Profile of cancer in the Eastern Mediterranean region: The need for action Ivana Kulhánová a, *, Freddie Bray a , Ibtihal Fadhil b , Ali Saeed Al-Zahrani c , Amani El-Basmy d , Wagida A. Anwar e , Amal Al-Omari f , Ali Shamseddine g , Ariana Znaor a , Isabelle Soerjomataram a a Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France b WHO, Regional Office of the Eastern Mediterranean, Cairo, Egypt c King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia d Epidemiology and Cancer Registry Department, Kuwait Cancer Control Center, Kuwait e Department of Community, Environmental and Occupational Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt f King Hussein Cancer Center, Amman, Jordan g Division of Hematology and Oncology, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon A R T I C L E I N F O Article history: Received 21 September 2016 Received in revised form 22 December 2016 Accepted 29 January 2017 Available online xxx Keywords: Cancer Mortality Incidence Risk factors Eastern Mediterranean region A B S T R A C T Background: Many countries in the Eastern Mediterranean region (EMR) are undergoing marked demographic and socioeconomic transitions that are increasing the cancer burden in region. We sought to examine the national cancer incidence and mortality profiles as a support to regional cancer control planning in the EMR. Methods: GLOBOCAN 2012 data were used to estimate cancer incidence and mortality by country, cancer type, sex and age in 22 EMR countries. We calculated age-standardized incidence and mortality rates (per 100,000) using direct method of standardization. Results: The cancer incidence and mortality rates vary considerably between countries in the EMR. Incidence rates were highest in Lebanon (204 and 193 per 100,000 in males and females, respectively). Mortality rates were highest in Lebanon (119) and Egypt (121) among males and in Somalia (117) among females. The profile of common cancers differs substantially by sex. For females, breast cancer is the most common cancer in all 22 countries, followed by cervical cancer, which ranks high only in the lower- income countries in the region. For males, lung, prostate, and colorectal cancer in combination represent almost 30% of the cancer burden in countries that have attained very high levels of human development. Conclusions: The most common cancers are largely amenable to preventive strategies by primary and/or secondary prevention, hence a need for effective interventions tackling lifestyle risk factors and infections. The high mortality observed from breast and cervical cancer highlights the need to break the stigmas and improve awareness surrounding these cancers. © 2017 Published by Elsevier Ltd. 1. Introduction The Eastern Mediterranean region (EMR) is home to more than 600 million inhabitants and is as culturally, as it is economically, diverse [1]. Non-communicable diseases including cancer have become a major health problem in the region. Cancer now ranks as the fourth leading cause of death, after cardiovascular diseases, infectious diseases and injuries. In 2012, approximately 550,000 new cases and 360,000 deaths from cancer were reported for the EMR countries [2]. Although the incidence of cancer is below that of western, high-income regions, the EMR region is expected to experience a 100% increase in the number of new cancer cases in the coming two decades, among the highest projected increases among WHO regions [3]. Monitoring cancer incidence and mortality is essential for cancer control planning and capacity-building for cancer research, yet data in the region are relatively scarce and often of sub-optimal quality. This study aims to comprehensively describe the cancer incidence and mortality pattern in the EMR countries and raise awareness of the need for better data as well as the opportunities * Corresponding author at: Section of Cancer Surveillance, International Agency for Research on Cancer, 150 Cours Albert Thomas, 69008 Lyon, France. E-mail address: kulhanovai@fellows.iarc.fr (I. Kulhánová). http://dx.doi.org/10.1016/j.canep.2017.01.009 1877-7821/© 2017 Published by Elsevier Ltd. Cancer Epidemiology 47 (2017) 125–132 Contents lists available at ScienceDirect Cancer Epidemiology The International Journal of Cancer Epidemiology, Detection, and Prevention journa l homepage: www.cancerepidemiology.net