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. 2021 Jul:7:1101-1109.
doi: 10.1200/GO.21.00065.

Cancer Registration in the Middle East, North Africa, and Turkey: Scope and Challenges

Zahi Abdul-Sater  1 , Ali Shamseddine  2 , Ali Taher  2 , Fouad Fouad  3 , Ghassan Abu-Sitta  1   4 , Ibtihal Fadhil  5 , Raya Saab  6 , Richard Sullivan  7 , Salim M Adib  3 , Shadi Saleh  1   3 , Deborah Mukherji  1   2 ; ICRIM
Affiliations

Cancer Registration in the Middle East, North Africa, and Turkey: Scope and Challenges

Zahi Abdul-Sater et al. JCO Glob Oncol. 2021 Jul.

Abstract

Purpose: National cancer control strategies have been identified as essential tools for reducing and managing the growing burden of cancer in low- and middle-income countries. Cancer registration is an instrumental component of any cancer control strategy, providing the data to inform effective cancer policy. In the Middle East, North Africa, and Turkey (MENAT) region, cancer registration varies immensely and faces multifaceted challenges including protracted conflict. This study investigates and maps out the present capacities and outputs of cancer registration in the MENAT region and identifies thematic barriers facing implementation and utilization of cancer registry data.

Materials and methods: We used a self-administered online survey with open and close-ended questions targeting national and institutional cancer registry managers in the MENAT countries.

Results: Registry managers from 19 MENAT countries reported the presence of 97 population-based, 48 hospital-based, and 24 pathology-based registries. Most population-based registries were well- or partially developed. Lack of accurate death records, complete medical records, and communication between stakeholders and deficiencies in trained personnel were critical challenges that were more severe in active conflict zones and neighboring conflict-affected regions. Cancer registration challenges included weak health infrastructure, absence of legislation mandating cancer registration, and disruption of cancer registration because of active conflict and loss of funding. Refugee host countries, such as Lebanon, Turkey, and Jordan, also reported conflict-related challenges including refugee mobility and lack of accurate data on forced migrants.

Conclusion: This study provides a much-needed understanding of the current landscape and contextual challenges affecting cancer registration in the MENAT. These data are important for identifying areas on which to focus regional capacity-strengthening initiatives.

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Conflict of interest statement

Ali ShamseddineConsulting or Advisory Role: BayerSpeakers' Bureau: Novartis, Sanofi, Merck, MSD, Amgen, Bayer, PfizerResearch Funding: Bristol Myers Squibb, Merck, Bristol Myers Squibb/MedarexTravel, Accommodations, Expenses: Amgen, MSD, Merck, Algorithm SAL Richard SullivanHonoraria: PfizerConsulting or Advisory Role: Pfizer Deborah MukherjiHonoraria: Novartis, Roche, Merck, Bristol Myers Squibb, Pfizer, Astellas Pharma, AstraZenecaConsulting or Advisory Role: MSD Oncology, Pfizer, Bristol Myers Squibb, Astellas PharmaResearch Funding: Bristol Myers Squibb, Merck Serono, NovartisTravel, Accommodations, Expenses: Amgen, Merck SeronoNo other potential conflicts of interest were reported.

Figures

FIG 1
FIG 1
Scope and challenges of cancer registration in the MENAT. (A) Status of cancer registries in the MENAT. (B) Cancer registration challenges in the MENAT. (C) Properties of cancer registries in the MENAT. MENAT, Middle East, North Africa, and Turkey.
FIG 2
FIG 2
Cancer registration in conflict-affected countries in the MENAT region. (A) Status of cancer registries in conflict. (B) Cancer registration challenges in the MENAT. (C) Properties of cancer registries in the MENAT. MENAT, Middle East, North Africa, and Turkey.
FIG A1
FIG A1
(A) MENAT PBCR that are voting or associate members in the IACR. Data extracted from IACR website on May 15, 2020. (B) Cancer registries in the MENAT region that are published in different volumes of CI5. Circle size corresponds to the number of registries published in the CI5 volume. CI5, Cancer Incidence in Five Continents; IACR, International Association of Cancer Registries; KSA, Kingdom of Saudi Arabia; MENAT, Middle East, North Africa, and Turkey; PBCR, population-based cancer registry; UAE, United Arab Emirates.
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