The United States Virgin Islands (USVI) is a U.S. territory located in the Caribbean Sea approximately 1,100 miles south-east of Florida. The 2020 Census reported a population of 87,146, almost evenly distributed between the two largest inhabited islands of St. Croix and St. Thomas, with smaller populations on St. John and Water Island. Most of the population identifies as Black/African American, with a small percentage of Hispanic and Haitian Creole residents. The poverty rate in the USVI is 32.5%, and approximately 20% of the population lack health insurance. The US Virgin Islands Department of Health (VIDOH) functions as both the state regulatory agency and territorial public health agency (VI Code Titles 3 & 19) with direct responsibility for conducting programs of preventive medicine, including special programs in Chronic Disease Prevention and Management and Family Planning, among others.
The VI Breast and Cervical Cancer Early Detection Program (VI-BCCEDP) will build on the current infrastructure to increase access to breast and cervical cancer screening services currently provided within the Title X-Family Planning Program (VIFPP). Current services include breast and cervical cancer screening, early detection, and diagnostic and treatment referral services toward the goal of reducing the burden of these cancers among women and their families in the territory. The VI-BCCEDP will offer innovative and high-quality breast and cervical cancer screening, early detection, diagnostic and treatment referral services with priority given to individuals from low-income families and populations disproportionately burdened by breast or cervical cancer (i.e., populations of focus).
The VI-National Comprehensive Cancer Control Program (VI-NCCCP) will expand and restructure the existing Cancer Control Coalition (CCC) to ensure representation from multisectoral agencies that directly and indirectly influence and impact cancer prevention and treatment in the USVI. The CCC will utilize available data (e.g., incidence, mortality, survivorship, and risk factors) to develop a Comprehensive Cancer Control Plan that will guide how the burden of cancer will be addressed in the USVI. The plan will identify, describe, and prioritize populations who are disproportionately affected by cancer to include populations with increased risk factors and reduced access to screening and early detection services based on socioeconomic status, race/ethnicity, geographic location, and other social determinants of health. The program’s activities will focus on reducing risk factors through prevention education messaging, community outreaches, and the implementation of evidenced-based interventions (EBIs) and increasing the quality of life of cancer survivors. The VI-BCCEDP and VI-NCCCP will collaborate on messaging and the provision of EBIs through its partners.
The V.I. Central Cancer Registry will serve as the support and surveillance component to the VI-BCCEDP and VI-NCCCP, providing data on cancer incidence, patient demographics, treatment, and outcomes. These data will help in the reduction of cancer-related health-disparities among our population by building an accurate understanding of the burden of cancer in our Territory and highlighting areas for further study, supporting the creation of early detection programs, and educating the community on the importance of early screening. The three programs will work collectively to monitor and disseminate data to the CCC, decision makers, and the community; develop cancer screening and health equity goals; and assure program monitoring and evaluation towards continuous quality improvement and program success.