Cancer Care in Resource-Limited Countries: Jordan as an Example

JCO Global Oncology, Journal Year: 2024, Volume and Issue: 10

Published: Sept. 1, 2024

Jordan, a lower- to middle-income country, is relatively small, but with rapidly growing population and challenged economy. Cancer health care problem currently ranked second, after cardiovascular diseases, as cause of death. Jordan's national cancer registry continues suffer from problems mostly related long lag time in reporting, absence outcome data, accurate staging. The number new patients diagnosed Jordan increasing at an expected, none disturbing rate, fueled by growth, improving life expectancy, changing structure that hosts more older population, high rate obesity, smoking, lack adequate exercise. However, age-standardized for incidence significantly lower than Western societies, yet, mortality higher. Despite efforts, still advanced stages younger age. breast program represents great example opportunistic screening led significant downstaging cancer. Efforts evaluate the feasibility programs colorectal lung cancers are underway. Tremendous efforts resulted execution largest clinical genetics region helps identify at-risk relatives hereditary cancers. Low-resourced countries, including will not be able keep up cost care. A better access trials moving ambulatory settings should offset some this cost. control addresses all issues early detection, through active cost-effective treatment assures wider palliative care, hospice, survivorship under expanded universal coverage, urgent priority.

Language: Английский

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Presentation and management outcomes of Retinoblastoma among Syrian refugees in Jordan

Frontiers in Oncology, Journal Year: 2023, Volume and Issue: 12

Published: Jan. 13, 2023

The humanitarian crisis in Syria has had a profound impact on the entire region. In this study, we report patterns of presentation and management outcomes Syrian patients with Retinoblastoma (Rb) treated at single tertiary cancer center Jordan. This is retrospective comparative study refugees Jordanian citizens who Rb between 2011 2020. Collected data included patient demographics, presentation, tumor stage, treatment modalities, eye salvage rate, metastasis, mortality. Thirty (16 (53%) bilateral disease) 124 (51(41%) were diagnosed during period. median age diagnosis for was 10 32 months unilateral consecutively, compared to 6 28 citizens. lag time signs disease initiation 3 refugees, 1 month citizens.Refugees more likely present advanced stage (p=0.046). Out 46 affected eyes refugees; (70%) group D or E, while out 175 among citizens; 98 (56%) E. Therefore, mandate primary enucleation (48%) (25%) (p=0.003). However, 24 received conservative therapy, 15 (62%) successfully salvaged, 131 105 (80%) salvaged (p=0.06). Two (7%) four (3.2%) died from metastasis. presented due delay referral that increased burden by decreasing chance globe salvage. timely intervention similar outcome Rb; probably reflection all specialized center. We advocate rare life-threatening best possible outcome.

Language: Английский

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Clinical Characteristics, Prognostic Factors and Treatment Outcomes of Patients with Bone-Only Metastatic Breast Cancer

Cancer Management and Research, Journal Year: 2022, Volume and Issue: Volume 14, P. 2519 - 2531

Published: Aug. 1, 2022

Bone is the most frequent site of breast cancer metastasis. Differences between those who present with de novo bone-only metastasis (BOM) and progress to disease following a diagnosis early-stage are not clear. Such differences in clinical course might have an impact on aggressiveness treatment. This study presents pathological features, along treatment outcomes, patients BOM relation timing type bone metastasis.Patients were retrospectively reviewed. De was defined as diagnosed at presentation or within first 4 months follow-up. Treatment outcomes novo, compared subsequent BOM, presented.242 patients, median age (range) 52 (27-80) years enrolled. The majority (77.3%) had multiple sites involvement (82.6%). At follow-up 37.7 months, overall survival (OS) for significantly shorter than developed so subsequently; 40.8 (95% CI, 51.1-184.1) 80.9 36.4-47.9), p < 0.001. Tumor grade, hormone receptor status lesions (lytic versus sclerotic) significant outcomes.Breast distinct entity unfavorable prognosis associated survival. Several risk factors poor identified inform plans.

