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Znaor A, Eser S, Bendahhou K, Shelpai W, Al Lawati N, ELBasmi A, Alemayehu EM, Tazi MA, Yakut C, Piñeros M. Stage at diagnosis of colorectal cancer in the Middle East and Northern Africa: A population-based cancer registry study. Int J Cancer 2024; 155:54-60. [PMID: 38456478 DOI: 10.1002/ijc.34895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 01/29/2024] [Accepted: 01/30/2024] [Indexed: 03/09/2024]
Abstract
Colorectal cancer (CRC) is the 2nd most common cancer and 3rd most common cause of death in the Middle East and Northern Africa (MENA) region. We aimed to explore CRC stage at diagnosis data from population-based cancer registries in MENA countries. In 2021, we launched a Global Initiative for Cancer Registry Development (GICR) survey on staging practices and breast and CRC stage distributions in MENA. According to the survey results, population-based data on TNM stage for CRC were available from six registries in five countries (Kuwait, Morocco, Oman, Türkiye, UAE). The proportion of cases with unknown TNM stage ranged from 14% in Oman to 47% in Casablanca, Morocco. The distribution of CRC cases with known stage showed TNM stage IV proportions of 26-45%, while the proportions of stage I cancers were lowest in Morocco (≤7%), and highest (19%) in Izmir, Türkiye. Summary extent of disease data was available from six additional registries and four additional countries (Algeria, Bahrain, Iraq, Qatar). In summary, the proportions of CRC diagnosed with distant metastases in Oman, Bahrain and UAE were lower than other MENA countries in our study, but higher than in European and the US populations. Harmonising the use of staging systems and focusing stage data collection efforts on major cancers, such as CRC, is needed to monitor and evaluate progress in CRC control in the region.
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Affiliation(s)
- Ariana Znaor
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France
| | - Sultan Eser
- Faculty of Medicine, Balikesir University, Balikesir, Türkiye
| | | | - Wael Shelpai
- National Cancer Registry, Dubai, United Arab Emirates
| | | | - Amani ELBasmi
- Kuwait National Cancer Registry, Kuwait City, Kuwait
| | | | | | - Cankut Yakut
- Izmir Provincial Cancer Registry, Izmir, Türkiye
| | - Marion Piñeros
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France
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Mohammad BF, Andsoy II. Health behaviors, knowledge, screening, and attitudes toward colorectal cancer among Iraqi adults. Public Health Nurs 2024; 41:514-524. [PMID: 38475879 DOI: 10.1111/phn.13302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 02/20/2024] [Accepted: 02/21/2024] [Indexed: 03/14/2024]
Abstract
OBJECTIVE This study aimed to evaluate the Iraqi population's health behaviors, knowledge, screening, attitudes toward colorectal cancer (CRC), and possible predictors that may affect their knowledge level. DESIGN Cross-sectional study. SAMPLE One thousand three hundred sixty-one Iraqi adults from Sulaymaniyah/Iraq. MEASUREMENTS The odds ratio (OR) was used to find the association between knowledge of CRC and associated factors. RESULTS Among participants, 6.1% had a colonoscopy, 4.0% had a sigmoidoscopy, and 60.8% heard CRC screening. Participants had low knowledge level of CRC risk factors (5.52 ± 1.39), and symptoms (3.73 ± 1.16) and had a medium knowledge of screening (4.35 ± 1.02). Respondents who retired (OR = 1.30; p = .00) and who had graduated from university (OR = 0.86; p = .01) had a high knowledge of CRC, while those who were aged 70 and above (OR = -1.08; p = .00) had a low knowledge of CRC. Furthermore, it was found that Iraqi adults who answered "no idea" to questions related to attitude and who answered incorrectly questions related to risk factors were likely to have low knowledge (p = .00). CONCLUSIONS We found a lack of knowledge, screening, and misconceptions about CRC and screening among Iraqi adults. Thus, health training and screening programs should target Iraqi populations.
