Gastric cancer in the Arab World: a systematic review

Background: Gastric cancer (GC) is the fourth most common cancer worldwide, characterized by multifactorial pathogenesis and a heterogeneous geographic distribution. The complexity of this malignancy has evolved, with environmental and genetic factors and treatment strategies being more studied. Aims: We aimed to group and organize the clinicopathological and epidemiological features of GC in the Arab World and compare with data from Western countries. Methods: To obtain the highest number of topic-related articles, an extensive electronic search was conducted in the PubMed MEDLINE and Cochrane databases up to March 2022 using Boolean operators with a combination of keywords and MeSH terms. A total of 42 articles were retained after screening in accordance with the objectives of the study. The estimated age-standardized incidence rates in the Arab World were collected from the GLOBOCAN 2020 database. Results: A total of 46 articles were retrieved from 11 countries in the Arab World. Epidemiological elements were collected, especially tumour attributes, risk factors and population characteristics, in addition to some therapeutic strategies. Results were regrouped by theme and then organized in tables and charts, allowing a global and regional approach to the subject. Conclusion: This review shows that the Arab World is considered a low-rate GC incidence region, presenting almost the same tumour characteristics as the Western countries. The lack of GC data in the Arab World should trigger a rise in research on this type of malignancy to better understand the subject.

Eastern Mediterranean Health Journal [2022; Vol.28, Issue 7]

Eastern Mediterranean Health Journal is the official health journal published by the Eastern Mediterranean Regional Office of the World Health Organization. It is a forum for the presentation and promotion of new policies and initiatives in health services; and for the exchange of ideas concepts epidemiological data research findings and other information with special reference to the Eastern Mediterranean Region. It addresses all members of the health profession medical and other health educational institutes interested NGOs WHO Collaborating Centres and individuals within and outside the Region.

المجلة الصحية لشرق المتوسط هى المجلة الرسمية التى تصدرعن المكتب الاقليمى لشرق المتوسط بمنظمة الصحة العالمية. وهى منبر لتقديم السياسات والمبادرات الجديدة فى الصحة العامة والخدمات الصحية والترويج لها، و لتبادل الاراء و المفاهيم والمعطيات الوبائية ونتائج الابحاث وغير ذلك من المعلومات، و خاصة ما يتعلق منها باقليم شرق المتوسط. وهى موجهة الى كل اعضاء المهن الصحية، والكليات الطبية وسائر المعاهد التعليمية، و كذا المنظمات غير الحكومية المعنية، والمراكز المتعاونة مع منظمة الصحة العالمية والافراد المهتمين بالصحة فى الاقليم و خارجه

La Revue de Santé de la Méditerranée Orientale est une revue de santé officielle publiée par le Bureau régional de l’Organisation mondiale de la Santé pour la Méditerranée orientale. Elle offre une tribune pour la présentation et la promotion de nouvelles politiques et initiatives dans le domaine de la santé publique et des services de santé ainsi qu’à l’échange d’idées de concepts de données épidémiologiques de résultats de recherches et d’autres informations se rapportant plus particulièrement à la Région de la Méditerranée orientale. Elle s’adresse à tous les professionnels de la santé aux membres des instituts médicaux et autres instituts de formation médico-sanitaire aux ONG Centres collaborateurs de l’OMS et personnes concernés au sein et hors de la Région.

Salt content of processed foods in the Islamic Republic of Iran, and compliance with salt standards

Background: The World Health Organization recommends a maximum daily salt intake of 5 g for adults; the Islamic Republic of Iran has national standards for salt content of foods. Aims: This study aimed to determine the salt content of industrial (made in large-scale food companies) and non-industrial (made in local stores using traditional methods) foods in Tehran province and compare it with the Iranian national standards. Methods: We determined the salt content of 555 industrial and non-industrial products from parts of Tehran province in 2016 and 2018. The types of foods examined were: canned vegetables, industrial and non-industrial pickled vegetables, industrial and non-industrial tomato paste/tomato sauce, industrial and non-industrial nuts, and non-industrial barberry juice. The salt content of each product and its compliance with Iranian national standards was evaluated. Results: The salt content of industrial tomato paste/sauce in 2016 (2.05 g/100 g) and non-industrial tomato paste/sauce in 2018 (2.37 g/100 g) was higher than the Iranian standard (1.5/2.0 g/100 g). The mean salt content of both industrial (1.97 g/100 g) and non-industrial (2.16 g/100 g) nuts was higher than the Iranian standard (1.88 g/100 g), as was the mean salt content of non-industrial juice (0.79 g/100 mL versus 0.25 g/100 mL). In 2018, only 48% and 40% of industrial and nonindustrial tomato pastes/sauces met the Iranian standard. Overall, industrial products conformed better with the national standard than non-industrial products. Conclusions: Efforts are needed to reduce the salt content of processed food in the Islamic Republic of Iran and ensure they meet the Iranian standards.

