Literature Review and Profile of Cancer Diseases Among Afghan Refugees in Iran: Referrals in Six Years of Displacement

Abstract

BackgroundThere is a paucity of research on the profile of cancers among displaced populations, specifically Afghan refugees in Iran. This study illustrates the pattern of cancers in this population, and highlights the challenges of cancer care in displaced people with the intent that this data will facilitate appropriate allocation of resources to improve care in this population.Material/MethodsThis was a retrospective cross-sectional study, in which we collected the demographics and profile of cancers among Afghan refugees from 2005 to 2010 from referrals to the United Nations High Commissioner for Refugees (UNHCR) offices in Iran. Accrued evidence by other studies published between January 1993 and July 2014 pertaining to cancer diagnoses in refugees from Afghanistan, Tibet, Syria, Jordan, and Iraq was reviewed.ResultsCancer diagnoses accounted for 3083 of 23 152 total referrals, with 49% female and 51% male cases; 23.3% were 0–17 years of age, 61.2% were 18–59, and 15.5% were above 60. The most common health referral for females and males (0–17) was malignant neoplasms of lymphatic and hematopoietic tissue, accounting for 34.2%. In the age groups 18–59 and above 60 for both male and females it was malignant neoplasm of the digestive system, occurring in 26.3% and 48.7%, respectively.ConclusionsIn the setting of humanitarian crises especially war, cancer diagnoses among refugees is a major health burden both on the host countries and the international community with serious implications considering the recent growing trend in the Middle Eastern countries. The prevalence of certain cancer diagnoses among refugees, like gastrointestinal, respiratory, breast, and genitourinary cancers necessitates a multidirectional approach, primarily aimed at prevention and early detection. International partnerships are essential for improvement in cancer surveillance service availability, and delivery of the standard of care, in an overall effort to reduce the human cost, monetary, and resource associated burdens of cancer.Recommendations to implement effective prevention and management goals as well as improved record keeping in the refugee setting and the acquisition of secure and sustainable funding sources should be implemented in collaboration with global humanitarian agencies like UNHCR.

Prevalence and Pattern of Non-communicable Diseases in Children in Jos, Nigeria

“…The reason for the higher prevalence observed in our study could be due to the fact that the other two studies were carried out in 2008 while our study was done four years later, possibly due to the fact that the incidence of NCDs is rising even in the developing countries. This is in line with the projection [11,12,13] that by 2020 the prevalence of NCDs in individuals aged 15-59 years would rise to between 37% and 42%.…”

Cancer care in times of conflict: cross border care in Pakistan of patients from Afghanistan

“…The most common cancers among adult patients in our cohort were upper gastrointestinal, breast and colorectal malignancies, whereas most paediatric patients presented with haematological malignancies (Figure 3). These findings are similar to previous studies investigating cancer among Afghan refugees in Iran and Pakistan [10,11,14]. The aetiology of cancer is complex but risk factors, including environmental exposure to munitions and the toxic remnants of war, poor dietary and lifestyle habits, including the heavy use of tobacco-based products such as naswar, and the lack of cancer surveillance programmes likely contribute to the development of cancer in this population [11,[15][16][17][18].…”

“…NCDs, which include the spectrum of cancers, are predicted to constitute over 80% of the global burden of disease by 2020 and will disproportionately affect Low-and Middle-Income Countries, especially refugee populations, with damaging long-term health and socio-economic consequences [9][10][11]. This is particularly relevant for conflict-affected regions which face a triple burden of disease encompassing communicable diseases, NCDs and trauma with limited healthcare resources and constant insecurity [2,12,13].…”

“…The lack of a cancer surveillance programme, the cost of treatment, as well as lack of knowledge about cancer treatments lead to significant delays in patients seeking medical attention and presenting with advanced disease. The situation is exacerbated by on-going conflict and insecurity, financial hardship and limited access to follow-up or definitive treatment [11].…”

Displaced children with cancer in Lebanon: A sustained response to an unprecedented crisis

“…There are very few published data regarding the management of the financial needs of cancer care in refugee populations. A few studies have attempted to characterize types of prevalent cancers and referral mechanisms in refugee settings, such as Afghan, Nigerian, and other refugee populations . The UNHCR has attempted to address cancer care in refugees through the exceptional care committees, where applications for cancer treatment support were submitted and studied for eligibility .…”