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Al-Shamsi HO, Abu-Gheida I, Sameh K, Tahoun NE, Musallam KM. Arab Countries and Oncology Clinical Trials: A Bibliometric Analysis. Cancers (Basel) 2023; 15:4428. [PMID: 37760398 PMCID: PMC10526906 DOI: 10.3390/cancers15184428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 08/29/2023] [Accepted: 08/30/2023] [Indexed: 09/29/2023] Open
Abstract
The increasing cancer burden is a major health concern in Arab countries with cross-regional variations in cancer profiles. Given the limited oncology research output and scarce data on cancer trial participation in the Arab region, this study explored the therapeutic cancer trial landscape in Arab countries over the past 20 years. A bibliometric analysis of the PubMed database was conducted on primary publications of therapeutic trials with a participating Arab center. Arab countries participated in 320 published cancer-related therapeutic trials (2000-2021). During this period, there was a consistent increase in the number of trials, sample size, multiregional site participation, and number of randomized trials. However, most trials were small, did not receive external funding, and included a single Arab site. Compared with Arab-only trials, trials with joint non-Arab sites were larger (p = 0.003) and more likely to be externally funded (p < 0.001). Citation numbers and journal impact factors were higher in trial publications with joint non-Arab authorship than those without (p < 0.001, for both). Despite improving conduct and publication records of oncology trials with Arab centers, cancer trial participation remains limited in Arab countries. Concerted efforts are required to encourage sponsorship and international collaboration in this region.
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Affiliation(s)
- Humaid O. Al-Shamsi
- Burjeel Cancer Institute, Burjeel Medical City, Abu Dhabi P.O. Box 92510, United Arab Emirates; (I.A.-G.); (K.M.M.)
- College of Medicine, Gulf Medical University, Ajman P.O. Box 4184, United Arab Emirates
- Emirates Oncology Society, Dubai P.O. Box 6600, United Arab Emirates
- College of Medicine, University of Sharjah, Sharjah P.O. Box 27272, United Arab Emirates
- Gulf Cancer Society, Alsafa P.O. Box 2311, Kuwait
| | - Ibrahim Abu-Gheida
- Burjeel Cancer Institute, Burjeel Medical City, Abu Dhabi P.O. Box 92510, United Arab Emirates; (I.A.-G.); (K.M.M.)
| | - Kareem Sameh
- Pfizer Gulf FZ LLC, Dubai Media City, Dubai P.O. Box 502749, United Arab Emirates; (K.S.); (N.E.T.)
| | - Nouran E. Tahoun
- Pfizer Gulf FZ LLC, Dubai Media City, Dubai P.O. Box 502749, United Arab Emirates; (K.S.); (N.E.T.)
| | - Khaled M. Musallam
- Burjeel Cancer Institute, Burjeel Medical City, Abu Dhabi P.O. Box 92510, United Arab Emirates; (I.A.-G.); (K.M.M.)
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Piñeros M, Ginsburg O, Bendahhou K, Eser S, Shelpai WA, Fouad H, Znaor A. Staging practices and breast cancer stage among population-based registries in the MENA region. Cancer Epidemiol 2022; 81:102250. [PMID: 36115143 PMCID: PMC9693698 DOI: 10.1016/j.canep.2022.102250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 08/25/2022] [Accepted: 09/05/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Availability of stage information by population-based cancer registries (PBCR) remains scarce for diverse reasons. Nevertheless, stage is critical cancer control information particularly for cancers amenable to early detection. In the framework of the Global Initiative for Cancer Registry Development (GICR), we present the status of stage data collection and dissemination among registries in the Middle East and Northern Africa (MENA) region as well as the stage distribution of breast cancer patients. METHODS A web-based survey exploring staging practices and breast cancer stage was developed and sent to 30 PBCR in 18 countries of the MENA region. RESULTS Among 23 respondent PBCR, 21 collected stage data, the majority (80%) for all cancers. Fourteen registries used a single classification (9 TNM and 5 SEER), 7 used both staging systems in parallel. Out of 12,888 breast cancer patients (seven registries) 27.7% had unknown TNM stage (11.1% in Oman, 46% in Annaba). When considering only cases with known stage, 65.3% were early cancers (TNM I+II), ranging from 57.9% in Oman to 83.3% in Batna (Algeria), and 9.9% were stage IV cancers. Among the nine registries providing SEER Summary stage for breast cancer cases, stage was unknown in 19% of the cases, (0 in Bahrain, 39% in Kuwait). Stage data were largely absent from the published registry reports. CONCLUSION Despite wide stage data collection by cancer registries, missing information and low dissemination clearly limit informing efforts on early detection. The use of two classification systems in parallel implies additional workload and might undermine completeness. The favourable results of early cancer (TNM I+II) in two thirds of breast cancer patients needs to be interpreted with caution and followed up in time. Although efforts to improve quality of stage data are needed, our findings are particularly relevant to the WHO Global Breast Cancer Initiative.
