1
|
Bencina G, Ugrekhelidze D, Shoel H, Oliver E, Meiwald A, Hughes R, Eiden A, Weston G. The indirect costs of vaccine-preventable cancer mortality in the Middle East and North Africa (MENA). J Med Econ 2024; 27:1036-1045. [PMID: 39046303 DOI: 10.1080/13696998.2024.2384264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2024] [Revised: 07/19/2024] [Accepted: 07/22/2024] [Indexed: 07/25/2024]
Abstract
BACKGROUND Infections are responsible for ∼13% of cancer cases worldwide, with human papillomavirus (HPV) and hepatitis B (HBV) among the infections associated with cancer for which vaccines are available. The aim of this study was to estimate the indirect cost of premature mortality related to cancers caused by HPV and HBV in Middle East and North Africa (MENA) countries. METHODS The number of deaths and years of life lost (YLL) in 2019 from four HPV-related cancers: cervical cancer, oral cavity cancer, laryngeal cancer, and oropharynx cancer, as well as HBV-related liver cancer were sourced from the Institute for Health Metrics Evaluation (IHME) Global Burden of Disease database. HPV-attributable fractions were applied to deaths and YLL. The human capital approach was used to measure productivity loss, through value of YLL (VYLL), and estimated using gross domestic product per capita (World Bank; in USD). Seventeen countries in the MENA region were included. Four countries in the region were not included due to data availability. RESULTS In 2019, there were 11,645 potentially vaccine-preventable cancer-related deaths across the MENA region. This resulted in an indirect cost of $1,688,821,605, with 76.1% of this accrued in the Middle East ($1,284,923,633). The number of deaths in the Middle East (5,986) were similar to Northern Africa (5,659) but YLL were higher in Northern Africa (179,425) compared to the Middle East (169,207). The highest indirect cost per death occurred in Qatar ($1,378,991), compared to $14,962 in Sudan. Oral cavity cancer had the highest VYLL per death ($186,084). CONCLUSIONS There is a high burden of premature mortality and indirect costs of potentially vaccine-preventable cancer-related deaths in the MENA region. Improved vaccination program implementation, increased vaccine coverage of HPV and HBV vaccinations, and continued prioritization of public health measures, such as screening, could effectively reduce premature mortality and associated costs.
Collapse
Affiliation(s)
- Goran Bencina
- Center for Observational and Real-World Evidence, Madrid, Spain
| | | | | | | | | | | | - Amanda Eiden
- Center for Observational and Real-World Evidence, Merck & Co., Inc., Rahway, NJ, USA
| | | |
Collapse
|
2
|
Lakkis NA, Abdallah RM, Musharrafieh UM, Issa HG, Osman MH. Epidemiology of Breast, Corpus Uteri, and Ovarian Cancers in Lebanon With Emphasis on Breast Cancer Incidence Trends and Risk Factors Compared to Regional and Global Rates. Cancer Control 2024; 31:10732748241236266. [PMID: 38419342 PMCID: PMC10903209 DOI: 10.1177/10732748241236266] [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: 08/07/2023] [Revised: 01/22/2024] [Accepted: 02/08/2024] [Indexed: 03/02/2024] Open
Abstract
OBJECTIVES This study explores the incidence and trends of breast (Bca), corpus uteri (CUca), and ovarian (Oca) cancer in Lebanon, a Middle Eastern country. It compares the Bca rates to regional and global ones and discusses Bca risk factors in Lebanon. INTRODUCTION Globally, Bca is the premier cause of cancer morbidity and mortality in women. METHODS Data on female Bca, CUca, and Oca published by the Lebanese national cancer registry were obtained (ie, for the years of 2005 to 2016). The age-standardized incidence rates (ASIRw) and age-specific rates per 100,000 female population were computed. RESULTS From 2005 to 2016, Bca, Oca, and CUca ranked first, sixth, and seventh, respectively, for cancer incidence among women in Lebanon. Bca alone accounted for 39.4% of all new female cancer cases. The ASIRw increased significantly for Bca and CUca (APC: 3.60 and 3.73, P < .05) but not for Oca (APC: 1.27, P > .05). The Bca ASIRw (per 100,000) increased significantly from 71.0 in 2005 to 115.6 in 2013 (P < .05), then decreased steadily but non-significantly to reach 96.8 in 2016 (P > .05). Lebanon's Bca ASIRw is comparable to developed countries. This may reflect altered sociological and reproductive patterns as the country transitions from regional to global trends. The five-year age-specific rates analysis revealed that Bca rates rose steeply from 35-39 to 50-54, dropped slightly between 55 and 64, then rose till 75+. The five-year age-specific rates between 35 and 54 among Lebanese women were amongst the highest worldwide from 2008 to 2012, even higher than the rates in Belgium, which had the highest ASIRw of Bca worldwide in 2020. CONCLUSION Lebanon's Bca ASIRw is among the highest globally. It's important to investigate the contributing factors and develop a national Bca control strategy. This study supports the national recommendation in initiating Bca screening at age 40 for women.
