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DOI: 10.1055/s-0042-1755331
Cancer Diagnoses during Active Conflict: Experience from a Cancer Program in Northwest Syria

Abstract
Background Protracted conflict has destroyed Syria's health system with severe impacts on the diagnosis and treatment of chronic and high-cost diseases including cancer. Here, we review the type and (where possible) the stage of cancers diagnosed in a pathology laboratory serving Northwest Syria.
Methods We retrospectively reviewed all pathology reports which reported a diagnosis of cancer from a pathology department in Northwest Syria from January to December 2020.
Results A total of 397 new cancers were diagnosed during 2020 of which 191 were among males (48.1%) and 20 cases were in children aged 17 years or under (5%). The most common cancer in men was bladder cancer (15.7%) and skin cancers (14.7%) followed by cancers in the lymph nodes (includes primary and secondary; 9.9%.) In women, breast cancer (38.3%) followed by skin cancer skin (9.7%) and uterine cancer (8.7%) was the most common. The overall proportion of cancer diagnoses were breast cancer (20.2%), skin cancer (12.1%), cancer affecting lymph nodes (8.8%), and urinary bladder (8.3%) and colorectal cancer (7.3%).
Discussion This preliminary analysis is the first report of cancer types and demographics in areas outside of government control in Syria since the onset of the conflict. Despite limitations, it presents some indication of the burden of oncological diagnoses in this area. Further research which aims to describe and address the burden of cancer on populations under ongoing conflict and humanitarian crises remains essential, especially in Northwest Syria given ongoing attacks and severe underfunding. There is a particular need to investigate how best to apply interventions and support health systems and cancer services within conflict settings. More support and resources need to be allocated to cancer centers with long-term health partnership models. The underresourced and understaffed conditions of the hospital are significant limits to a more detailed report.
Authors' Contributions
B.A., A.T., M.H., and A.A. conceived the concept. B.A., G.T., H.M., and A.A. prepared the first draft and contributed significant to revisions. G.T. and H.M. supported data analysis. J.D., A.J., M.K., Y.A., M.A., M.H., and A.T. contributed to significant revisions of the manuscript and provided suggestions around key points to include.
Publikationsverlauf
Artikel online veröffentlicht:
08. September 2022
© 2022. Syrian American Medical Society. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
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References
- 1 Sahloul E, Salem R, Alrez W. et al. Cancer care at times of crisis and war: The Syrian example. J Glob Oncol 2016; 3 (04) 338-345
- 2 S. napshot on WoS Health resources and services availability monitoring system (HeRAMS) 2020 Q4: Oct-Dec.. Accessed July 21, 2022 at: https://reliefweb.int/report/syrian-arab-republic/snapshot-wos-health-resources-and-services-availability-monitoring-2
- 3 Humanitarian Response. Northwest Syria. Factsheet. Accessed July 21, 2022 at: https://www.humanitarianresponse.info/en/operations/stima/infographic/northwest-syria-factsheet
- 4 Health Resources Availability Monitoring System (HeRAMS).. Fourth Quarter, 2020 Report, Turkey Health Cluster for Northwest of Syria, October - December 2020. Accessed July 21, 2022 at: https://reliefweb.int/report/syrian-arab-republic/health-resources-availability-monitoring-system-herams-fourth-quarter-2
- 5 Abbara A, Marzouk M, Mkhallalati H. Health system fragmentation and the Syrian conflict. In: Bseiso J, Hofman M, Whittall J, eds. Everybody's War: The Politics of Aid in the Syria Crisis. New York, NY: the Oxford University Press; 2021: 33-57
- 6 Meyers T. Bringing cancer care to a conflict zone. Direct Relief. Accessed July 21, 2022 at: https://www.directrelief.org/2019/07/cancer-care-syria/
- 7 Syrian American Medical Society Foundation. SAMS oncology center in Idlib. Accessed July 21, 2022 at: https://www.sams-usa.net/media_post/sams-oncology-center-in-idlib/
- 8 Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2018; 68 (06) 394-42C4
- 9 Barbosa ALA, Vermeulen SHHM, Aben KK, Grotenhuis AJ, Vrieling A, Kiemeney LA. Smoking intensity and bladder cancer aggressiveness at diagnosis. PLoS One 2018; 13 (03) e0194039
- 10 Khattab A, Javaid A, Iraqi G. et al; BREATHE Study Group. Smoking habits in the Middle East and North Africa: results of the BREATHE study. Respir Med 2012; 106 (Suppl. 02) S16-S24
- 11 Kakaje A, Alhalabi MM, Alyousbashi A, Ghareeb A, Hamid L, Al-Tammemi AB. Smoking habits and the influence of war on cigarette and shisha smoking in Syria. PLoS One 2021; 16 (Suppl. 09) e0256829
- 12 Jawad M, Millett C, Sullivan R, Alturki F, Roberts B, Vamos EP. The impact of armed conflict on cancer among civilian populations in low- and middle-income countries: a systematic review. Ecancermedicalscience 2020; 14: 1039
- 13 Letašiová S, Medve'ová A, Šovčíková A. et al. Bladder cancer, a review of the environmental risk factors. Environ Health 2012; 11 (suppl 1): S11
- 14 Abdel-Razeq H, Tamimi F, Abdel-Razeq N. et al. Late presentation and suboptimal treatment of breast cancer among Syrian refugees: a retrospective study. J Int Med Res 2021; 49 (05) 3000605211018448
- 15 Kutluk T, Koç M, Öner İ. et al. Cancer among Syrian refugees living in Konya Province, Turkey. Confl Health 2022; 16 (01) 3
- 16 European Union Agency for Asylum.. Overview: areas of control. Accessed July 21, 2022 at: https://euaa.europa.eu/country-guidance-syria-2021/overview-areas-control