Clinical Characteristics and Outcomes of Cancer Cases Among Syrian Refugees From Southern Turkey.
Journal
JAMA network open
ISSN: 2574-3805
Titre abrégé: JAMA Netw Open
Pays: United States
ID NLM: 101729235
Informations de publication
Date de publication:
01 05 2023
01 05 2023
Historique:
medline:
25
5
2023
pubmed:
23
5
2023
entrez:
23
5
2023
Statut:
epublish
Résumé
Cancer was a common noncommunicable disease in Syria before the present conflict and is now a major disease burden among 3.6 million Syrian refugees in Turkey. Data to inform health care practice are needed. To explore sociodemographic characteristics, clinical characteristics, and treatment outcomes of Syrian patients with cancer residing in the southern border provinces of Turkey hosting more than 50% of refugees. This was a retrospective hospital-based cross-sectional study. The study sample consisted of all adult and children Syrian refugees diagnosed and/or treated for cancer between January 1, 2011, and December 31, 2020, in hematology-oncology departments of 8 university hospitals in the Southern province of Turkey. Data were analyzed from May 1, 2022, to September 30, 2022. Demographic characteristics (date of birth, sex, and residence), date of first cancer-related symptom, date and place of diagnosis, disease status at first presentation, treatment modalities, date and status at last hospital visit, and date of death. The International Statistical Classification of Diseases and Related Health Problems, Tenth Revision and International Classification of Childhood Cancers, Third Edition, were used for the classification of cancer. The Surveillance, Epidemiology, and End Results system was applied for staging. The diagnostic interval was defined as the number of days from first symptoms until the diagnosis. Treatment abandonment was documented if the patient did not attend the clinic within 4 weeks of a prescribed appointment throughout the treatment. A total of 1114 Syrian adult and 421 Syrian children with cancer were included. The median age at diagnosis was 48.2 (IQR, 34.2-59.4) years for adults and 5.7 (IQR, 3.1-10.7) years for children. The median diagnostic interval was 66 (IQR, 26.5-114.3) days for adults and 28 (IQR, 14.0-69.0) days for children. Breast cancer (154 [13.8%]), leukemia and multiple myeloma (147 [13.2%]), and lymphoma (141 [12.7%]) were common among adults, and leukemias (180 [42.8%]), lymphomas (66 [15.7%]), and central nervous system neoplasms (40 [9.5%]) were common among children. The median follow-up time was 37.5 (IQR, 32.6-42.3) months for adults and 25.4 (IQR, 20.9-29.9) months for children. The 5-year survival rate was 17.5% in adults and 29.7% in children. Despite universal health coverage and investment in the health care system, low survival rates were reported in this study for both adults and children with cancer. These findings suggest that cancer care in refugees requires novel planning within national cancer control programs with global cooperation.
Identifiants
pubmed: 37219908
pii: 2805174
doi: 10.1001/jamanetworkopen.2023.12903
pmc: PMC10208156
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e2312903Subventions
Organisme : Department of Health
ID : NIHR131207
Pays : United Kingdom
Références
Lancet. 2020 Mar 14;395(10227):855-856
pubmed: 32171397
BMC Cancer. 2022 May 12;22(1):532
pubmed: 35550042
J Int Med Res. 2021 May;49(5):3000605211018448
pubmed: 34038215
Lancet Oncol. 2016 Jul;17(7):865-867
pubmed: 27396633
Ecancermedicalscience. 2020 May 08;14:1039
pubmed: 32565892
JCO Glob Oncol. 2021 Jul;7:1101-1109
pubmed: 34236931
Confl Health. 2022 Jan 31;16(1):3
pubmed: 35101060
J Glob Oncol. 2016 Aug 31;3(4):338-345
pubmed: 28831442
Lancet Oncol. 2020 May;21(5):e280-e291
pubmed: 32359503
Public Health. 2019 Jul;172:146-152
pubmed: 31235210
Confl Health. 2021 Oct 18;15(1):77
pubmed: 34663406
Lancet Oncol. 2014 Jun;15(7):e290-7
pubmed: 24872112
Dan Med J. 2015 Apr;62(4):B5068
pubmed: 25872539
Cancer. 2005 Apr 1;103(7):1457-67
pubmed: 15712273
J BUON. 2017 Nov-Dec;22(6):1591-1594
pubmed: 29332358
Pediatr Hematol Oncol. 2020 Nov;37(8):707-716
pubmed: 32705959
Lancet Oncol. 2020 Apr;21(4):e185-e224
pubmed: 32240612
Lancet. 2018 Dec 15;392(10164):2553-2566
pubmed: 30528484
Lancet Oncol. 2020 May;21(5):637-644
pubmed: 32359488