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Tolba M, Skelton M, Abdul Sater Z, Fadhil I, Al-Zahrani A, Kutluk T, Akbarov K, Taher A, Sullivan R, Mula-Hussain L. Cancer Research in Vulnerable Populations: A Call for Collaboration and Sustainability From MENAT Countries. JCO Glob Oncol 2023; 9:e2300201. [PMID: 38096463 PMCID: PMC10730041 DOI: 10.1200/go.23.00201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Revised: 09/23/2023] [Accepted: 10/24/2023] [Indexed: 12/18/2023] Open
Abstract
PURPOSE Cancer is a major burden across Middle East, North Africa, Türkiye (MENAT). Many MENAT countries experience multiple conflicts that compound vulnerabilities, but little research investigates the linkages between vulnerability and cancer research. This study examines the current level and the potential for cancer research among vulnerable populations in the MENAT region, aiming to provide direction toward developing a research agenda on the region's vulnerable populations. METHODS Expert-driven meetings were arranged among the 10 authors. After obtaining institutional review board approval, a self-administered online survey questionnaire was circulated to more than 500 cancer practitioners working in 22 MENAT countries. RESULTS Two hundred sixteen cancer practitioners across the MENAT region responded. Fifty percent of the respondents identified clinical research in vulnerable patients with cancer as a significant issue; 21.8% reported previous research experience that included vulnerable populations, and 60% reported encountering vulnerable populations in their daily clinical practice. The main barriers to conducting research were lack of funding (60%), protected time (42%), and research training (35%). More than half of the respondents believed that wars/conflicts constituted an important source of vulnerability. The most vulnerable cancer populations were the elderly, palliative/terminally ill, those with concomitant mental health-related issues, those with other chronic illnesses, and socioeconomically deprived patients. CONCLUSION Results support that a major effort is needed to improve cancer research among vulnerable cancer populations in the MENAT region. We call for interdisciplinary research that accounts for the region's unique, compounding, and cumulative forms of vulnerability. This cancer research agenda on different vulnerable populations must balance sociobehavioral studies that explore sociopolitical barriers to quality care and clinical studies that gauge and refine treatment protocols. Building a research agenda through collaboration and solidarity with international partners is prime time.
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Affiliation(s)
- Marwan Tolba
- Department of Radiation Oncology, Dalhousie University, and Cape Breton Cancer Center, Sydney, Nova Scotia, Canada
| | - Mac Skelton
- Institute of Regional and International Studies, American University of Iraq, Sulaimani, Iraq
- Global Oncology Group, King's College London, London, United Kingdom
| | - Zahi Abdul Sater
- College of Public Health, Phoenicia University, Mazraat El Daoudiyeh, Lebanon
- Global Health Institute, American University of Beirut, Beirut, Lebanon
| | - Ibtihal Fadhil
- Eastern Mediterranean NCD Alliance, Dubai, United Arab Emirates
| | - Ali Al-Zahrani
- King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
- Gulf Center for Cancer Control & Prevention, Riyadh, Saudi Arabia
| | - Tezer Kutluk
- Department of Pediatrics, Division of Pediatric Oncology, Hacettepe University Faculty of Medicine & Cancer Institute, Ankara, Turkey
| | - Kamal Akbarov
- Division of Human Health, International Atomic Energy Agency, Vienna, Austria
| | - Ali Taher
- Hematology & Oncology, Naef K. Basile Cancer Institute, American University of Beirut Medical Center, Beirut, Lebanon
| | - Richard Sullivan
- King's College London & Guy's Comprehensive Cancer Centre, Global Oncology Group & Institute of Cancer Policy, Centre for Conflict & Health Research, London, United Kingdom
| | - Layth Mula-Hussain
- Department of Radiation Oncology, Dalhousie University, and Cape Breton Cancer Center, Sydney, Nova Scotia, Canada
- College of Medicine—Ninevah University, Mosul, Iraq
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