Abbas Noura F, Aoude Marc R, Kourie Hampig R, Al-Shamsi Humaid O
Department of Hematology-Oncology, Hotel Dieu De France Hospital, Saint Joseph University of Beirut, Riad El Solh, Lebanon.
Department of Oncology, Burjeel Cancer Institute, Burjeel Medical City, Abu Dhabi, United Arab Emirates.
Asian J Urol. 2024 Jul;11(3):406-422. doi: 10.1016/j.ajur.2023.10.001. Epub 2023 Oct 31.
Bladder cancer (BC) is a significant public health concern in the Middle East and North Africa, but the epidemiology and clinicopathology of the disease and contributors to high mortality in this region remain poorly understood. The aim of this systematic review was to investigate the epidemiological features of BC in the Arab world and compare them to those in Western countries in order to improve the management of this disease.
An extensive electronic search of the PubMed/PMC and Cochrane Library databases was conducted to identify all articles published until May 2022, following the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. A total of 95 articles were included in the final analysis after title, abstract, and full-text screening, with additional data obtained from the GLOBOCAN and WHO 2020 databases.
Most of the included articles were case-control studies examining the risk factors and molecular mechanisms of BC. These studies originated from 10 different countries, with Egypt being the most active contributor. While BC in the Arab world shares some common risk factors with Western countries, such as smoking and occupational exposure, it also exhibits unique features related to schistosomiasis. The high mortality rates in this region are alarming and can be attributed to various factors, including the prevalence of smoking, the impact of schistosomiasis, a combination of genetic and socioeconomic factors, treatment shortages, and limited access to care or inadequate assessment of the quality of care.
Despite the relatively low incidence of BC in Arab countries, the mortality rates are among the highest worldwide. BC tends to be more aggressive in the Arab world, making it essential to implement strategies to address this burden.
膀胱癌（BC）是中东和北非地区一个重大的公共卫生问题，但该疾病的流行病学、临床病理学以及导致该地区高死亡率的因素仍知之甚少。本系统评价的目的是调查阿拉伯世界膀胱癌的流行病学特征，并将其与西方国家的特征进行比较，以改善该疾病的管理。
按照系统评价和Meta分析的首选报告项目指南，对PubMed/PMC和Cochrane图书馆数据库进行了广泛的电子检索，以识别截至2022年5月发表的所有文章。经过标题、摘要和全文筛选后，最终分析纳入了95篇文章，并从GLOBOCAN和WHO 2020数据库获得了额外数据。
纳入的文章大多是病例对照研究，探讨膀胱癌的危险因素和分子机制。这些研究来自10个不同的国家，埃及是最活跃的贡献者。虽然阿拉伯世界的膀胱癌与西方国家有一些共同的危险因素，如吸烟和职业暴露，但它也表现出与血吸虫病相关的独特特征。该地区的高死亡率令人担忧，可归因于多种因素，包括吸烟的流行、血吸虫病的影响、遗传和社会经济因素的综合作用、治疗短缺以及获得医疗服务的机会有限或对医疗质量的评估不足。
尽管阿拉伯国家膀胱癌的发病率相对较低，但其死亡率在全球范围内位居前列。膀胱癌在阿拉伯世界往往更具侵袭性，因此必须实施应对这一负担的策略。
