Search

Background: Breast cancer incidence is increasing in the Gulf Cooperation Council (GCC) countries: Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, and United Arab Emirates., Aims: This study analysed geographical patterns, time trends, and age distribution of female breast cancer incidence among nationals and non-nationals in GCC countries., Methods: Available cancer registry data for 1979-2016 were retrieved for the GCC countries. Age-standardized rates (ASRs) per 100 000 women were calculated using the World standard population. Comparisons were made by calculating comparative incidence figures., Results: From 1998 to 2012, incidence among nationals was highest in Bahrain (ASR 61.85), Kuwait (ASR 52.66), and Qatar (ASR 56.90) and lowest in Saudi Arabia (ASR 19.76), Oman (ASR 22.33), and United Arab Emirates (ASR 31.05). In the most recent period, data were available only in Qatar (2014-2016) and Saudi Arabia (2013-2015). Non-nationals and nationals in Qatar had higher incidence rates than in Saudi Arabia. Incidence among nationals in Qatar was at least twice that in Saudi Arabia (comparative incidence figure 2.32). Incidence among non-nationals in Qatar was 3 times higher than in Saudi Arabia. Among nationals in Kuwait, 10.8% of cases of breast cancer occurred in women aged < 40 years in 2008-2012, compared with 24.2% in non-nationals in Qatar in 2014-2016., Conclusion: Breast cancer incidence has increased over time among women in most GCC countries, likely reflecting the improvements in healthcare access and screening programmes. Nationals and non-nationals developed breast cancer at a younger age than women in other high-income countries. Increased screening uptake is still required in the region. Evidence-based, locally-informed interventions should be implemented to address risk factors specific to the nationals and non-nationals in the GCC countries., (Copyright © Authors 2023; Licensee: World Health Organization. EMHJ is an open access journal. This paper is available under the Creative Commons Attribution Non-Commercial ShareAlike 3.0 IGO licence (CC BY-NC-SA 3.0 IGO; https://creativecommons.org/licenses/by-nc-sa/3.0/igo).)

Aims: Perinatal mental illness (PMI) is associated with a high risk of maternal and infant morbidity. Recently, several systematic reviews and primary studies have explored the prevalence and risk factors of PMI in the Middle East and North Africa (MENA) region. To our knowledge, there has been no critical analysis of the existing systematic reviews (SRs) on this topic in the MENA region. Our systematic overview primarily aimed to synthesize evidence from the published SRs on PMI in the MENA countries focusing on a) the prevalence of PMI and b) the risk factors associated with PMI. Methods: We conducted a systematic overview of the epidemiology of PMI in the Middle East and North Africa region by searching the PubMed, Embase, and PsycInfo databases for relevant publications between January 2008 and July 2019. In addition to searching the reference lists of the identified SRs for other relevant SRs and additional primary studies of relevance (those which primarily discussed the prevalence of PMI and/or risk and protective factors), between August and October 2019, we also searched Google Scholar for relevant studies. Results: After applying our inclusion and exclusion criteria, 15 systematic reviews (SRs) and 79 primary studies were included in our overview. Studies utilizing validated diagnostic tools report a PMI prevalence range from 5.6% in Morocco to 28% in Pakistan. On the other hand, studies utilizing screening tools to detect PMI report a prevalence range of 9.2% in Sudan to 85.6% in the United Arab Emirates. Wide variations were observed in studies reporting PMI risk factors. We regrouped the risk factors applying an evidence-based categorization scheme. Our study indicates that risk factors in the relational, psychological, and sociodemographic categories are the most studied in the region. Conversely, lifestyle-related risk factors were less studied. Conclusions: Our systematic overview identifies perinatal mental illness as an important public health issue in the region. Standardizing approaches for estimating, preventing, screening, and treating perinatal mental illness would be a step in the right direction for the region.