Epidemiology of Breast, Corpus Uteri, and Ovarian Cancers in Lebanon With Emphasis on Breast Cancer Incidence Trends and Risk Factors Compared to Regional and Global Rates.

OBJECTIVES: This study explores the incidence and trends of breast (Bca), corpus uteri (CUca), and ovarian (Oca) cancer in Lebanon, a Middle Eastern country. It compares the Bca rates to regional and global ones and discusses Bca risk factors in Lebanon. INTRODUCTION: Globally, Bca is the premier cause of cancer morbidity and mortality in women. METHODS: Data on female Bca, CUca, and Oca published by the Lebanese national cancer registry were obtained (ie, for the years of 2005 to 2016). The age-standardized incidence rates (ASIRw) and age-specific rates per 100,000 female population were computed. RESULTS: From 2005 to 2016, Bca, Oca, and CUca ranked first, sixth, and seventh, respectively, for cancer incidence among women in Lebanon. Bca alone accounted for 39.4% of all new female cancer cases. The ASIRw increased significantly for Bca and CUca (APC: 3.60 and 3.73, P < .05) but not for Oca (APC: 1.27, P > .05). The Bca ASIRw (per 100,000) increased significantly from 71.0 in 2005 to 115.6 in 2013 (P < .05), then decreased steadily but non-significantly to reach 96.8 in 2016 (P > .05). Lebanon's Bca ASIRw is comparable to developed countries. This may reflect altered sociological and reproductive patterns as the country transitions from regional to global trends. The five-year age-specific rates analysis revealed that Bca rates rose steeply from 35-39 to 50-54, dropped slightly between 55 and 64, then rose till 75+. The five-year age-specific rates between 35 and 54 among Lebanese women were amongst the highest worldwide from 2008 to 2012, even higher than the rates in Belgium, which had the highest ASIRw of Bca worldwide in 2020. CONCLUSION: Lebanon's Bca ASIRw is among the highest globally. It's important to investigate the contributing factors and develop a national Bca control strategy. This study supports the national recommendation in initiating Bca screening at age 40 for women.

University students' intentions to seek psychological counseling, attitudes toward seeking psychological help, and stigma.

BACKGROUND: Mental health problems are prevalent among university students worldwide. Studies have shown that most students do not disclose and do not get the psychological help and support they need. OBJECTIVES: This survey aims to investigate the intentions to seek psychological counseling (ISC) among university students, their attitudes toward seeking professional psychological help (ATSPPH), and the predictors of those intentions and attitudes including stigma. DESIGN AND METHODS: a cross-sectional survey was conducted among 420 students at the American University of Beirut (AUB). RESULTS: Depression, test anxiety, and difficulty sleeping are the three main reasons students would seek psychological help. The source the students most preferred to ask for help was one's family followed by psychologists and psychiatrists. Students' ATSPPH is a positive predictor of their ISC, while students' self-stigma of seeking help (SSOSH) is a negative predictor of their ATSPPH. Moreover, students' awareness of the psychological help system available on campus, free of charge, is a positive predictor for both ISC and ATSPPH. CONCLUSION: Different interventions are needed to reduce stigma and enhance students' mental health literacy and awareness of the available professional psychological help on campus.

Lung Cancer and Risk Factors in Lebanon: Epidemiology, Temporal Trends, and Comparison to Countries From Different Regions in the World.

