Abstract
BackgroundWithin a dramatic socio-political context, cancer represents a growing health burden in the Gaza Strip. We investigated the survival experience of people diagnosed with breast (BC) or colorectal (CRC) cancer from 2005 to 2014.MethodsData included 1360 BC cases (median age 55.1 years) and 722 CRC cases (median age: 59.5 years; 52.5% men) recorded by the Gaza Cancer Registry according to a standard protocol. Clinical information was available for cases diagnosed in 2005–2006 only. Survival probabilities were estimated by Kaplan-Meyer method, while hazard ratios (HRs) and 95% confidence intervals (CI), adjusted for age and sex, were computed to assess factors associated with the risk of death.ResultsFive-year survival was 65.1% for women with BC and 50.2% for patients with CRC. Advanced age (> 65 years), stage, and grade increased the death risk. Full access to therapies was associated with a reduced risk of death as compared with patients who had limited access (HR = 0.26, 95% CI:0.13–0.51 for BC; and HR = 0.11, 95% CI:0.04–0.31 for CRC).Conclusion(s)The 5-year survival after BC or CRC in the Gaza Strip was in line with estimates from surrounding Arab countries, but it was much lower than in developed Mediterranean countries (e.g., in Italy or in Jewish people in Israel).
Highlights
Within a dramatic socio-political context, cancer represents a growing health burden in the Gaza Strip
Study population We described the general characteristics and the cancer survival experience of people living in the Gaza Strip, diagnosed with breast cancer (BC) or CRC in 2005–2014, according to the information recorded in the population-based Gaza Cancer Registry (GCR)
Hazard ratios (HRs) for all-cause mortality, and the corresponding 95% confidence intervals, were estimated using the Cox proportional hazard model adjusted for age at diagnosis (< 35, 35–44, 45–54, 55–64, 65–74, 75+ years) and gender, as appropriate [12]
Summary
Within a dramatic socio-political context, cancer represents a growing health burden in the Gaza Strip. We investigated the survival experience of people diagnosed with breast (BC) or colorectal (CRC) cancer from 2005 to 2014. The Gaza Strip, a narrow land located in the southern part of the Occupied Palestinian Territory (OPT), is an overcrowded area with a population of 1.8 million people (i.e., 5000 persons per km2) [1]. In the OPT, two population-based cancer registries were established in 1996 by the Palestinian Ministry of Health (MoH) -one in the West Bank, and one in the Gaza Strip [4]. Given the geopolitical context of the Gaza Strip [7, 8], the data collection process cannot fully reflect the whole cancer burden in the area. Of all cases recorded between 2005 and 2014, breast cancer (BC) was the most common cancer among women (26.0% -skin cancers included), while colorectal cancer (CRC) was the second most common cancer in men (9.7% of all cases)
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