Language: Английский

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Breast Cancer Beliefs and Screening Practices among Syrian Refugee Women and Jordanian Women

International Journal of Environmental Research and Public Health, Journal Year: 2023, Volume and Issue: 20(4), P. 3645 - 3645

Published: Feb. 18, 2023

Despite significant declines in breast cancer (BC) incidence the West, this disease is widespread Jordan, where detection occurs at much advanced stages. This particularly concerning for Syrian refugee women resettled who are less likely to undergo preventative procedures because of poor health literacy and lack services access. The present work assesses compares awareness screening behaviors among Jordanian residing close Syrian–Jordanian border city Ar-Ramtha. A cross-sectional survey was conducted using a validated Arabic version Breast Cancer Screening Beliefs Questionnaire (BCSBQ). total 138 160 participated study. Results indicate that 93.6% ≥ 40 years age reported never having undergone mammogram. low attitudes toward general checkup (mean score refugees 45.6 vs. 42.04 Jordan women; p = 0.150). Barriers BC were higher 56.43) than 61.99, 0.006). Women with education more report fewer barriers (p 0.027). study documents women, indicating future needed alter current towards mammograms early measures especially rural areas Jordan.

Language: Английский

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Are Syrian refugee breast cancer patients diagnosed at advanced stage and do they have treatment delays?

Future Oncology, Journal Year: 2023, Volume and Issue: 19(14), P. 983 - 989

Published: May 1, 2023

Aim: To compare the clinicopathological features and time to reach treatment of patients with breast cancer among Syrian refugees (SR) Turkish citizens (TC). Methods: Retrospective data from 2014 2021 were extracted hospital database. Student's t-test, Mann-Whitney U test χ2 used two groups. Results: Data 88 SR 402 TC analyzed. The mean age was 45 years for SRs 50 TCs. Breast subtypes similar in both de novo metastatic ratio 23% 21.3% TCs between Conclusion: Provided absence any obstacle healthcare system, are diagnosed treated like their host nation.

Language: Английский

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Central nervous system tumors in patients coming from areas of conflict in the Middle East/North Africa region: an experience from King Hussein Cancer Center

Frontiers in Oncology, Journal Year: 2023, Volume and Issue: 13

Published: May 17, 2023

The global cancer burden has been disproportionately shifting towards low- and middle-income countries (LMICs). Limited availability accessibility to screening, treatment surveillance, increase in the prevalence lack of control risk factors, underdeveloped healthcare infrastructures have greatly contributed disparity burden.A retrospective cohort study was conducted that included adult pediatric patients with an established diagnosis Central Nervous System (CNS) tumors including brain or spinal which different demographic, clinical characteristics, financial were presented.749 stemming from various Middle East/North Africa (MENA) region Libya (34.2%), Palestine (19.8%), Iraq (15.4%), Syria (14.6%) Yemen (14.5%), Sudan (1.5%). Most adults (66%) a median age 34-year-old. 104 had died (13.9%), 80 still alive (10.7%) most (n= 565, 75.5%) lost follow-up. added cost managing these is 10,172,935 Jordanian Dinars (JOD), King Hussein Cancer Foundation (KHCF) covering around 34.3% total cost.Our aimed at taking closer look coming areas conflict MENA diagnosed treated for CNS Center (KHCC) over 12-year period. It found even contributions sources almost half faced entire alone.

Language: Английский

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Syrian Refugee and Turkish Women with Breast Cancer: A Comparison on Clinicopathological Features and Survival

Archives of Iranian Medicine, Journal Year: 2023, Volume and Issue: 26(1), P. 29 - 35

