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Cancer in the Arab World: Magnitude of the Problem

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NHL Low SES, malnutrition, parasitic & viral infections (Epstein-Barr) ... NHL. Qatar. Oman. Bahrain. UAE. KSA. Most Common Cancer Sites among Females. Uterus. Uterus ... – PowerPoint PPT presentation

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Title: Cancer in the Arab World: Magnitude of the Problem


1
Cancer in the Arab World Magnitude of the Problem
  • Inas Elattar, DrPH
  • Professor of Biostatistics
  • Department of Biostatistics Epidemiology
  • NCI, Egypt
  • APHA
  • November, 2004

2
Introduction
  • Cancer incidence in Arab countries is increasing.
    This is due partly to
  • Reduction in the incidence of infectious diseases
  • Increase in the population average age
  • Westernization of social and dietary habits
  • Increase smoking
  • Increase of the incidence of hepatitis B and C
  • Wrong use of plastic materials, pesticides and
    insecticides
  • Low socioeconomic status

3
Cancer Databases in Arab World
Yemen
National Cancer Registry
Regional Cancer Registry
No Registry
4
Source of Data
  • National Population-based Cancer Registries
  • Gulf Center for Cancer Registration, 2000
  • Qatar, Oman, Bahrain, and UAE
  • Saudi Arabia, 1999-2000
  • Kuwait, 2001
  • Jordan, 1999
  • Regional Population-based Cancer Registries
  • Egypt Gharbiah 1999
  • Algeria Algiers, Constantine, Oran, Setif,
    Globocan 2002
  • Tunisia Tunis, Sousse, Sfax, Globocan 2002
  • All others Globocan 2002, IARC

5
Age-Adjusted Incidence Rates in Arab World, Males
121
180
166
180
96
180
114
123
72
123
88
154
99
60
81
99
178
123
102
178
178
178
Rates/100,000
6
Age-Adjusted Incidence Rates in Arab World,
Females
120
167
159
167
87
216
78
118
77
127
90
85
137
61
94
89
176
118
84
176
176
176
Rates/100,000
7
Male to Female Ratio, All Cancer Sites
8
ASR of Stomach Cancer in Arab World
9
ASR of Colorectal Cancer in Arab World
10
ASR of Liver Cancer in Arab World
11
Relative Frequency of Liver Cancer, NCI - Egypt
1975-2002
12
Egypt Mortality Statistics, 2001 Most common
sites (The Cancer Database, 2001)
13
Trend of HCC Mortality in Egypt, 1981-1996
14
ASR of Lung Cancer in Arab World
15
Prevalence of Smoking in Arab World
16
ASR of Prostate Cancer in Arab World
17
ASR of Bladder Cancer in Arab World
18
Histological Type of Bladder Cancer
  • The first differential pattern which
    characterizes bilharzial bladder cancer is the
    histological type of the tumor
  • SCC type is the most frequent type of cancer in
    countries with a high prevalence of
    schistosomiasis
  • SCC type is rare in industrialized countries
  • TCC type is considered typical for chemically
    induced bladder cancer
  • TCC type is low in areas with schistosomiasis

19
Changing Pattern of Bladder Cancer Type, NCI
1975-2002
20
ASR of Lymphomas in Arab World
21
Age Specific Incidence Rates (ASIR) of Lymphoma
in Selected Arab Countries (Males)
22
ASR of Leukemias in Arab World
23
ASR of Breast Cancer in Arab World (Females)
24
Age Specific Incidence Rates (ASIR) of Breast in
Selected Arab Countries (Females)
25
ASR of Cervical Cancer in Arab World
26
ASR of Cancer of Uterus in Arab World
27
ASR of Cancer of Ovary in Arab World
28
Cancer in Arab World Main conclusions
  • Lung High prevalence of smoking
  • Liver Endemicity of hepatitis B C
  • Bladder Smoking, Schistosoma
  • NHL Low SES, malnutrition, parasitic viral
    infections (Epstein-Barr)
  • Prostate Increasing with aging population
  • Breast Leading cancer similar to developed
    countries, present at younger age
  • Cervix High in Algeria, 50 of cases are
    diagnosed in late stage

29
Most Common Cancer Sites among Males
30
Most Common Cancer Sites among Males
31
Most Common Cancer Sites among Females
32
Most Common Cancer Sites among Females
33
National Cancer Institute, Cairo, Egypt
34
National Cancer Institute, Cairo, Egypt
  • The National Cancer Institute (NCI) is the
    largest comprehensive cancer center in Egypt
  • The present hospital with its 550 beds is
    overloaded by patients referred from allover the
    country
  • During the years 2001-2002 38,400 new patients
    visited the NCI
  • 19,568 (51) were malignant cases
  • Half of the cases were males
  • 11 were children, less than or equal to 18 years
  • About 54 of the cases were between the ages 41
    through 65 years

35
19,568 New Cancer Cases by Systems, NCI 2001-2002
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