������

Public health infrastructure in the Middle East and North African (MENA) region is greatly lacking; this is no surprise to any of its residents. These long-standing structural weaknesses and the overall inequalities in these nations were made even more clear by .

Yet in recent years, the types of cancer awareness events popularised throughout the West have taken hold in the Arab region. In the United Arab Emirates, pharmaceutical giant Pfizer launched phase 2 of a campaign specific to the region, ,��to promote awareness and self-screening, including a round table with a breast cancer survivor.

Meanwhile, in the Gaza Strip, as part of the ��campaign, health authorities, charities, religious leaders, and even bakers came together to encourage early detection and screening.

Despite greatly different economic and political conditions, breast cancer i in both Gaza and the UAE, and in both countries, the cancer is diagnosed in later stages, reducing treatment options and survivability.

"While the region has many concerns, separating rising cancer rates, or any health issue, from the other factors negatively impacting the region is representative of a non-intersectional and depoliticised approach to health"

Cancer is a group of diseases that can present when a group of cells begins growing out of control in body tissue, eventually invading other parts of the body. It is a in almost every country in the world, and it affects people across demographics and geographies. In 2020, there were approximately 19 million new cases diagnosed globally, most of which are breast, lung, or colorectal cancer, and 10 million deaths.

The that on current trajectories, cancer rates will increase by 60 percent��over just the next 20 years. Cancer not only increases population mortality and disability but poses significant strain to health systems and health financing. Many cancers develop over the long term and there is no way to reverse population cancer rates overnight.

Unfortunately, many of the , like tobacco use, physical inactivity, environmental pollution, and occupational carcinogens, are present in the MENA, exacerbated by many fragile governments and countries in a conflict that are unable to meet even the most basic health needs of their populations.

Smoking is among the most pervasive behaviours that contribute to cancer in MENA, especially lung cancer. While smoking rates are decreasing around the world, , and rates are estimated to increase to 62 percent��by 2025. There remains high variation between nations, with Oman reporting the lowest rates.

, with more than 80 percent��of Jordanian men saying they have smoked or used nicotine products. This has contributed to “” cancer rates in Jordan, many diagnosed in patients younger than age 50.

In , where cancer rates are among the highest in the MENA, smoking (cigarette and water pipe) led to most cancer diagnoses. About a third of the residents in , including 30 percent��of doctors and 20 percent��of pregnant women. The country, deep into a financial and political crisis, faces smoking-related health costs near $150 million dollars.

Aside from the health risks, the economic effects are undeniable; , it is estimated that the region lost $30 billion due to mortality attributed to smoking.

While lung cancer is among the most common cancers in males in the MENA, women are less likely to smoke. In women from the region, as is the case worldwide, breast cancer is the most prevalent form of cancer and accounts for the majority of cancer cases throughout the region.

In 2016, died due to breast cancer in the Arab region. show an increasing trend in MENA, yet part of that may be attributed to more widespread screening efforts. Unfortunately, few countries collect high-quality data consistently; only Kuwait, Oman, Jordan, and Tunisia had breast cancer registries before 1998.

Aside from smoking, the highest risk factors for many forms of cancer include a poor diet, low physical activity, and greater rates of obesity, and the MENA region is transitioning to greater rates of all these factors.

Egypt, Bahrain, Jordan, Kuwait, Saudi Arabia and the UAE , ranging from 74-86 percent��of women and 69-77 percent��of men, rates that are significantly higher than the for overweight (39 percent) and obesity (13 percent). These factors are hypothesised to lead to higher cancer rates; for example, up to are thought to be brought on by obesity and poor diet.

"For all forms of cancer, across demographics, early screening and treatment is key in preventing cancer from advancing and increasing survivability. Yet despite some improvement in accessibility in recent decades, cancer screening is still largely underdeveloped across the region"

While the region has many concerns, separating rising cancer rates, or any health issue, from the other factors negatively impacting the region, is representative of a that, especially in light of the pandemic, is outdated and does not adhere to increasing evidence about social and political determinants of health. Thus, identifying steps that could improve population health, including reducing the cancer burden, goes hand-in-hand with mechanisms that can rebuild broken societies and realign public priorities.

The first priority for the MENA must be prevention. The reality is that a country cannot thrive politically, economically, or socially without a healthy populace. With a mix of , populations could be both incentivised to take certain cancer-preventing actions while dissuaded from engaging in actions that increase cancer risks.

For all forms of cancer, across demographics, early screening and treatment are key in preventing cancer from advancing and increasing survivability. Yet despite some improvement in accessibility in recent decades, cancer screening is still largely underdeveloped across the region. Aside from populations not being informed about the importance or availability of screening, many MENA countries.

Neither of these initiatives – preventing cancer and ensuring sufficient capacity to treat it – is possible from a perspective that devalues human life at the expense of political and economic power.

The cancer trajectory of the region in the coming decades is unlikely to show a reversal of the increase in recent years without making needed changes today. While some countries are taking some steps, .

Like many of the other challenges facing the region in the 21st century, a long-term approach that is still not the norm in many Arab states is needed.

This article was����by the Arab Center Washington DC on November 18, 2021, and was republished with permission.

Dr Yara M. Asi is an Assistant Professor at the School of Global Health Management��and Informatics, University of Central Florida

Follow her on��