Collapse
Affiliation(s)
- Najla A. Lakkis
- Department of Family Medicine, American University of Beirut Medical Center (AUBMC), Beirut, Lebanon
| | - Reem M. Abdallah
- Department of Obstetrics and Gynecology, American University of Beirut Medical Center (AUBMC), Beirut, Lebanon
| | - Umayya M. Musharrafieh
- Department of Family Medicine, American University of Beirut Medical Center (AUBMC), Beirut, Lebanon
| | - Hanane G. Issa
- Institute of Health Informatics, University College London, London, UK
| | - Mona H. Osman
- Department of Family Medicine, American University of Beirut Medical Center (AUBMC), Beirut, Lebanon
| |
Collapse
|
3
|
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.
Collapse
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.)
| |
Collapse
|
4
|
Nejadghaderi SA, Kolahi AA, Noori M, Sullman MJM, Safiri S. The burden of pancreatic cancer and its attributable risk factors in the Middle East and North Africa region, 1990-2019. J Gastroenterol Hepatol 2023; 38:1535-1545. [PMID: 37218385 DOI: 10.1111/jgh.16217] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 04/07/2023] [Accepted: 05/03/2023] [Indexed: 05/24/2023]
Abstract
BACKGROUND AND AIM Globally, pancreatic cancer is recognized as one of the most lethal types of cancers. We report the burden of pancreatic cancer and its attributable risk factors in the Middle East and North Africa (MENA) region, from 1990 to 2019, by age, sex, and socio-demographic index. METHODS Publicly available data from the Global Burden of Disease 2019 study were used to report the incidence, deaths, and disability-adjusted life years (DALYs) attributable to pancreatic cancer, as counts and age-standardized rates with 95% uncertainty intervals. RESULTS In 2019, pancreatic cancer had an age-standardized incidence rate of 5.3 and a death rate of 5.5 (per 100 000) in MENA, which have increased by 97.5% and 93.4%, respectively, since 1990. There were 563.6 thousand DALYs attributable to pancreatic cancer in 2019, with an age-standardized DALY rate of 123.0, which has increased by 84.9% since 1990. The highest number of incident cases was found in the 60-64 and 65-69 age groups, among male and female, respectively. In addition, the MENA/global DALY ratios were higher in all age groups for both sexes in 2019, than they were in 1990. There was a positive association between socio-demographic index and the burden of pancreatic cancer. Smoking, high fasting plasma glucose, and high body mass index were responsible for 19.2%, 9.3%, and 9.3% of the attributable DALYs in 2019, respectively. CONCLUSIONS There was a clear and substantial increase in the burden of pancreatic cancer in the MENA region. Prevention programs should be implemented in the region that target these three risk factors.
