Progress and remaining challenges for cancer control in the Gulf Cooperation Council.

Cancer is a growing global health-care problem, especially in under-resourced countries. Cancer prevalence in Gulf Cooperation Council (GCC) countries is projected to increase, potentially leading to a major burden on the economy. Policy makers in GCC countries have invested in the development of National Cancer Control Strategies to address the current and future burden of cancer through different initiatives and policies for prevention, early detection, and management of cancer. These strategies include capacity building, health education, and global partnerships to strengthen health-care systems. The aim of this Review is to highlight the status of cancer control programmes in GCC countries, describe what has been achieved to date, and identify the gaps, with recommendations on how to lower the burden of cancer in the Gulf region in the future. TRANSLATION: For the Arabic translation of the abstract see Supplementary Materials section.

Incidence and Trends of Liver Cancer in the Gulf Cooperation Council States, 1998-2012.

BACKGROUND: Liver cancer has been identified as the fifth most common cancer in males and ninth in females in the Gulf Cooperation Council (GCC) States. Taking into consideration that GCC states have comparable cultural and demographic backgrounds, this study aimed to examine the trends and patterns of liver cancer cases in the GCC states and to compare these with other regions. MATERIALS AND METHODS: The data were obtained from the Gulf Centre for Cancer Control and Prevention, which has maintained its database for GCC states since 1998. In total, 8,012 primary liver cancer cases were recorded for 15 years, from 1998 to 2012. Demographic information and cancer data for all cases were reviewed and analyzed, including sex, age, nationality, histological type and staging. Trends in the frequency of cases, agespecific incidence and stage at diagnosis were presented and compared for three periods (1998-2002, 2003-2007 and 2008-2012) for the six GCC countries. RESULTS: The trends show a balanced decrease in the number of liver cancer cases between 1998 and 2012. Over one-third of patients who presented were diagnosed with advanced liver cancer; however, 45.4% of the cases were left unknown. CONCLUSION: While the Gulf countries have achieved some success in reducing the number of liver cancer cases, there is a clear defect in the documentation of the cancer staging in some countries, and more effort is needed to improve early diagnosis.

Trends in Thyroid Cancer Incidence in the Gulf Cooperation Council States: a 15-Year Analysis.

INTRODUCTION: Thyroid cancer is a predominant malignancy in the Gulf Cooperation Council (GCC) states. Explicit regional assessments of incidence are crucial among countries that share similar demographic, cultural, and economic characteristics. This study provides an assessment of trends in thyroid cancer in the GCC over fifteen years. METHODS: Data included cases in the GCC, reported to the Gulf Center for Cancer Registration during 1998-2012 (N=10,417). Age-specific rates, age-standardized rates (ASR), and stage at diagnosis are compared between the GCC states during 1998-2002, 2003-2007, and 2008-2012. Standardization of rates was performed using the World Standard Population. RESULTS: Between 1998-2002 and 2008-2012, the frequency of thyroid cancer in the GCC was approximately fourfold higher in females than males. The average ASR increased from 1.8 to 2.4/100,000 for males and 5.7 to 8.4/100,000 for females. Age-specific incidence showed a shift towards a younger age for women and an older age for males. During 1998-2012, the proportion of localized stage at diagnosis ranged from 18% in Oman to 57% in the UAE. The proportion of unknown stage varied considerably among states, ranging from 13% to 64%. Over the study period, the proportion of unknown stage increased in all but two states (Bahrain and Saudi Arabia). CONCLUSION: The incidence of thyroid cancer in the GCC has generally increased. This could reflect improved testing, leading to enhanced detection and diagnosis of thyroid cancers, as well as a possible increase in exposure to risk factors. Improved ascertainment of stage data is essential to reflect changes in early diagnosis activities.

Cervical Cancer Incidence and Trends among Nationals of the Gulf Cooperation Council States, 1998-2012.

BACKGROUND: Cervical cancer is the ninth most common female malignancy in the Gulf Cooperation Council (GCC) States. We describe trends in cervical cancer incidence among GCC nationals. GCC states include Bahrain, Kuwait, Oman, Saudi Arabia, Qatar and the United Arab Emirates; which share similar demographic, socioeconomic and cultural backgrounds. METHODS: The Gulf Centre for Cancer Control and Prevention (GCCCP) has maintained a database of cancer in the GCC states since 1998. Women diagnosed with invasive cervical cancer during the 15 years 1998-2012 were included (N=2,332). Age-specific incidence over three periods (1998-2002, 2003-2007 and 2008-2012) are presented for all states combined. Trends in the frequency of registered cases, age-standardized incidence rates (ASRs) and in the distribution of stage at diagnosis for the six member states are compared between the three periods. RESULTS: Over the 15-year period, the peak age of cervical cancer diagnosis has slightly shifted towards older age. While the number of cases in the GCC has increased, the ASR has decreased. 39% of women were diagnosed in localized stage. The proportion of unknown stage ranged between 10% in the UAE and 58% in Oman, and has increased over time in Kuwait, Oman and the UAE. CONCLUSION: The present study indicates some success in cervical cancer preventive measures but the GCC may still see an increase in the number of cases in the coming years. More efforts should be directed towards documentation of stage and towards early diagnosis.