Global Health Institute, American University of Beirut, Beirut, LB.
Naef K Basile Cancer Institute, Faculty of Medicine, American University of Beirut, Beirut, LB.
Ann Glob Health. 2020 Nov 6;86(1):142. doi: 10.5334/aogh.2809.
The global cancer burden is disproportionately greater in low- and middle-income countries, including those affected by conflict in the Middle East and North Africa (MENA) region. Contributing factors include inadequate control of risk factors plus limited surveillance and treatment options. Weak healthcare infrastructure may be further compounded by the conflict prevalent in multiple MENA countries. Improved cancer surveillance, research, and capacity strengthening are essential for implementing cancer control plans in the MENA region, requisite for reducing the disproportionate cancer burden.
This article aims to understand the barriers to cancer research and training in conflict-affected MENA countries, and to identify opportunities for developing capacities for reliable cancer research strategies.
This study employs a mixed-method approach utilizing an online questionnaire with open and close ended questions targeting oncologists and cancer researchers in conflict-affected MENA countries. For open-ended questions, we performed a qualitative content analysis to identify thematic barriers.
Forty-eight respondents, mostly Medical and Radiation Oncologists, completed the questionnaire. The most significant training needs were conducting clinical, basic, and qualitative cancer research. The most prominent barriers identified were insufficient training in data analysis and research design (77% and 75% of respondents, respectively) and insufficient institutional and government funding (94% and 85%, respectively). For the qualitative data, we organized the barriers into six themes, the most common was the lack of research infrastructure (28%).
Despite an escalating cancer burden, conflict-affected MENA countries are lagging in knowledge production and implementation of evidence-based cancer research. Novel modes of knowledge transmission and collaboration across geographical and political boundaries are sorely needed. Based on our study, we recommend developing innovative and accessible training opportunities focusing on developing basic, clinical, and qualitative research skills. Research capacity-strengthening initiatives should encourage the investigation of context-specific research questions with the potential to make a meaningful impact on cancer control in the region.
全球癌症负担在中低收入国家（包括受中东和北非（MENA）地区冲突影响的国家）中不成比例地更大。促成因素包括对危险因素的控制不足，加上监测和治疗选择有限。薄弱的医疗保健基础设施可能因多个 MENA 国家普遍存在的冲突而进一步恶化。改善癌症监测、研究和能力建设对于在 MENA 地区实施癌症控制计划至关重要，这是减少不成比例的癌症负担的必要条件。
本文旨在了解受冲突影响的 MENA 国家癌症研究和培训的障碍，并确定制定可靠癌症研究策略能力建设的机会。
本研究采用混合方法，利用针对受冲突影响的 MENA 国家的肿瘤学家和癌症研究人员的在线问卷，采用开放式和封闭式问题。对于开放式问题，我们进行了定性内容分析，以确定主题障碍。
48 名受访者，主要是医学和放射肿瘤学家，完成了问卷。最需要的培训是进行临床、基础和定性癌症研究。确定的最突出障碍是数据分析和研究设计方面的培训不足（分别有 77%和 75%的受访者），以及机构和政府资金不足（分别有 94%和 85%的受访者）。对于定性数据，我们将障碍组织成六个主题，最常见的是缺乏研究基础设施（28%）。
尽管癌症负担不断增加，但受冲突影响的 MENA 国家在知识生产和实施基于证据的癌症研究方面落后。迫切需要跨越地理和政治边界的新型知识传播和合作模式。基于我们的研究，我们建议开发创新和易于访问的培训机会，重点是发展基础、临床和定性研究技能。研究能力建设倡议应鼓励调查具有潜在意义的针对具体情况的研究问题对该地区癌症控制的影响。
