Cancer Report
Middle East Cancer Consortium releases pioneering report
The United States-based
National Cancer Institute
(NCI), part of the National
Institutes of Health, on 27
April released “Cancer
Incidence in Four Member
Countries (Cyprus, Egypt,
Israel and Jordan) of the
Middle East Cancer
Consortium (MECC) Compared
with US SEER” (Surveillance,
Epidemiology, and End
Results). The monograph
compiles information on
cancer incidence between
1996 and 2001, drawn from
cancer registries in four
member countries as part of
the Joint Cancer Registration
Project of the Middle East
Cancer Consortium.
The MECC’s primary goal
is to reduce the incidence
and impact of cancer in the
Middle East through collaborative
research. It was
established in 1996 with an
official agreement among
the Ministries of Health of
Cyprus, Egypt, Israel,
Jordan, and the Palestinian
Authority.
MECC executive director,
Michael Silbermann, DMD,
PhD, states in the monograph’s
preface: “Prior to the
agreement, most of the
countries in the consortium
had only recently begun to
establish population-based
registries. By accelerating
and strengthening this
process, the Joint Cancer
Registration Project very
quickly became the flagship
of MECC’s activities in the
region.”
Joe Harford, PhD, director
of NCI’s Office of
International Affairs and the
primary liaison to MECC,
said: “MECC represents one
of the few co-operative
efforts in the Middle East
that has managed to
continue uninterrupted
through the challenging
times in the region. The new
monograph comes at the
10th anniversary of the
signing of the ministerial
agreement forming MECC. It
is our hope that the publication
of these data and the
interesting questions that
they raise will stimulate
research that will benefit not
only the people of the
Middle East but will also
deepen our understanding of
cancer to the benefit of all.”
The monograph includes
information on interpretation
of the data, including
the study population, how
data were collected, and the
strengths and limitations of
the data. For comparative
purposes, tables show
cancer incidence rates from
both the MECC registry
regions and the SEER
registry programme in the
United States. SEER, an NCI programme, is an authoritative
source of information
on cancer incidence and
survival in the United States
and is considered the standard
for quality among
cancer registries around the
world.
“This project represents a
decade of hard work and
collaboration between scientists
from each of these countries
and is a model for international
scientific collaboration
in troubled regions of
the world,” said Laurence
Freedman, PhD, director,
Biostatistics Unit, Gertner
Institute for Epidemiology,
Sheba Medical Center, lead
author and chair of the
MECC’s Steering Committee
for Joint Cancer Registration.
Major findings in MECC
monograph
- Jordanians had the
lowest overall incidence
of cancer, while the
United States SEER population
and Israeli Jews
had substantially higher
overall cancer incidence
rates than in the other
MECC populations.
- While overall lung
cancer incidence was
much lower in the MECC
populations than in the
US SEER population, the
rates were comparable to
US SEER rates in Israeli
Arab men younger than
60, who are known to
have high tobacco
consumption.
- Israeli Jews had colorectal
cancer rates higher than
the US SEER population
and more than twice as
high as the other MECC
populations. This finding
calls for further investigation
of genetic and
dietary/environmental
factors among these
populations.
- Liver cancer incidence rates in Egyptians were
five to seven times as
high as those of the other
MECC populations, and
more than three times
the US SEER population.
This may be related to
the higher prevalence of
hepatitis B and C in the
population or to contamination
of food by aflatoxin,
a toxin produced
by many species of fungi.
- Egyptians and Israeli
Jews had rates of non-
Hodgkin lymphoma
higher than in the US
SEER population and
considerably higher than
in the other MECC populations.
Further studies of
risk factors for this malignancy
are needed in this
region of the world.
- Breast cancer incidence
was high in Israeli Jews,
comparable to the US
population. The other
MECC countries had
much lower rates. The
rates of breast cancer
among women under 55
years of age were higher
in Israeli Jews than in the
US population, which
may be related to the
genetic mutations in the
“BRCA” genes known to
be more prevalent among
Ashkenazi women.
- The incidence of
esophageal cancer in the
MECC countries was
among the lowest in the
world, which may be
related to the relatively
low consumption of
alcohol in the region.
This finding calls for
further study, as there is a
high prevalence of
smoking in most MECC
countries, which tends to
increase esophageal
cancer rates.
- Childhood cancer (under
15 years) was higher
overall in the Cyprus
population than in the
US SEER population and
the other MECC populations.
The Cypriots
reported high rates of
childhood leukemia and
central nervous system
malignancies, while the
incidence of childhood
lymphoma was particularly
high among
Egyptians, compared
with the other MECC
populations.
- Rates of urinary bladder
cancer were very high
among Egyptians and
Israeli Jews, higher than
the US SEER population.
Egypt’s high rate may be
partly explained by previously
high rates of schistosomiasis,
a parasitic
disease caused by infection
with schistosome
blood flukes that damage
the bladder, which is a
known risk factor for
urinary bladder squamous
cell carcinoma.
Three additional registries
– in Gaza, the West Bank
in the Palestinian
Authority, and in Turkey
– also participate in the
MECC Cancer Registration
Project. Data from these
registries will likely be
included in future MECC
publications.
The monograph is available
at the SEER Web site at: http://seer.cancer.gov/publications/mecc
For more info regarding
MECC visit: http://mecc.cancer.gov
