|NCI Releases Report on Cancer Incidence in Middle East
The National Cancer Institute (NCI), part of the National Institutes of Health,
today released Cancer Incidence in Four Member Countries (Cyprus, Egypt,
Israel and Jordan) of the Middle East Cancer Consortium (MECC) Compared with
The monograph compiles information on cancer incidence between 1996 and 2001,
drawn from cancer registries in four member countries as part of the Joint Cancer
Registration Project of the Middle East Cancer Consortium (MECC).
The MECC’s primary goal is to reduce the incidence and impact of cancer in the
Middle East through collaborative research. It was established in 1996 with an
official agreement among the Ministries of Health of Cyprus, Egypt, Israel, Jordan,
and the Palestinian Authority.
MECC Executive Director, Michael Silbermann, D.M.D., Ph.D., states in the monograph’s
preface, “Prior to the agreement, most of the countries in the consortium had
only recently begun to establish population-based registries. By accelerating
and strengthening this process, the Joint Cancer Registration Project very quickly
became the flagship of MECC’s activities in the region.”
“MECC represents one of the few cooperative efforts in the Middle East that
has managed to continue uninterrupted through the challenging times in the region,” said
Joe Harford, Ph.D., Director of NCI’s Office of International Affairs and the
primary liaison to MECC. “The new monograph comes at the 10th anniversary of
the signing of the ministerial agreement forming MECC. It is our hope that the
publication of these data and the interesting questions that they raise will
stimulate research that will benefit not only the people of the Middle East but
will also deepen our understanding of cancer to the benefit of all.”
The monograph includes information on interpretation of the data, including
the study population, how data were collected, and the strengths and limitations
of the data. For comparative purposes, tables show cancer incidence rates from
both the MECC registry regions and the Surveillance, Epidemiology, and End Results
(SEER) registry program in the United States. SEER, an NCI program, is an authoritative
source of information on cancer incidence and survival in the United States and
is considered the standard for quality among cancer registries around the world.
“This project represents a decade of hard work and collaboration between scientists
from each of these countries and is a model for international scientific collaboration
in troubled regions of the world,” said Laurence Freedman, Ph.D., director, Biostatistics
Unit, Gertner Institute for Epidemiology, Sheba Medical Center, lead author and
chair of the MECC’s Steering Committee for Joint Cancer Registration.
Major findings in this monograph include the following:
- Jordanians had the lowest overall incidence of cancer, while the United States
SEER population and Israeli Jews had substantially higher overall cancer incidence
rates than in the other MECC populations. Cypriots, Israeli Arabs, and Egyptians
had intermediate cancer incidence rates.
- While overall lung cancer incidence was much lower in the MECC populations
than in the U.S. SEER population, the rates were comparable to U.S. SEER rates
in Israeli Arab men younger than 60, who are known to have high tobacco consumption.
- Israeli Jews had colorectal cancer rates higher than the U.S. SEER population
and more than twice as high as the other MECC populations. This finding calls
for further investigation of genetic and dietary/environmental factors among
- Liver cancer incidence rates in Egyptians were five to seven times as high
as those of the other MECC populations, and more than three times the U.S.
SEER population. This may be related to the higher prevalence of hepatitis
B and C in the population or to contamination of food by aflatoxin, a toxin
produced by many species of fungi.
- Egyptians and Israeli Jews had rates of non-Hodgkin lymphoma higher than
in the U.S. SEER population and considerably higher than in the other MECC
populations. Further studies of risk factors for this malignancy are needed
in this region of the world.
- Breast cancer incidence was high in Israeli Jews, comparable to the U.S.
population. The other MECC countries had much lower rates. The rates of breast
cancer among women under 55 years of age were higher in Israeli Jews than in
the U.S. population, which may be related to the genetic mutations in the BRCA genes known to be more prevalent among Ashkenazi women.
- The incidence of esophageal cancer in the MECC countries was among the lowest
in the world, which may be related to the relatively low consumption of alcohol
in the region. This finding calls for further study, as there is a high prevalence
of smoking in most MECC countries, which tends to increase esophageal cancer
- Childhood cancer (under 15 years) was higher overall in the Cyprus population
than in the U.S. SEER population and the other MECC populations. The Cypriots
reported high rates of childhood leukemia and central nervous system malignancies,
while the incidence of childhood lymphoma was particularly high among Egyptians,
compared with the other MECC populations.
- Rates of urinary bladder cancer were very high among Egyptians and Israeli
Jews, higher than the U.S. SEER population. Egypt’s high rate may be partly
explained by previously high rates of schistosomiasis, a parasitic disease
caused by infection with schistosome blood flukes that damage the bladder,
which is a known risk factor for urinary bladder squamous cell carcinoma.
Three additional registries — in Gaza, the West Bank in the Palestinian Authority,
and in Turkey — also participate in the MECC Cancer Registration Project. Data
from these registries will likely be included in future MECC publications.
The monograph is available at the SEER Web site at http://seer.cancer.gov/publications
and on the MECC Web site at http://mecc.cancer.gov, under Cancer Registry Project.
For more information about the Surveillance, Epidemiology, and End Results Program
of the National Cancer Institute, please go to http://seer.cancer.gov/.
For more information about cancer, please visit the NCI Web site at http://www.cancer.gov or call NCI's Cancer Information Service at 1-800-4 CANCER (1-800-422-6237).
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