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Background: 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., Methods: Data 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., Results: Five-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).

Background: Genetic susceptibility plays a key role in the development of nasopharyngeal carcinoma (NPC) and in fact the disease presents with an unusually high incidence in certain regions of the world like North Africa. We investigated the association between polymorphism of the Transforming growth factor-β1 (TGF-β1) and risk of NPC in North Africa. TGF-β1 is a multifunctional cytokine that acts as both a tumor suppressor and a stimulator of cancer development; it has been shown to influence risk of numerous other carcinomas including lung, breast and prostate cancer., Methods: TGF-β1 polymorphisms C-509T and T869C were studied in a large North African sample of 384 NPC cases and 361 controls, matched for age, sex and urban or rural residence in childhood. Genotypes were determined using polymerase chain reaction-restriction fragment length polymorphism., Results: No association was observed between individual single nucleotide polymorphisms or their haplotypes and NPC susceptibility (for TGF-β1 C-509T: OR = 0.74; 95 % CI 0.46 - 1.18; for TGF-β1 T869C: OR = 0.86; 95 % CI 0.56 - 1.31), even when the samples were stratified by age, gender and TNM stage., Conclusion: Contrary to what has been observed in Asian samples, in our North African sample, the TGF-β1 C-509T and T869C polymorphisms did not substantially influence NPC susceptibility.

Background: Incidence rates of various cancers are increasing in Arab countries and are expected to reach those of industrialized ones in few decades. This paper aimed to describe the incidence rates of most common cancers--and/or of those cancer preventable through modifiable behaviors--recorded in the province of Setif, Algeria from 1986 through 2010., Methods: Cancer diagnoses for the 1986-2010 period were provided by the population-based Cancer Registry of Setif, disentangled by site, morphology, age (quinquennia), sex, and calendar period. The corresponding population was obtained from the Algerian Institute of Statistics. Age-standardized rates (world population) (ASR-WR) were computed by calendar period (five quinquennias from 1986-1990 to 2006-2010), while annual percent changes (APCs) were computed for the period 1996-2010., Results: During the 2006-2010 period, ASR-WR for all cancer sites were 106.4/100,000 in men and 110.3 in women. The four leading cancers were: lung (18.0%); colon-rectum (9.6%); bladder (9.1%); and prostate (6.5%) in men; breast (36.4%); colon-rectum (8.5%); cervix uteri (6.0%); and thyroid (6.0%) in women. Between 1996-2010, overall cancer incidence increased statistically significantly (p < 0.05) in both men (APC = +2.5%) and women (APC = +3.7%). Statistically significant decreasing trends were observed for nasopharyngeal carcinoma (APC = -3.4%) in men, and for cervical (APC = -4.2%) and gallbladder (APC = -3.2%) cancers in women. Statistically significant increasing trends were observed for most common cancers both in men (lung:+1.8%, colon-rectum:+5.4%, prostate:+4.3%, liver:+8.9%, and bladder:+5.9%) and women (breast:+8.2%, colon-rectum:+4.5%, lung:+10.0%, liver:+5.4%, thyroid:+5.3%, and larynx:+13.8%)., Conclusions: International recommendations against cancer must be strongly promoted in Setif after taking into account epidemiological transition, lifestyle, and environmental changes.

Although genetic susceptibility to nasopharyngeal carcinoma (NPC) has been recognized for a long time, little is known about the responsible genes. X-Ray repair cross-complementing protein 1 (XRCC1) and human 8-oxo-guanine glycosylase 1 (hOGG1) genes are involved in deoxyribonucleic acid (DNA) repair and were found associated with NPC risk in three Asian case-control studies. The objective of the present study was to test these genes in a sample from North Africa, one of the major NPC endemic regions in the world. Three single nucleotide polymorphisms (SNPs) in the XRCC1 gene and one SNP in the hOGG1 gene were genotyped in 598 NPC cases from Morocco, Algeria, and Tunisia and 545 controls frequency matched by recruitment center, age, sex, and urban/rural household. The genotype and allelic distributions for the hOGG1 (326)Ser/Cys SNP and for the XRCC1 (399)Arg/Trp, (280)Arg/His, and (194)Arg/Trp SNPs did not differ significantly among NPC cases and controls. The XRCC1 (194)Trp allele frequency was significantly lower in the North African population than in Asian population (f = 0.04 vs. 0.31 in Cantonese Chinese and 0.21 Han Chinese). The hOGG1 (326)Ser allele frequency was significantly higher in the North African population (f = 0.73) than in Asian populations (f = 0.39 in Taiwanese). The results of the present study obtained from a large sample indicate that the XRCC1 and hOGG1 genes are unlikely to play a role in the susceptibility to NPC in North Africans. Our results do not corroborate those found in Asian population on smaller samples., (Copyright ©2011 Wiley-Liss, Inc.)

