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中东和北非(MENA)地区儿童及青少年癌症差异:不同社会经济阶层的发病率、死亡率和生存率

Pediatric and adolescent cancer disparities in the Middle East and North Africa (MENA) region: incidence, mortality, and survival across socioeconomic strata.

作者信息

Shukla Ankita, Zeidan Rouba Karen, Saddik Basema

机构信息

Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates.

Department of Family and Community Medicine and Behavioural Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates.

出版信息

BMC Public Health. 2024 Dec 30;24(1):3602. doi: 10.1186/s12889-024-21155-8.

Abstract

BACKGROUND

Cancer is one of the leading causes of death in children and adolescents, with a significant concentration in low and middle-income countries. Previous research has identified disparities in cancer incidence and mortality based on a country's level of development. The Middle East and North Africa (MENA) region comprises of countries with heterogeneous income and development levels. This study aims to investigate whether discrepancies in cancer incidence and mortality among children and adolescents exist in countries within the MENA region.

MATERIALS AND METHODS

Data on cancer incidence and mortality were drawn from the Global Burden of Disease Study (GBD) 2019 for all malignant neoplasms (including non-melanoma skin cancers). The analysis was restricted to children and adolescents aged less than 20 years. Mortality- to-Incidence ratios (MIR) were calculated as a proxy measure of survival for each cancer type and country and Spearman's correlation coefficient measured the association between socio-demographic index (SDI), incidence rates, mortality rates, and MIR.

RESULTS

In 2019, cancer incidence in the MENA region was 4.82/100,000 population, while mortality rate was 11.65/100,000 population. Cancer incidence and mortality was higher among males compared to females. A marked difference was observed in cancer-related mortality rates between low-income and high-income countries. MIR was higher in low-income countries, particularly for males and specific cancer types such as liver, colon and rectum, brain and central nervous system (CNS) cancers, and non-Hodgkin lymphoma among others. A negative correlation was observed between a country's SDI and MIR (-0.797) and SDI and mortality rates (-0.547) indicating that higher SDI corresponds to lower MIR and lower mortality rates.

CONCLUSION

These findings highlight the need for evidence-based interventions to reduce cancer-related mortality and disease burden among children and adolescents, particularly in low-income countries within the region and for cancer types with the highest mortality rates. Additionally, efforts should focus on establishing registries to provide up-to-date national data on cancer incidence and mortality in countries within the region.

摘要

背景

癌症是儿童和青少年的主要死因之一,在低收入和中等收入国家尤为集中。先前的研究已经确定了基于国家发展水平的癌症发病率和死亡率差异。中东和北非(MENA)地区由收入和发展水平各异的国家组成。本研究旨在调查中东和北非地区各国儿童和青少年的癌症发病率和死亡率是否存在差异。

材料与方法

癌症发病率和死亡率数据取自《2019年全球疾病负担研究》(GBD)中所有恶性肿瘤(包括非黑色素瘤皮肤癌)的数据。分析仅限于20岁以下的儿童和青少年。计算死亡率与发病率之比(MIR)作为每种癌症类型和国家生存率的替代指标,Spearman相关系数衡量社会人口指数(SDI)、发病率、死亡率和MIR之间的关联。

结果

2019年,中东和北非地区的癌症发病率为每10万人4.82例,而死亡率为每10万人11.65例。男性的癌症发病率和死亡率高于女性。低收入国家和高收入国家在癌症相关死亡率方面存在显著差异。低收入国家的MIR较高,特别是男性以及某些特定癌症类型,如肝癌、结肠癌和直肠癌、脑和中枢神经系统(CNS)癌症以及非霍奇金淋巴瘤等。观察到一个国家的SDI与MIR(-0.797)以及SDI与死亡率(-0.547)之间呈负相关,表明较高的SDI对应较低的MIR和较低的死亡率。

结论

这些发现凸显了采取循证干预措施以降低儿童和青少年中癌症相关死亡率和疾病负担的必要性,特别是在该地区的低收入国家以及死亡率最高的癌症类型方面。此外,应致力于建立登记处,以提供该地区各国关于癌症发病率和死亡率的最新国家数据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5a16/11684239/fb710034c9de/12889_2024_21155_Fig1_HTML.jpg

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