Collapse
Affiliation(s)
- Seyed Aria Nejadghaderi
- Research Center for Integrative Medicine in Aging, Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
- School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali-Asghar Kolahi
- Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Noori
- Student Research Committee, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Mark J M Sullman
- Department of Life and Health Sciences, University of Nicosia, Nicosia, Cyprus
- Department of Social Sciences, University of Nicosia, Nicosia, Cyprus
| | - Saeid Safiri
- Hematology and Oncology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Community Medicine, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| |
Collapse
|
5
|
Tolba M, Skelton M, Abdul Sater Z, Fadhil I, Al-Zahrani A, Kutluk T, Akbarov K, Taher A, Sullivan R, Mula-Hussain L. Cancer Research in Vulnerable Populations: A Call for Collaboration and Sustainability From MENAT Countries. JCO Glob Oncol 2023; 9:e2300201. [PMID: 38096463 PMCID: PMC10730041 DOI: 10.1200/go.23.00201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Revised: 09/23/2023] [Accepted: 10/24/2023] [Indexed: 12/18/2023] Open
Abstract
PURPOSE Cancer is a major burden across Middle East, North Africa, Türkiye (MENAT). Many MENAT countries experience multiple conflicts that compound vulnerabilities, but little research investigates the linkages between vulnerability and cancer research. This study examines the current level and the potential for cancer research among vulnerable populations in the MENAT region, aiming to provide direction toward developing a research agenda on the region's vulnerable populations. METHODS Expert-driven meetings were arranged among the 10 authors. After obtaining institutional review board approval, a self-administered online survey questionnaire was circulated to more than 500 cancer practitioners working in 22 MENAT countries. RESULTS Two hundred sixteen cancer practitioners across the MENAT region responded. Fifty percent of the respondents identified clinical research in vulnerable patients with cancer as a significant issue; 21.8% reported previous research experience that included vulnerable populations, and 60% reported encountering vulnerable populations in their daily clinical practice. The main barriers to conducting research were lack of funding (60%), protected time (42%), and research training (35%). More than half of the respondents believed that wars/conflicts constituted an important source of vulnerability. The most vulnerable cancer populations were the elderly, palliative/terminally ill, those with concomitant mental health-related issues, those with other chronic illnesses, and socioeconomically deprived patients. CONCLUSION Results support that a major effort is needed to improve cancer research among vulnerable cancer populations in the MENAT region. We call for interdisciplinary research that accounts for the region's unique, compounding, and cumulative forms of vulnerability. This cancer research agenda on different vulnerable populations must balance sociobehavioral studies that explore sociopolitical barriers to quality care and clinical studies that gauge and refine treatment protocols. Building a research agenda through collaboration and solidarity with international partners is prime time.
Collapse
Affiliation(s)
- Marwan Tolba
- Department of Radiation Oncology, Dalhousie University, and Cape Breton Cancer Center, Sydney, Nova Scotia, Canada
| | - Mac Skelton
- Institute of Regional and International Studies, American University of Iraq, Sulaimani, Iraq
- Global Oncology Group, King's College London, London, United Kingdom
| | - Zahi Abdul Sater
- College of Public Health, Phoenicia University, Mazraat El Daoudiyeh, Lebanon
- Global Health Institute, American University of Beirut, Beirut, Lebanon
| | - Ibtihal Fadhil
- Eastern Mediterranean NCD Alliance, Dubai, United Arab Emirates
| | - Ali Al-Zahrani
- King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
- Gulf Center for Cancer Control & Prevention, Riyadh, Saudi Arabia
| | - Tezer Kutluk
- Department of Pediatrics, Division of Pediatric Oncology, Hacettepe University Faculty of Medicine & Cancer Institute, Ankara, Turkey
| | - Kamal Akbarov
- Division of Human Health, International Atomic Energy Agency, Vienna, Austria
| | - Ali Taher
- Hematology & Oncology, Naef K. Basile Cancer Institute, American University of Beirut Medical Center, Beirut, Lebanon
| | - Richard Sullivan
- King's College London & Guy's Comprehensive Cancer Centre, Global Oncology Group & Institute of Cancer Policy, Centre for Conflict & Health Research, London, United Kingdom
| | - Layth Mula-Hussain
- Department of Radiation Oncology, Dalhousie University, and Cape Breton Cancer Center, Sydney, Nova Scotia, Canada
- College of Medicine—Ninevah University, Mosul, Iraq
| |
Collapse
|