BACKGROUND: Lung cancer (Lca) is the leading cause of cancer morbidity and mortality worldwide. This study examines the Lca incidence and trends in Lebanon and compares them to regional and global ones. It also discusses Lca risk factors in Lebanon. METHODS: Lung cancer data from the Lebanese National Cancer Registry for 2005 to 2016 was obtained. The age-standardized incidence rates (ASRw) and age-specific rates per 100 000 population were calculated. RESULTS: Lung cancer ranked second for cancer incidence in Lebanon from 2005-2016. Lung cancer ASRw ranged from 25.3 to 37.1 per 100 000 males and 9.8 to 16.7 per 100 000 females. Males 70-74 and females 75+ had the highest incidence. Lung cancer ASRw in males increased significantly at 3.94% per year from 2005 to 2014 (P > .05), then decreased non-significantly from 2014 to 2016 (P < .05). Lung cancer ASRw in females increased significantly at 11.98% per year from 2005 to 2009 (P > .05), then increased non-significantly from 2009 to 2016 (P < .05). Males' Lca ASRw in Lebanon was lower than the global average in 2008 and became similar in 2012 (34.1 vs 34.2 per 100 000); However, females' Lca ASRw was almost comparable to the global average in 2008 and exceeded it in 2012 (16.5 vs 13.6, respectively, per 100 000). Males' and Females' Lca ASRw in Lebanon were among the highest in the Middle East and North Africa (MENA) region but lower than those estimated for North America, China and Japan, and several European countries. The proportion of Lca cases attributed to smoking among Lebanese males and females was estimated at 75.7% and 66.3% for all age groups, respectively. The proportion of Lca cases attributed to air pollution with PM10 and PM2.5 in Lebanon was estimated at 13.5% for all age groups. CONCLUSION: Lung cancer incidence in Lebanon is among the highest in the MENA region. The leading known modifiable risk factors are tobacco smoking and air pollution.

Prescribing antibiotics in adults with respiratory tract infections in Lebanon.

INTRODUCTION: Antibiotic resistance is a global concern that has significant health and economic burden. The inappropriate use of antibiotics is a major cause of antibiotic resistance; this includes both unnecessary and incorrect prescriptions. Most antibiotics are prescribed in primary care, mainly for respiratory tract infections. This study examines the prescribing practices of physicians for respiratory tract infections in ambulatory settings in Lebanon. METHODS: The study was a cross-sectional review of prescriptions given to a group of employees working in two companies in Greater Beirut in Lebanon (n = 469) between September 2017 and March 2018. Prescriptions and related medical reports were reviewed. Data on the type of infection and the employees' demographics were collected. Antibiotic treatment was considered appropriate based on its adherence to international scientific societies' recommendations and clinical guidelines, including those of the Infectious Diseases Society of America. RESULTS: A total of 372 medical reports and prescriptions were reviewed; 88.2% of these prescriptions included antibiotics. The rate of antibiotic treatment was 82.0% for a diagnosis of flu-like symptoms and 94.6% for acute pharyngitis, of which 34.5% included third generation cephalosporins and fluoroquinolones. Around 93.7% of patients with acute bronchitis without pneumonia received antibiotics, mostly broad-spectrum ones. A significant association was found between the specialty of the prescribing physicians and some types of upper respiratory tract infections. CONCLUSION: This study reveals a high prevalence of inappropriate antibiotic prescribing for respiratory tract infections in the Lebanese ambulatory practice, contributing to the emergence of antimicrobial resistance in the country. It calls for urgent multifaceted interventions to limit unnecessary use and promote antibiotic stewardship.

A Pilot Intervention to Promote Positive Parenting in Refugees from Syria in Lebanon and Jordan.

BACKGROUND: Early childhood development (ECD) is a crucial milestone that shapes a child's health, wellbeing, education, and personality. Several factors come into play, and each requires the nurturing care of caregivers. Although the importance of ECD is well understood, the implementation of ECD programs is scarce, especially in poor and vulnerable communities. OBJECTIVE: To improve parents' wellbeing, parenting stress levels, parenting behavior, and discipline strategies after the implementation of a newly designed parenting intervention. PARTICIPANTS AND SETTING: Parents from Syria (125 mothers and fathers) in three refugee camps in Lebanon and Jordan. METHODS: This was a pilot cohort study in which parents' wellbeing, parenting stress levels, parenting behavior, and discipline strategies were evaluated before and after participating in training in the form of interactive and educational sessions to ameliorate their relations and interactions with their children. RESULTS: By the end of this study, parents' mental health and wellbeing improved (p < 0.001, Cohen's d: 0.61) and their parenting index score was reduced (p < 0.001, Cohen's d: 1.24). Some of their dysfunctional interactions with their children as well as the perceived difficulties and conduct problems in their children aged 3 to 6 years were also reduced significantly. CONCLUSION: The intervention used in this study succeeded in improving some aspects of parenting practices and disciplines and in improving the parents' wellbeing; however, more research is needed to assess its long-term effects on parents and their children. Moreover, some adjustments need to be made in the intervention to be more adapted to the context of refugees and underprivileged communities.