Cancer among syrian refugees living in Konya Province, Turkey

Abstract

Background With more than 3.6 million Syrian refugees Turkey hosts the world's largest number of Syrians. Considering the morbidity, mortality, and healthcare spending, cancer is one of the leading health and economic burden for patients and healthcare systems. However, very limited information available in the scientific literature to understand the burden and characteristics of cancer in countries hosting Syrian refugees. The aim of the present study is to evaluate the demographic and clinical characteristics, treatment outcome of Syrian cancer patients living in Konya, Turkey. Methods We retrospectively reviewed medical records of Syrian cancer patients at three major institutions from 2005 to 2020. The information regarding demographic and clinical characteristics of patients were identified. The number of days between the first symptom and diagnosis was considered as the “diagnostic interval”. Patients who failed to attend clinics within four weeks of appointment were assumed abandoned treatment. Survival curves were estimated using the Kaplan–Meier method. Results We identified 230 adult and 38 children refugee diagnosed with cancer during the study period. With regards to adult patients, there were 114 (49.6%) male and 116 (50.4%) female. The median age at diagnosis was 52.4, 47.3 years for male, female respectively. The five most common cancer by site among all were; breast (24.8%), colorectal (10.9%), lung (7.4%), central nervous system (CNS) (7.0%), and stomach (5.2%). 93 (40.4%) had metastatic disease at diagnosis. The overall survival probability was 37.5% at five years for the adult population. Data were extracted for 20 boys and 18 girls with childhood cancer. Their median age at diagnosis was 5.8 and 6.0 years respectively. The three most common childhood cancer were; leukemias (21.1%), lymphomas (21.1%), and CNS (13.2%). Excluding leukemia, 13 (43.3%) of childhood cancer cases had the advanced disease at diagnosis. Three year survival probality was 69.5%. The median diagnostic interval for adult and childhood cancer was 96.5 (IQR = 53–165) and 23 (IQR = 13.5–59) days respectively. Twenty-one adults and four children had treatment abandonment. Conclusion This study contributes to understanding the burden of cancer among Syrian refugees living in Konya, growing health issue for refugees. Larger and prospective studies will help to measure the real burden and compare the difference in cancer risk factors, care, and outcomes among the refugee and host populations.

Comparison of Histopathological Characteristics of Laryngeal Squamous Cell Carcinoma in Turkish and Syrian Patient Populations

“…[7] Kutluk et al have reported the similar results and a prevalence of 2.2% for laryngeal cancer in their study. [3] LC is the cancer of respiratory tracts and 184,404 new cases with related 99,840 deaths have been reported in the year of 2020 worldwide. LC has made up 1% of all newly diagnosed cancer cases and cancer-related deaths.…”

Access to Radiation Therapy by Syrian Refugees Displaced to Turkey

“…Only a few include information on the utilization of RT in this population. 7 , 8 , 9 The results demonstrated that although Syrian refugees have access to free cancer screening and treatment, the majority of patients are diagnosed at an advanced stage. There was a diversity for reported rates of RT access.…”

“…Several demographic and clinical factors, such as residence in a refugee camp, advanced stage, and administration of concurrent chemoradiotherapy, were significantly associated with noncompliance. 9 On the other hand, Kutluk et al 7 and Bakkal-Temi et al 8 reported better treatment access of 20% to 39.6%.…”

“…The health care access of refugees has been viewed as a priority in Turkey. 7 Health services for Syrian refugees started in April 2011. Since then, Turkey has been creating legislative and institutional reforms to build an effective national system in parallel with international standards.…”

“…The Ministry of Health also established mobile cancer screening units for Syrian refugees to overcome diagnosis at advanced stages. 2 , 7 …”