Background: Cannabis is the most widely consumed illicit drug worldwide and the relation between cannabis smoking and lung cancer is suggestive, albeit inconclusive., Method: We conducted three hospital based case-control studies in Tunisia, Morocco, and Algeria, three areas of high prevalence of cannabis consumption as well as production. This paper presents the pooled analysis of these three studies restricted to men with a total of 430 cases and 778 controls., Results: Ninety-six percent of the cases and 67.8% of the controls were tobacco smokers and 15.3% of the cases and 5% of the controls were ever cannabis smokers. All cannabis smokers were tobacco users. Adjusting for country, age, tobacco smoking, and occupational exposure, the odds ratio (OR) for lung cancer was 2.4 (95% confidence interval [CI]: 1.6-3.8) for ever cannabis smoking. This association remained after adjustment for lifetime tobacco packyears as continuous variable, OR = 2.3 (95% CI: 1.5-3.6). The OR adjusted for intensity of tobacco smoking (cigarette/d) among current tobacco smokers and never cannabis smokers was 10.9 (95% CI: 6.0-19.7) and the OR among current tobacco users and ever cannabis smokers was 18.2 (95% CI: 8.0-41.0). The risk of lung cancer increased with increasing joint-years, but not with increasing dose or duration of cannabis smoking., Conclusion: Our results suggest that cannabis smoking may be a risk factor for lung cancer. However, residual confounding by tobacco smoking or other potential confounders may explain part of the increased risk.

North Africa is one of the major Nasopharyngeal Carcinoma (NPC) endemic regions. Specific food items unique to this area were implicated to be associated with NPC risk, but results were inconsistent. Here we have performed a large-scale case-control study in the Maghrebian population from Tunisia, Algeria and Morocco. From 2002 to 2005, interviews were conducted on 636 cases and 615 controls. Controls were hospitalized individuals from 15 non-cancer hospital departments, or friends and family members of non-NPC cancer subjects, matched by center, childhood household type (rural or urban), age and sex. Conditional logistic regression is used to evaluate the risk of factors. In results, consumption of rancid butter, rancid sheep fat and preserved meat not spicy (mainly quaddid) were associated with significantly increased risk of NPC, while consumption of cooked vegetables and industrial preserved fish was associated with reduced risk. Other foods such as fresh citrus fruits and spicy preserved meat (mainly osban) in childhood, industrial made olive condiments in adulthood, were marginally associated. In multivariate analyses, only rancid butter, rancid sheep fat and cooked vegetables were significantly associated with NPC. In regard to possible causative substances, our results implicate the involvement of butyric acid, a potential Epstein-Barr virus (EBV) activator.

Objective: Diabetes mellitus stands as a major public health issue in Algeria and has an important socioeconomical impact. Our study involved a representative sample of 1457 subjects and aimed at assessing the prevalence of type 2 diabetes and glucose intolerance in the population of Setif Wilaya, aged between 30 and 64 years old., Material and Methods: Diagnosis was based on oral glucose tolerance test, according to World Health Organisation criteria., Results: Diabetes prevalence was 8.2% (CI: 95%: 6.8% to 9.6%). It increased with age, while 50% of cases were undiagnosed, without any difference according to sex nor urban (7.3%)/rural (9.7%) distribution. Glucose intolerance prevalence was 7.1 (CI 95%: 5,8% to 8,4%). Age-standardized prevalence, according to world population data provided by WHO, was 9.08% for diabetes and 7.5% for glucose intolerance. When the new American Diabetes Association Criteria were used, prevalence of type 2 diabetes was 8.8 (CI: 95%: 7.3% to 10.2%) and that of fasting hyperglycemia was 6.9% (CI: 95%: 5.6 to 8.2). According to these new criteria, among the 66 cases with undiagnosed diabetes, 79% presented with a fasting blood glucose > or =126 mg/dl., Conclusion: This relatively high diabetes prevalence calls for an appropriate management and health education, particularly focused on high risk subjects. These results bring the the first detailed prevalence data in an Algerian population.

