Clinicopathological characteristics of gene-positive breast cancer in the United Arab Emirates.

INTRODUCTION: Breast cancer is the most prevalent cancer in the United Arab Emirates (UAE). This is the first study to provide data on predisposition of breast cancer susceptibility genes with associated clinical and pathological aspects in the UAE. MATERIAL & METHODS: A retrospective chart review for breast cancer patients undergoing genetic testing from 2016 to 2018. According to National Comprehensive Cancer Network (NCCN) guidelines genetic testing was offered. The analyzed data included; age, ethnicity, family cancer history, pathogenic variant, histopathology, stage, molecular subtype and proliferation. RESULTS: 309 patients underwent genetic testing with a positive result in 130 patients (11.9%) over a period of 36 months. In 34.6% pathogenic and likely pathogenic variants were identified. BRCA2 was the most common gene identified. The mean age was 42.9 years (±9.01). Positive family history was identified in 66 patients (50.7%). Majority had stage 1 or 2 disease (66.2%), invasive ductal carcinoma (81.5%) and hormone receptor positive cancer (45.3%). CONCLUSIONS: This is the first study in the UAE to describe the clinical and pathological characteristics of hereditary breast cancer in a mixed ethnic group with dominant Arabic population. Further genetic studies will be required in the UAE population, as the prevalence of breast cancer continues to rise.

Prevalence and characteristics of sellar masses in the city of Al Ain, United Arab Emirates: 2010 to 2016.

BACKGROUND: The prevalence of sellar masses (SMs) is reported in Europe and North America but only limited data are available from the Middle East and North Africa (MENA) region. OBJECTIVES: Assess the prevalence and characteristics of SMs in Al Ain city, United Arab Emirates. DESIGN: Retrospective, descriptive multicenter study. SETTING: Three endocrine centers in Al Ain. PATIENTS AND METHODS: All patients diagnosed with SMs in the city of Al Ain, Emirate of Abu Dhabi, between 2011 and 2016 were evaluated. Cases were identified using ICD 9 and 10 codes and demographic and clinical data were collected. The prevalence rate was calculated for patients alive and residing in Al Ain city until 31 December 2016. MAIN OUTCOME MEASURES: Clinical presentations and prevalence rate. SAMPLE SIZE: 272. RESULTS: The mean (SD) age on presentation was 40.8 (14.3) years (range: 6-114 years, median: 40.0). The 170 (61.8%) females and 128 (46.5%) were native citizens of the United Arab Emirates. Two hundred and forty five (90%) patients had pituitary adenomas (PAs) while 27 (10%) had non-pituitary sellar lesions. The four most common SMs were prolactinoma (n=139, 51.1%), nonfunctioning adenoma (NFA) (n= 69, 25.4%), somatotroph adenoma (n=32, 11.8%) and craniopharyngioma (n=15, 5.5%). Patients with prolactinoma, corticotroph adenoma, and Rathke's cleft cyst had small sellar masses (<1 centimeter) while the majority of patients with other SMs had macroadenomas. Hypogonadism and growth hormone deficiency was present in 41.8% and 20.5% of the patients, respectively. Of 268 patients with available data, 82 patients underwent surgery while 25 patients received radiotherapy. At the end of 2016, 197 patients were residing in Al Ain city. The overall prevalence of SMs was 25.7/100 000 with PAs constituting most of these masses (n=177) for a prevalence of 23.1/100 000. CONCLUSIONS: This is the first study of SMs in the United Arab Emirates and the MENA region. Prolactinoma and NFA were the two most common SMs. Further studies are needed to explore the reasons for the lower prevalence of SMs in our region compared with other countries. LIMITATIONS: Retrospective design, relatively small sample size. CONFLICT OF INTEREST: None.

Comparison of perceptions of unmet supportive care needs between cancer patients and their oncologists.

PURPOSE: The prevalence of cancer in the Middle East is increasing and predicted to nearly double by 2030. In the United Arab Emirates (UAE), cancer ranks as the third leading cause of death. Yet, there are limited data describing the needs of cancer patients in the region. The purpose of this study is to compare cancer patients' reports of unmet supportive care needs with the perceptions of their oncologists. METHODS: A cross-sectional survey of cancer patients and their oncologists, using an Arabic translation of the short form of the Supportive Care Needs Survey (SCNS-SF34), was conducted at a major oncology center in the UAE between December 2014 and March 2017. Descriptive statistics and McNemar test were calculated to determine differences in unmet need responses between oncologists and patients. RESULTS: Nine physicians (100%) and 210 of 268 (78.3%) patients completed the questionnaire. Oncologists accurately assessed the level of unmet physical needs of their patients, but significantly underestimated unmet psychological supportive care needs of the patients. Male patients expressed significantly lower (p < 0.05) physical and psychological unmet needs, compared to female patients. CONCLUSION: Our findings reveal a general concordance between physician and patient perspectives of unmet supportive care needs. This is reassuring as physician perceptions impact the care patients receive. We present multifaceted supportive care strategies for oncology patients in the region.

Supportive care needs of multicultural patients with cancer in the United Arab Emirates.

Despite the high prevalence of cancer in the Middle East, there is limited published data reporting the needs of cancer patients in this region of the world. The purpose of this study is to assess the unmet supportive care needs of oncology patients in the United Arab Emirates (UAE). From December 2014 to December 2016, a cross-sectional survey of cancer patients was conducted at a large tertiary care hospital and an oncology referral centre in the UAE, using a validated Arabic translation of the supportive care needs survey--short form (SCNS-SF34-A), assessing cancer-specific perceived needs across five domains: psychological, health system information, patient care and support, physical and daily living and sexuality. Chi-square test and Pearson's correlation coefficient were used to assess the association between variables. Participant responses were tabulated as mean ± standard error of the mean (SEM). The response rate was 78% (210/268). Five of the 10 items from the psychological domain constituted the 10 most prevalent unmet moderate or high needs, followed by physical and daily living needs (3.04 ± 0.029, p < 0.001), health system information (3.03 ± 0.02, p < 0.001), patient care and support (2.95 ± 0.24, p < 0.001), with low sexuality needs (1.79 ± 0.08, p < 0.001). Women had significantly higher psychological unmet needs. Cultural differences were noted only in the health system information domain. Improvements in mental health services, development of multidisciplinary cancer care teams, introduction of cancer support groups and fully engaging women in all treatment decisions are feasible and easy to implement interventions that can significantly improve the care and wellbeing of oncology patients in the UAE.

Characteristics of salivary gland tumours in the United Arab Emirates.

Salivary gland tumours (SGT) are relatively rare cancers characterised by striking morphological diversity and wide variation in the global distribution of SGT incidence. Given the proximity to the head and neck structures, management of SGT has been clinically difficult. To the best of our knowledge, there are no epidemiological studies on SGT from the United Arab Emirates (UAE) or the Gulf Cooperation Council Countries (GCC). Patient charts (N = 314) and associated pathological records were systematically reviewed between the years 1998-2014. Predominance of benign (74%) compared with malignant (26%) SGT was observed. Among the 83 malignant SGT identified, frequency was higher in males (61%) than in females (39%) and peak occurrence was in the fifth decade of life. Mucoepidermoid carcinoma was the most common type of tumour (35%) followed by adenoid cystic carcinoma (18.1%) and acinar cell carcinoma (10.8%). A similar pattern of tumour distribution was seen in patients from GCC, Asian, and Middle East countries. This is the first report to address the distribution of salivary gland tumours in a multiethnic, multicultural population of the Gulf. The results suggest that the development of an SGT registry will help clinicians and researchers to better understand, manage, and treat this rare disease.