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Affiliation(s)
- Marion Piñeros
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France.
| | - Ophira Ginsburg
- Center for Global Health, US National Cancer Institute, MD, USA
| | | | - Sultan Eser
- Balıkesir University, Faculty of Medicine, Balikesir, Turkey
| | | | - Heba Fouad
- WHO Regional Office for the Eastern Mediterranean, Cairo, Egypt
| | - Ariana Znaor
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France
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Alkhalawi E, Znaor A, Al-Zahrani AS. Quality of data from cancer registries in the Eastern Mediterranean region. Lancet Oncol 2022; 23:449-451. [PMID: 35358450 DOI: 10.1016/s1470-2045(22)00072-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 01/26/2022] [Indexed: 01/02/2023]
Affiliation(s)
- Eman Alkhalawi
- Department of Family and Community Medicine, King Abdulaziz University, Jeddah 21589 Saudi Arabia.
| | - Ariana Znaor
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France
| | - Ali Saeed Al-Zahrani
- Gulf Centre for Cancer Control and Prevention, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
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Fadhil I, Alkhalawi E, Nasr R, Fouad H, Basu P, Camacho R, Alsaadoon H. National cancer control plans across the Eastern Mediterranean region: challenges and opportunities to scale-up. Lancet Oncol 2021; 22:e517-e529. [PMID: 34735820 DOI: 10.1016/s1470-2045(21)00410-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 07/07/2021] [Accepted: 07/12/2021] [Indexed: 12/15/2022]
Abstract
National cancer control planning is crucial for countries in the WHO Eastern Mediterranean region. This region is challenged with an increase in cancer incidence leading to substantial disease burden, premature deaths, and increasing health-care costs in most countries. Huge inequity in cancer control planning and implementation exists between and within the countries. Over half of the countries (12 [55%] of 22) have standalone comprehensive National Cancer Control Plans and six (27%) have non-communicable disease plans that include cancer. The implementation of cancer plans has common challenges related to weak governance structure, few coordination mechanisms within countries, and inadequate human and financial resources. In most countries, the plan is not costed. Yet, the majority of countries (20 [91%]) reported having fully or partially funded plans. Additionally, political instability and conflicts affecting over half of the countries in the Eastern Mediterranean region have enormously affected cancer planning and implementation, both among the affected countries and those that host large numbers of refugees. In this Policy Review, we used the WHO regional framework for action on cancer to systematically analyse the status of cancer control planning and implementation across the six domains of cancer control, from prevention to palliation. We highlight the gaps, and the opportunities for bridging these gaps, to achieve scale-up on implementation of cancer control programmes in the Eastern Mediterranean region.
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Affiliation(s)
- Ibtihal Fadhil
- The Eastern Mediterranean NCD Alliance, Kuwait City, Kuwait.
| | - Eman Alkhalawi
- Department of Family and Community Medicine, King Abdulaziz University, Jeddah, Saudi Arabia; Cancer Survival Group, Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Rihab Nasr
- Department of Anatomy, Cell Biology and Physiology, Faculty of Medicine, Cancer Prevention and Control Program, Naef K Basile Cancer Institute, American University of Beirut, Beirut, Lebanon
| | - Heba Fouad
- NCD Surveillance Unit, WHO, Regional Office for the Eastern Mediterranean, Cairo, Egypt
| | - Partha Basu
- Early Detection, Prevention, and Infections Branch, International Agency for Research on Cancer, WHO, Lyon, France
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