Development and psychometric testing of a Gastric Cancer Behavioural Risk Assessment Inventory (GC-BRAI)

Background: Gastric cancer (GC) is one of the most common cancers worldwide. There is no disease-specific tool for GC risk assessment in research and practice settings within the Iranian sociocultural context.Aims: To develop and assess the psychometric properties of the Gastric Cancer Behavioral Risk Assessment Inventory (GC-BRAI) in GC patients in Northwest Islamic Republic of Iran.Methods: Face-to-face interviews were performed on a convenient sample of 175 GC patients and a purposive sample of 350 matched non-GC patients as a control group. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were performed to appraise the structure validity of GC-BRAI and examine its possible latent constructs.Results: The designed instrument with its 5 latent factors indicated acceptable internal consistency (0.72), reliability (0.99) and fit indices (χ2/degrees of freedom = 2.24, root mean square error of approximation = 0.049, adjusted goodness of fit index = 0.91 and root mean square residual = 0.085). The identified components were specific nutritional behaviours, typical daily diet, routine heartburn-causing behaviours or foods in diet, daily use of rice and smoked foods, and tobacco smoking/alcohol consumption, which all indicated a significant association (P= 0.0001) with high-risk of GC.Conclusions: GC-BRAI can be considered a feasible tool to measure individual GC risk and a reliable data collection instrument in tailor-made risk reduction interventional programmes.

Tobacco chewing and risk of gastric cancer: a case–control study in Yemen

This study aimed to assess the risk factors for gastric cancer in Yemen. A hospital-based case-control study of 70 cases and 140 controls was carried out in Sana'a city between May and October 2014. A structured questionnaire was used to collect information through direct interview. Living in rural areas, tobacco chewing and drinking untreated water were significant risk factors for gastric cancer. Frequent consumption of chicken, cheese, milk, starchy vegetables, cucumber, carrots, leeks, sweet pepper, fruit drinks, legumes and olive oil were associated significantly with decreased risk of gastric cancer. Multiple logistic regression analysis showed that chewing tobacco and frequent consumption of white bread were associated with increased risk of gastric cancer, whereas frequent consumption of chicken, cooked potatoes and fruit drinks had an inverse association. Risk of gastric cancer can be prevented by health education and increasing community awareness

La présente étude avait pour objectif d'évaluer les facteurs de risque du cancer de l'estomac au Yémen. Une étude cas-témoin en milieu hospitalier impliquant 70 cas et 140 témoins a été menée dans la ville de Sanaa entre mai et octobre 2014. Un questionnaire structuré a été utilisé pour collecter des informations au cours d'entretiens directs. La résidence en zone rurale, la consommation de tabac à chiquer et d'eau de boisson non traitée constituaient des facteurs de risque significatifs pour le cancer de l'estomac. Une consommation fréquente de poulet, de fromage, de lait, de légumes riches en amidon, de concombres, de carottes, de poireaux, de poivrons, de boissons fruitées, de légumes et d'huile d'olive était fortement associée à une diminution du risque de cancer de l'estomac. L'analyse de régression logistique multiple a montré que le tabac à chiquer et une consommation fréquente de pain blanc étaient associés à une augmentation du risque de cancer de l'estomac, tandis que la consommation fréquente de poulet, de pommes de terre cuites et de boissons fruitées avait une association inverse. Il est possible de prévenir le risque de cancer de l'estomac grâce à une éducation en santé et à la sensibilisation de la communauté

Epidemiological and pathological features of cancer in Fez Boulemane region, Morocco

In Fez-Boulemane, Morocco, there is no cancer registry so there is a lack of information about the incidence and characteristics of cancer in the region. In this retrospective study we examined the epidemiological and pathological features of 5532 cases of cancer collected from the Department of Pathology in Hassan II University Hospital of Fez from 2004 to 2010. The mean age of the patients was 53.5 years and 52% were male. Digestive cancers and skin cancers were the most common. Digestive cancers were predominantly colorectal and stomach. Cancers of the urinary bladder and colorectal cancers were the leading cancers in men accounting respectively for 9% and 8% of all male cancers. In women, cancers of the breast [62%] and uterine cervix [22.6%] predominated. As a first step in cancer control in our area, establishment of a regional cancer registry is recommended

Evaluation of specific biochemical indicators of Helicobactepylori-associated gastric cancer in Egypt

The aim of the study was to assess the accuracy of some specific biochemical indicators in discriminating between Helicobacter pylori-associated gastritis and H. pylori-associated stomach cancer [serum gastrin level, serum soluble E-cadherin and tissue COX-2 activity, as well as serodiagnostic markers for H. pylori infection] in order to find a simple diagnostic test that can reasonably predict the development of gastric cancer. The study participants comprised 20 patients with gastric carcinoma, 20 patients with positive H. pylori-associated gastritis and 20 individuals as the control group. Standard procedures and quality control measures were followed. Using cut-off values and ROC analysis to assess the diagnostic abilities of the biochemical indicators, E-cadherin showed the highest sensitivity [100%]. We suggest that close follow-up together with periodic endoscopic examination for all patients with persistent H. pylori infection and serum soluble E-cadherin level above 5 microg/mL is essential

Urinary iodine/creatinine ratio in patients with stomach cancer in Urmia, Islamic Republic of Iran

We carried out a case-control study is to investigate the relationship between iodine deficiency and stomach cancer. We compared the ratio of urinary iodine to urinary creatinine in 100 patients diagnosed with stomach cancer and 84 people in a control group. Mean urinary iodine levels were lower in the patients with stomach cancer, 61.9 micro g/g creatinine, compared to 101.7 micro g/g creatinine in the control group [P < 0.0001]. More of the cancer patients [49.0%] had severe iodine deficiency [< 25 micro g/g creatinine] than people in the control group [19.1%] [P< 0.0001]. We found the relationship between stomach cancer and iodine deficiency to be significant