Epidemiology of Gastric Cancer in North Africa and the Middle East from 1990 to 2017.

Introduction: Gastric cancer is the fifth most common cancer worldwide and the third cause of cancer deaths and disability-adjusted life years (DALYs) worldwide. The countries of the Middle East and North Africa are similar in many determinants of health, but there are significant differences in the incidence of gastric cancer in these countries. Therefore, the purpose of this study was to compare the burden of gastric cancer in MENA countries with appropriate policies to reduce the incidence and mortality of gastric cancer in the region.

Materials And Methods: GBD database data were used to assess the gastric cancer indices in MENA countries consisted of 21 countries in the Middle East and North Africa in 1900 and 2017. Gastric cancer-related analysis using DALY counts, which is the sum of YLLs (total years lost due to premature death) and YLDs (years lost due to disability), and incidence rates, prevalence rates, death rates, and standardized age rates (ASR) were measured.

Results: The incidence of gastric cancer has decreased in the world and the MENA region from 1990 to 2017, which is higher than the global average in MENA. But death rates in the region have decreased below the global average. The trend of changes in DALY count has increased from 1990 to 2017 in all countries in the region except Turkey. This increase is higher in men than in women and also in Iran. In these countries, the highest percentage of total DALY of gastric cancer is attributable to the risk factors for high sodium and cigarette consumption, in Turkey and the United Arab Emirates, respectively (from 1990 to 2017) Also, the largest decrease is in the UAE and Iraq, respectively.

Conclusion: Despite a decrease in the incidence of gastric cancer and, possibly, due to late diagnosis and poor health services, the attenuation of gastric cancer is high in MENA countries. Therefore, it is recommended to reduce the attenuation of screening programs before 50 years old for early detection in addition to prevention programs and to reduce smoking, especially in men.