Cancer diagnosis in areas of conflict

Abstract

To date, many Arab countries within the Middle East are facing political, financial, and social instability from war and conflicts. These conflicts have led to severe resources shortages and sometimes complete breakdowns in cancer care and diagnosis. Cancer diagnosis at early stages is the most vital step in achieving optimal cancer care and outcomes. Shortages in cancer diagnostic services have meant that many people within areas of conflict are ultimately deprived of these services in their own countries. Therefore, many of these cancer sufferers must bear travel expenses to neighboring countries in order to seek these services. A lack of prevention, screening, and diagnostic services for this population is known to deepen the cancer care deficit within these areas. Additionally, the financial burden of traveling abroad alongside the need to secure childcare and time off work can be overwhelming. As a result, patients within areas of conflict are frequently diagnosed at later stages and are less likely to receive optimal management plans. Though conflict-affected regions encounter many similar challenges in delivering quality cancer care, pronounced region-specific differences do exist. Therefore, it is important to build a roadmap that can provide tailored solutions to deficits in instruments, manpower, and facilities for each and every region involved. Keeping in mind the importance of collaboration and coordination on national and international levels to address the ground disparity in cancer diagnostic services, the main objective of this review article is to examine the significant problems, shortages, and difficulties in providing cancer diagnosis with a focus on imaging to conflict-affected populations in the Middle East (mainly Iraq, Syria, Yemen, and Sudan). Finally, we discuss how access to cancer diagnostic imaging services has been impacted by these conflicts.

Lung Cancer Diagnoses and Outcomes During the Syrian War, 2011-2018

“…8,37 It should be noted that this delay in diagnosis also complicates the management plans and poses higher financial burden on the patients and the system. 38 Our study also showed a 5-year survival rate of 0.1% and a 1-year survival rate of 13.1%; numbers that raise red flags when compared with survival rates worldwide. The most recent 5-year survival rate in the US 35,39 and in wealthier countries in the Middle East and North Africa region (commonly referred to as MENA) (eg, Qatar) 40 approximated 25%.…”

“…Additionally, several reports described how the Syrian armed conflict affected the availability of specialized physicians, health care facilities, and screening programs, and increased the challenges in cancer diagnosis . It should be noted that this delay in diagnosis also complicates the management plans and poses higher financial burden on the patients and the system …”

“… 8 , 37 It should be noted that this delay in diagnosis also complicates the management plans and poses higher financial burden on the patients and the system. 38 …”

“…This burden has been explicitly studied in countries receiving the highest number of Syrian refugees, 44 and is expected to have a higher gravity in Syria. The dramatic collapse of the Syrian economy put most Syrians in the grip of hunger, 45 and was additionally affected by the imposed sanctions and corruption as well as the loss of human resources, 23 , 38 restricting the ability of cancer care to recover. Accordingly, the recovery of the Syrian health care system faces significant challenges in the absence of a full resolution of the war.…”

Systemic Barriers to Optimal Cancer Care in Resource-Limited Countries: Jordanian Healthcare as an Example

“…Jordan has the largest population of refugees per capita in the world, with Syrians comprising the majority of the refugee population in Jordan [ 36 ]. Refugees face multiple challenges when it comes to cancer care in Jordan [ 37 ]. The Syrian refugee crisis has deeply affected the surrounding region since its onset in 2011, affecting more than five million Syrians that have sought refuge outside their homeland, predominantly in Turkey, Jordan, and Lebanon [ 38 ].…”