Epidemiology of cancer in Saudi Arabia thru 2010–2019: a systematic review with constrained meta-analysis<span style="font-size: 12px"> Running title: epidemiology of cancer in Saudi Arabia thru 2010–2019</span>

Abstract

Background Cancer is emerging as a major global health-care system challenge with a growing burden worldwide. Due to the inconsistent cancer registry system in Saudi Arabia, the epidemiology of cancer is still dispersed in the country. Consequently, this review aimed to assemble the epidemiological metrics of cancer in Saudi Arabia in light of the available published data during the period from (2010–2019). Methods Published literature from Saudi Arabia relating to cancer incidence, prevalence, risk factors, and other epidemiological metrics were accessed through electronic search in Medline/PubMed, Cochrane, Scopus, Web of Knowledge, Google Scholar, and public database that meet the inclusion criteria. Relevant keywords were used during the electronic search about different types of cancers in Saudi Arabia. No filters were used during the electronic searches. Data were pooled and odds ratios (ORs) and 95% confidence interval (95%CI) were calculated. A random-effects meta-analysis was performed to assess the well-determined risk factors associated with different types of cancers. Results The most common cancers in Saudi Arabia are breast, colorectal, prostate, brain, lymphoma, kidney and thyroid outnumbering respectively. Their prevalence rates and OR (95%CI) as follow: breast cancer 53% and 0.93 (0.84–1.00); colon-rectal cancer (CRC) 50.9% and 1.2 (0.81–1.77); prostate cancer 42.6% and 3.2 (0.88–31.11); brain/Central Nervous System cancer 9.6% and 2.3 (0.01–4.2); Hodgkin and non-Hodgkin's lymphoma 9.2% and 3.02 (1.48–6.17); kidney cancer 4.6% and 2.05 (1.61–2.61), and thyroid cancer 12.9% and 6.77 (2.34–19.53). Conclusion Within the diverse cancers reported from Saudi Arabia, the epidemiology of some cancers magnitude 3-fold in the latest years. This increase might be attributed to the changing in the Saudi population lifestyle (adopting western model), lack of cancer awareness, lack of screening & early detection programs, social barriers toward cancer investigations. Obesity, genetics, sedentary lifestyle, tobacco use, viral infection, and iodine & Vit-D deficiency represent the apparent cancer risk factors in Saudi Arabia.

The prevalence and associated predictors for Bethesda III–VI for reporting thyroid cytopathology in Royal Commission Hospital, Kingdom of Saudi Arabia

“…3 , 28 A significant geographical variation in the incidence of thyroid cancer throughout the KSA was documented in 2013. 5 This geographical variation pointed to different risk factors contributing to thyroid cancer: nutritional patterns, together with excessive weight gain, 39 high consumption of processed chicken and fresh and processed fish products 25 and environmental carcinogens, such as pollutants and radiation exposure. 24 Furthermore, the differences in the genetic backgrounds of the study groups and the polygenetic factors – activation of oncogenes such as Rat sarcoma (RAS), human gene that encodes a protein called B-Raf (BRAF), receptor tyrosine kinase/phenylthiocarbamide (RET/PTC) and the overstimulation of the phosphatidylinositol 3-kinase/protein kinase B (PI3K/AKT) pathway – are involved in thyroid tumorigenesis.…”

“…37 Interestingly, our results and result of literature review study showed almost similar findings regarding the benign, Bethesda III-VI, and the 38 The high prevalence of Bethesda III-VI might be explained by the global increase of thyroid cancer, 1,2 in gulf countries 3,4 and in KSA. 5,27,39 Moreover, this could be explained by the improvement of high-quality ultrasounds and screening for thyroid nodulesenhancing detection and diagnosis of thyroid cancers -and a possible increase in exposure to risk factors. 3,28 A significant geographical variation in the incidence of thyroid cancer throughout the KSA was documented in 2013.…”

The Economic Burden Associated with the Management of Different Stages of Breast Cancer: A Retrospective Cost of Illness Analysis in Saudi Arabia

“…In Saudi Arabia, breast cancer is the predominant type of cancer with an overall incidence rate of 14.8% among both genders, accounting for 29.7% of cancer among females. Moreover, the breast cancer mortality rate in Saudi Arabia was estimated at 8.5% of all cancer-related deaths [ 3 ].…”

Patterns and grades of presentation of colon cancer in Northern Saudi Arabia

“…The disease tends to affect the younger generation, particularly women. Most cases present with advanced stages of the disease, denoting the lack of screening or public awareness towards early detection [ 8 , 9 ]. Several studies from Saudi Arabia have claimed a low level of awareness towards CRC prevention, screening, and early diagnosis [ 10 , 11 ], which revealed patients seeking help at the late stages of the disease.…”