results:
Participant recruitment and data collection have not started. Planning and development to implement the logistics for data collection are ongoing. We envisage active patient recruitment in 2026.
Conclusions:
This is the first investigation on the influence of overseas travel on cancer care in multiple Caribbean SIDS. Our work will produce recommendations to fill performance gaps in the systems for cancer care in the Eastern Caribbean that will improve patients’ lives at multiple phases. It is an important first step to developing data resources for high-quality research in understudied SIDS. Clinical Trial: None
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