Published: Jan. 1, 2023

Background: Cancer is a significant health problem for refugees and host countries. Breast cancer the most common among refugees. The subject of our study to examine clinical pathological features Syrian with breast compare them Turkish patients cancer. Methods: Data between January 2018 December 2020 were retrospectively reviewed. histological features, treatment modalities overall survival collected analyzed. Results: A total number 338 women included in this study. Ninety-nine (29.3%) 239 (70.7%) Turkish. median follow-up time was significantly lower (P<0.001). Median OS 146 months 116 group (P=0.022). Independent risk factors associated long receiving adjuvant chemotherapy (HR 0.465; 95% CI 0.234–0.926; P=0.029), radiotherapy 0.372 0.182–0.758; P=0.007), hormonotherapy 0.367; 0.201–0.669; P=0.001). rates chemotherapy, radiotherapy, hormonal therapy (P=0.023, P=0.005, P=0.002, respectively). Conclusion: are more likely receive suboptimal treatments. They have inferior compared local patients. Our findings highlight need provision such vulnerable populations. We suggest that attention should be paid cancer, as it

Language: Английский

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Disparities in Breast Cancer Characteristics Among Syrian Migrants and Jordanian Women in the Jordan Cancer Registry from 2010 to 2016

JAMA Network Open, Journal Year: 2023, Volume and Issue: 6(7), P. e2325197 - e2325197

Published: July 24, 2023

This case series analyzes breast cancer characteristics of women diagnosed with ancer in the Jordan Cancer Registry by Syrian migrant status to determine inequities.

Language: Английский

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Categorization of the Nottingham Prognostic Index in Breast Carcinoma: A Retrospective Study of 473 Female Patients

Al- Anbar Medical Journal, Journal Year: 2023, Volume and Issue: 0(0), P. 0 - 0

Published: Aug. 23, 2023

Background: The Nottingham prognostic index (NPI) combines lymph node status, tumor size, and histological grade, reflecting breast cancer's metastatic behavior, growth rate, genetic instability. NPI is a commonly used, clinically relevant, internationally validated system for classifying early locally advanced cancer cases [TNM (tumor, nodes, metastasis) stages I, II, III] into three or more groups. important patients clinicians to decide whether undergo adjuvant chemotherapy following surgery. Objectives: To determine the prevalence of various categories in Duhok, Iraqi Kurdistan establish correlation between variety clinical, pathological, immunohistochemical parameters. Materials Methods: This retrospective cross-sectional study was conducted Oncology Clinic at Azadi Teaching Hospital, Iraq. data included age, side involved, multi-centricity cancer, type, category, surgery excision margins. histopathological type carcinoma, lympho-vascular invasion (LVI), dermal invasion, nipple involvement. IHC profile ER, PR, Her2-neu ki67 index. These were expressed frequencies percentages, correlated with previous parameters using appropriate statistical tests, P-value < 0.5% considered statistically significant difference. Results: There no association focality, ER status (P-value = 0.93, 0.55, 0.64, respectively). Significant correlations exist with, involvement, surgical margins PR 0.03, 0.029, 0.046, 0.011, highly when against stage, Ki-67, 0.001 all). Conclusion: Most that examined belonged moderate poor numerical categories, these NPIs show associations Her2-neu.

Language: Английский

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De-Escalating Treatment Strategies for Patients with Human Epidermal Growth Factor Receptor-2 (HER2)-Positive Early-Stage Breast Cancer

Cancers, Journal Year: 2024, Volume and Issue: 16(20), P. 3478 - 3478

Published: Oct. 14, 2024

Almost one-fifth of breast cancer cases express Human Epidermal Growth Factor-2 (HER2), and such expression is associated with highly proliferative tumors poor prognosis. The introduction anti-HER2 therapies has dramatically changed the natural course this aggressive subtype cancer. However, therapy can be substantial toxicities, mostly cardiac, high cost. Over past few years, there been growing interest in de-escalation to minimize adverse events healthcare costs, while maintaining efficacy treatment. Data from clinical observations single-arm studies have eluted minimal impact low-risk patients, like those node-negative small tumors. Though single-arm, APT trial, which patients node-negative, received single-agent paclitaxel for 12 cycles plus trastuzumab 1 year, was a practice-changing study. Several other recently published studies, PERSEPHONE shown more convincing data that 6 months not inferior months, terms disease-free survival (DFS), suggesting de-escalating strategies shorter treatment may appropriate some patients. Other involved an adaptive, response-directed approach, personalized depends on tumor genomic profiling.

Language: Английский

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