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. 2023 Mar 23:13:1083836.
doi: 10.3389/fonc.2023.1083836. eCollection 2023.

The state of cancer research in fragile and conflict-affected settings in the Middle East and North Africa Region: A bibliometric analysis

Zahi Abdul Sater  1 , Theresa Farhat  1 , Mohamed N Elsayed  1 , Yara Youssef  2 , Marium Husain  3 , Malak Kaddoura  1 , Lubna Jaber  1 , Deborah Mukherji  4 , Ali Taher  4
Affiliations

The state of cancer research in fragile and conflict-affected settings in the Middle East and North Africa Region: A bibliometric analysis

Zahi Abdul Sater et al. Front Oncol. .

Abstract

Background: Cancer represents a disproportionate burden in LMICs, especially conflict-affected countries in the MENA region. Research output on cancer fails to match the growing burden in the region. This bibliometric study aims to examine the status and trends of cancer research in fragile and conflict-affected settings in the MENA region from 2000 to 2021, while also incorporating economic and demographic indicators as additional factors of analysis.

Methods: The Web of Science databases were searched for publications related to cancer research in Iraq, Lebanon, Libya, Palestine, Syria, and Yemen from January 1, 2000, to December 31, 2021. The retrieved publications were screened based on preset eligibility criteria and the final list was analyzed using the Bibliometrix Package in R to generate the annual scientific production and citations, journals, institutions, authors, collaborations, keywords, and title co-occurrence. Each country's annual scientific production was analyzed against its annual GDP per capita.

Results: A total of 4,280 documents met the inclusion criteria in this research. The annual number of publications revealed a significant increase over the past 20 years. These publications were mostly published in international journals that had impact factors rated in the 3rd or 4th quartiles. The overall contribution of researchers from Fragile and Conflict-Affected Settings (FCS) to cancer research was 6.5% of the MENA cancer research productivity, despite comprising around 23% of the total MENA region's population. Lebanon had the highest publication productivity at the country level, followed by Iraq and Syria. GDP per capita was not significantly correlated with cancer research across the countries under investigation. At the institutional level, the American University of Beirut was the most prolific institution and had the highest number of collaborations and the widest range of cooperative partners. Most first authors were male researchers. There is an interest in cancer expression, prevalence, diagnosis, and management in terms of commonly researched topics.

Conclusion: This study underscores the need for a concerted effort to improve cancer research outcomes in FCS, which can be achieved through targeted research, increased investment in research infrastructure and capacity-building initiatives, and greater regional and global collaboration.

Keywords: Arab world; MENA region; bibliometric; cancer research; conflict settings.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Annual number of cancer research publications in FCS in the MENA region from 2000 to 2021.
Figure 2
Figure 2
The average annual citations of cancer research publications in FCS in the MENA region from 2000 to 2021.
Figure 3
Figure 3
Top 20 most relevant sources by the number of publications on cancer research in FCS in the MENA region from 2000 to 2021.
Figure 4
Figure 4
Country production from 2000 to 2021.
Figure 5
Figure 5
Most relevant affiliations per article on cancer research in FCS in the MENA region from 2000 to 2021. From top to bottom: American University of Beirut, Lebanese University, Saint Joseph University, University of Baghdad, Lebanese American University, Damascus University, Sanaa University, An-Najah National University, Al Nahrain University, University of Basra, Hawler Medical University, University of technology Baghdad, Mustansiriyah University, Beirut Arab University, University of Kufa, University of Aleppo, University of Duhok, University of Balamand, Makassed general hospital, University of Babylon.
Figure 6
Figure 6
Top corresponding authors’ countries on cancer research in FCS countries in the MENA region from 2000 to 2021. SCP stands for single-country publication. MCP stands for multiple-country publication.
Figure 7
Figure 7
(A) Percentage of first authors from FCS compared to non-FCS. Gender distribution of first authors (B) and (C) by FCS.
Figure 8
Figure 8
Country collaboration on cancer research in FCS in the MENA region from 2000 to 2021. The dimensions of the rectangles symbolize the number of cooperative partners, while the font size of the countries shows the number of their collaborations. Additionally, the closeness of the countries’ partnership is reflected by the thickness of the lines. Arrows indicate the FCS countries included in this study.
Figure 9
Figure 9
Co-occurrence network of most frequently used author keywords on cancer research in FCS in the MENA region from 2000 to 2021. The rectangle size reflects the total number of highly cited articles, while the color and thickness of the lines reflect the link clustering and strength, respectively.
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