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. 2020 Oct 29:14:1129.
doi: 10.3332/ecancer.2020.1129. eCollection 2020.

Mapping breast cancer journal publications in conflict settings in the MENA region: a scoping review

Rima A Abdul-Khalek  1 , Ghassan Abu-Sitta  1 , Nassim El Achi  1 , Walaa Kayyal  1 , Ahmad Elamine  1 , Aya Noubani  1 , Marilyne Menassa  1 , Fahad Ahmed  2 , Richard Sullivan  3 , Deborah Mukherji  1
Affiliations

Mapping breast cancer journal publications in conflict settings in the MENA region: a scoping review

Rima A Abdul-Khalek et al. Ecancermedicalscience. .

Abstract

Background: Breast cancer is a major cause of cancer-related morbidity and mortality among women in the the Middle East and North Africa (MENA) region. Conflict and political instability in the region may affect medical research output, including that on breast cancer. This scoping review aims to systematically identify and map breast cancer publications across different stages of the cancer care pathway and across conflict-affected countries within the MENA region. The findings of this work will highlight the impact of conflict on cancer research that could be mitigated with the proper contextualised capacity strengthening intervention.

Methods: We followed the PRISMA-Scr methodology. We searched for peer-reviewed publications on topics related to breast cancer in 11 databases: Medline, PubMed, EMBASE, Web of Science, PROQUEST, CINAHL, Global Index Medicus, Arab World Searches Complete, Popline, Scopus and Google Scholar using both controlled vocabulary and keywords. Publication abstracts and full-text versions were screened for duplicates and included in our study based on pre-specified eligibility criteria: focused on breast cancer, related to the specific country of analysis and human or health system studies. We used a structured data extraction form to extract information related to the article, its methodology and the cancer care pathway being studied.

Results: A total of 19,215 citations were retrieved from our search. After removing duplicates, a total of 8,622 articles remained. Title and abstract screening retained 1,613 articles. Publications with first author affiliations to Turkey were consistently the highest across all categories of the cancer care pathway. Trends show an increase in articles from Lebanon, Jordan and Palestine after 2015. Early exploratory and epidemiological studies represented the majority of breast cancer research, followed by policy and implementation research and lastly experimental research. Most research conducted followed an observational study design. Important gaps were identified in the research output related to advanced breast cancer and palliative care (Libya, Syria and Yemen), mental health (Libya), and knowledge and education of breast cancer (Libya and Syria).

Conclusion: This scoping review has identified key areas in breast cancer research that lack significant research activity in conflict MENA settings. These areas, including but are not limited to palliative care, mental health, and education, can be prioritised and developed through regional collaboration and contextualised capacity strengthening initiatives.

Keywords: breast cancer; conflict; research capacity.

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Conflict of interest statement

All authors have no conflicts of interest.

Figures

Figure 1.
Figure 1.. Study flow chart.
Figure 2.
Figure 2.. Total number of publications from conflict-affected countries by first author’s country of affiliation.
Figure 3.
Figure 3.. Total number of publications related to conflict-affected countries of the MENA region by first author’s country of affiliation.
Figure 4.
Figure 4.. Trends in breast cancer publications by countries of first authors from the MENA region: (a) unadjusted (b) and adjusted for population size.
Figure 5.
Figure 5.. Type of research: early exploratory and epidemiological, trials or health services research.
Figure 6.
Figure 6.. Percentage of publications across the breast cancer care pathway (by country and by pathway).
See this image and copyright information in PMC

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