Background: The aim of our work was to identify risk factors specific to populations in our region for primary prevention of risk behaviors, particularly eating habits., Methods: We conducted a case-control study on dietary factors of nasopharyngeal carcinoma in the Setif area in Algeria. The study included 72 cases and 72 controls matched for age, sex and area of residence. The variables analyzed were identified by an anthropological study., Results: Increased risk of disease was associated with consumption of traditionally preserved foods such as "harissa", pickled fruit and vegetables and dried and salted meat. These factors were commonly found in other endemic areas. Certain products appeared to be specific to the Setif area including dried and salted fat, especially after prolonged exposure. Rancid butter was related to a 4 to 7-fold increase in risk and use of pickling increased the risk of nasopharyngeal carcinoma 4 to 12-fold depending on the type of food., Conclusions: These data point to the need for biochemical analysis of food specimens to search for the carcinogenic agents and to the importance of an immediate information and education program on food habits for the populations living in this area.

The possible role of bacteria in the etiology of nasopharyngeal carcinoma (NPC) was studied by bacteriological and biochemical analyses of nasopharyngeal swabs collected in the cavum and in the fossa of Rosenmüller of NPC patients and healthy controls in France and Algeria. Counts of total bacteria and of total nitrate-reducing bacteria, mainly enterobacteria, were higher in the Maghrebians than in the Caucasians. The composition of the bacterial flora was different: in Maghrebians, enterobacteria were present in five of 17 control subjects and eight of 15 NPC patients, while the prevalence was only one out of 15 control subjects in Caucasians. Twelve of 32 bacterial species isolated from Caucasians and Maghrebians with normal or tumorous nasopharyngeal microflora were able to catalyse nitrosation of morpholine in vitro. This result suggests that colonization of the nasopharynx by microflora that contain nitrate-reducing microorganisms which can form N-nitroso compounds might represent a risk factor for NPC in Maghrebian populations.

Preliminary results are presented for a general population-based cancer registry in Setif, Algeria, for 1986-88. Standardised incidence rates for all sites, excluding non-melanoma skin cancer, are 70.1 for men and 59.9 for women: these rates are lower than those reported for most populations. The most frequent cancers are lung, stomach and liver in men, and cervix, liver and breast in women. Nasopharyngeal carcinoma is frequent in both sexes. Incidence of cancers of the gallbladder and extrahepatic bile ducts in women appears particularly high. These results represent the first detailed incidence data for all cancers in an Algerian population.

As most developing countries, Algeria does not seem to have escaped the tobacco epidemic raging around the world. Tobacco there has become one of the principal causes of death and illness. To confront this alarming situation, preventive measures have been taken. In particular, an epidemiological investigation of tobacco consumption was conducted among grade-school students in the Wilaya de Setif during the 1986-87 academic year. The fundamental data on tobacco dependency in grade school was obtained. 1,771 students from 12 to 20 years of age were polled through individual and anonymous questionnaires. The dimensions of this scourge were thus revealed: 18% of these students are smokers. The majority (97%) are boys. Smoking begins early, after age 10, with a high point at 14. To face this situation, a National Committee Against Tobacco was introduced by the Ministry of Public Health. A grade school programme is in the planning. The following proposals were made: to inform, widely and objectively, the grade-school population, the teachers and the parents; to take action above all in the primary schools, which constitute an ideal setting to reach these children, who are potential smokers, before they become long-term smokers.