Staging practices and breast cancer stage among population-based registries in the MENA region

Piñeros, Marion; Ginsburg, Ophira; Bendahhou, Karima; Shelpai, Wael A.; Fouad, Heba; Znaor, Ariana; Hammouda, Doudja; Bouzbid, S.; Beichi, Fayçal; Khaoula, Bouharati; Toudeft, Fadhila; Mikhail, Nabiel Nazmi Hanna; Al-Aubaidy, Khitam Mohseen Ali; Nimri, Omar; Janahi, Eman; Elbasmi, A; Ghosn, Nada; Attia, Adel A.; Masaud, Waled; Tazi, Mohammed Adnane; Lahham, Huda; Alemayehu, Elias Mamo; Numairi, Mona; Lawati, Najla Al; Khiari, Hyem; Karakilinc, Hulya; Yakut, Cankut

doi:10.1016/j.canep.2022.102250

Cited by 4 publications

(10 citation statements)

References 32 publications

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“…Out of 21 MENA cancer registries that reported collecting stage data in the previous survey, only 12 registries were able to provide the data for analysis. This reflects the previously reported finding that stage data, even when collected, are frequently not reported in the cancer registry reports, 16 thus requiring an additional effort to extract data from the cancer registry database.…”

Section: Discussionsupporting

confidence: 74%

“…15 To improve availability and achieve comparability between population-based stage data globally, IARC now recommends the use of TNM classification. 15,16 The possibility of recording of TNM data directly from the medical records will minimise the need for staging at the cancer registries that commonly do not have a capacity or skills for this additional task. In case when medical records are available, but information on stage is lacking, IARC has developed a tool for use at the PBCR to assign a TNM stage group for common cancers, called Essential TNM.…”

Section: Discussionmentioning

confidence: 99%

“…15 Previous studies have shown that in the MENA region, quality and completeness of medical records are a common challenge, and that stage information is frequently missing, either from the data sources or in the population-based cancer registry (PBCR) data. 16,17 An additional challenge is the use of classifications historically developed for the cancer registries, such as SEER stage/summary extent of disease 18 that are not comparable with TNM stage data used by clinicians. 5,15 For CRC, TNM and SEER stage/extent of disease classifications for CRC are only comparable for distant metastasis.…”

Section: Introductionmentioning

confidence: 99%

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Stage at diagnosis of colorectal cancer in the Middle East and Northern Africa: A population‐based cancer registry study

Znaor,

Eser,

Bendahhou

et al. 2024

Intl Journal of Cancer

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Colorectal cancer (CRC) is the 2nd most common cancer and 3rd most common cause of death in the Middle East and Northern Africa (MENA) region. We aimed to explore CRC stage at diagnosis data from population‐based cancer registries in MENA countries. In 2021, we launched a Global Initiative for Cancer Registry Development (GICR) survey on staging practices and breast and CRC stage distributions in MENA. According to the survey results, population‐based data on TNM stage for CRC were available from six registries in five countries (Kuwait, Morocco, Oman, Türkiye, UAE). The proportion of cases with unknown TNM stage ranged from 14% in Oman to 47% in Casablanca, Morocco. The distribution of CRC cases with known stage showed TNM stage IV proportions of 26–45%, while the proportions of stage I cancers were lowest in Morocco (≤7%), and highest (19%) in Izmir, Türkiye. Summary extent of disease data was available from six additional registries and four additional countries (Algeria, Bahrain, Iraq, Qatar). In summary, the proportions of CRC diagnosed with distant metastases in Oman, Bahrain and UAE were lower than other MENA countries in our study, but higher than in European and the US populations. Harmonising the use of staging systems and focusing stage data collection efforts on major cancers, such as CRC, is needed to monitor and evaluate progress in CRC control in the region.

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Section: Discussionsupporting

confidence: 74%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Stage at diagnosis of colorectal cancer in the Middle East and Northern Africa: A population‐based cancer registry study

Znaor,

Eser,

Bendahhou

et al. 2024

Intl Journal of Cancer

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“…Unknown stage at diagnosis may indicate incomplete information or reflect limited resources in cancer registries to retrieve the data. Large proportion of unknown stage hinders valid assessment of early detection or screening programmes, evaluation of treatment outcomes, and misinforms resource allocation and planning . Improved reporting of stage data are important to inform health care professionals and policymakers, international initiatives are under way to ameliorate this area.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, the expected effect of breast cancer screening on decreasing the rate of advanced breast cancer rates could not be well estimated due to the methodological limitations of observational studies in which the screened population was not compared with the unscreened population . Collecting stage data using PBCRs, creating standard definitions of stage systems used, and methodologies to study the effects of early diagnosis and screening are key to evaluate progress—or lack thereof—and reduce mortality from breast cancer worldwide …”

Section: Discussionmentioning

confidence: 99%

Global Stage Distribution of Breast Cancer at Diagnosis

Benitez Fuentes,

Morgan,

de Luna Aguilar

et al. 2024

JAMA Oncol

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ImportanceStage at diagnosis is a key prognostic factor for cancer survival.ObjectiveTo assess the global distribution of breast cancer stage by country, age group, calendar period, and socioeconomic status using population-based data.Data SourcesA systematic search of MEDLINE and Web of Science databases and registry websites and gray literature was conducted for articles or reports published between January 1, 2000, and June 20, 2022.Study SelectionReports on stage at diagnosis for individuals with primary breast cancer (C50) from a population-based cancer registry were included.Data Extraction and SynthesisStudy characteristics and results of eligible studies were independently extracted by 2 pairs of reviewers (J.D.B.F., A.D.A., A.M., R.S., and F.G.). Stage-specific proportions were extracted and cancer registry data quality and risk of bias were assessed. National pooled estimates were calculated for subnational or annual data sets using a hierarchical rule of the most relevant and high-quality data to avoid duplicates.Main Outcomes and MeasuresThe proportion of women with breast cancer by (TNM Classification of Malignant Tumors or the Surveillance, Epidemiology, and End Results Program [SEER]) stage group.ResultsData were available for 2.4 million women with breast cancer from 81 countries. Globally, the proportion of cases with distant metastatic breast cancer at diagnosis was high in sub-Saharan Africa, ranging from 5.6% to 30.6% and low in North America ranging from 0.0% to 6.0%. The proportion of patients diagnosed with distant metastatic disease decreased over the past 2 decades from around 3.8% to 35.8% (early 2000s) to 3.2% to 11.6% (2015 onwards), yet stabilization or slight increases were also observed. Older age and lower socioeconomic status had the largest proportion of cases diagnosed with distant metastatic stage ranging from 2.0% to 15.7% among the younger to 4.1% to 33.9% among the oldest age group, and from 1.7% to 8.3% in the least disadvantaged groups to 2.8% to 11.4% in the most disadvantaged groups.Conclusions and RelevanceEffective policy and interventions have resulted in decreased proportions of women diagnosed with metastatic breast cancer at diagnosis in high-income countries, yet inequality persists, which needs to be addressed through increased awareness of breast cancer symptoms and early detection. Improving global coverage and quality of population-based cancer registries, including the collection of standardized stage data, is key to monitoring progress.

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