Clinical Characteristics and Outcomes of Cancer Cases Among Syrian Refugees From Southern Turkey.

Autor:	Kutluk T; Department of Pediatric Oncology, Hacettepe University Faculty of Medicine and Cancer Institute, Ankara, Turkey., Sahin B; Department of Medical Oncology, Çukurova University, Adana, Turkey., Kirazli M; Department of Pediatric Oncology, Hacettepe University Faculty of Medicine and Cancer Institute, Ankara, Turkey., Ahmed F; Department of Pediatric Oncology, Hacettepe University Faculty of Medicine and Cancer Institute, Ankara, Turkey.; Now with Department of Public Health, Yıldırım Beyazıt University, Ankara, Turkey., Aydin S; Department of Pediatric Oncology, Hacettepe University Faculty of Medicine and Cancer Institute, Ankara, Turkey., Yesil Çinkir H; Department of Medical Oncology, Gaziantep University, Gaziantep, Turkey., Sezgin G; Department of Pediatric Hematology-Oncology, Çukurova University, Adana, Turkey., Bayram I; Department of Pediatric Hematology-Oncology, Çukurova University, Adana, Turkey., Ebinç S; Department of Medical Oncology, Dicle University, Diyarbakır, Turkey., Isikdogan A; Department of Medical Oncology, Dicle University, Diyarbakır, Turkey., Sasmaz I; Department of Pediatric Hematology, Çukurova University, Adana, Turkey., Okan V; Department of Hematology, Gaziantep University, Gaziantep, Turkey., Ilhan G; Department of Hematology, Mustafa Kemal University, Hatay, Turkey., Ören AC; Department of Pediatric Hematology-Oncology, Gaziantep University, Gaziantep, Turkey., Akbayram S; Department of Pediatric Hematology-Oncology, Gaziantep University, Gaziantep, Turkey., Harputluoglu H; Department of Medical Oncology, İnönü University, Malatya, Turkey., Ural C; Department of Hematology, Dicle University, Diyarbakır, Turkey., Ayyildiz O; Department of Hematology, Dicle University, Diyarbakır, Turkey., Aktas G; Department of Medical Oncology, Sütçü İmam University, Kahramanmaraş, Turkey.; Now at Medicalpoint Gaziantep Hospital, Gaziantep, Turkey., Uçar MA; Department of Hematology, Çukurova University, Adana, Turkey., Güvenç B; Department of Hematology, Çukurova University, Adana, Turkey., Köse D; Department of Pediatric Oncology, Harran University, Şanlıurfa, Turkey.; Now at Emsey Hospital, İstanbul Turkey., Acipayam C; Department of Pediatric Hematology-Oncology, Sütçü İmam University, Kahramanmaraş, Turkey., Güncan S; Department of Medical Oncology, Mersin University, Mersin, Turkey., Erçolak V; Department of Medical Oncology, Mersin University, Mersin, Turkey., Berber I; Department of Hematology, İnönü University, Malatya, Turkey., Akdeniz A; Department of Hematology, Mersin University, Mersin, Turkey., Akyay A; Department of Pediatric Hematology-Oncology, İnönü University, Malatya, Turkey., Üzel VH; Department of Pediatric Hematology-Oncology, Dicle University, Diyarbakır, Turkey., Söker M; Department of Pediatric Hematology-Oncology, Dicle University, Diyarbakır, Turkey., Sengelen M; Department of Public Health, Hacettepe University, Ankara, Turkey., Yalçin S; Department of Medical Oncology, Hacettepe University, Ankara, Turkey., Sullivan R; King's College London, Institute of Cancer Policy, Conflict & Health Research Group, London, United Kingdom.
Jazyk:	angličtina
Zdroj:	JAMA network open [JAMA Netw Open] 2023 May 01; Vol. 6 (5), pp. e2312903. Date of Electronic Publication: 2023 May 01.
DOI:	10.1001/jamanetworkopen.2023.12903
Abstrakt:	Importance: Cancer was a common noncommunicable disease in Syria before the present conflict and is now a major disease burden among 3.6 million Syrian refugees in Turkey. Data to inform health care practice are needed. Objective: To explore sociodemographic characteristics, clinical characteristics, and treatment outcomes of Syrian patients with cancer residing in the southern border provinces of Turkey hosting more than 50% of refugees. Design, Setting, and Participants: This was a retrospective hospital-based cross-sectional study. The study sample consisted of all adult and children Syrian refugees diagnosed and/or treated for cancer between January 1, 2011, and December 31, 2020, in hematology-oncology departments of 8 university hospitals in the Southern province of Turkey. Data were analyzed from May 1, 2022, to September 30, 2022. Main Outcomes and Measures: Demographic characteristics (date of birth, sex, and residence), date of first cancer-related symptom, date and place of diagnosis, disease status at first presentation, treatment modalities, date and status at last hospital visit, and date of death. The International Statistical Classification of Diseases and Related Health Problems, Tenth Revision and International Classification of Childhood Cancers, Third Edition, were used for the classification of cancer. The Surveillance, Epidemiology, and End Results system was applied for staging. The diagnostic interval was defined as the number of days from first symptoms until the diagnosis. Treatment abandonment was documented if the patient did not attend the clinic within 4 weeks of a prescribed appointment throughout the treatment. Results: A total of 1114 Syrian adult and 421 Syrian children with cancer were included. The median age at diagnosis was 48.2 (IQR, 34.2-59.4) years for adults and 5.7 (IQR, 3.1-10.7) years for children. The median diagnostic interval was 66 (IQR, 26.5-114.3) days for adults and 28 (IQR, 14.0-69.0) days for children. Breast cancer (154 [13.8%]), leukemia and multiple myeloma (147 [13.2%]), and lymphoma (141 [12.7%]) were common among adults, and leukemias (180 [42.8%]), lymphomas (66 [15.7%]), and central nervous system neoplasms (40 [9.5%]) were common among children. The median follow-up time was 37.5 (IQR, 32.6-42.3) months for adults and 25.4 (IQR, 20.9-29.9) months for children. The 5-year survival rate was 17.5% in adults and 29.7% in children. Conclusions and Relevance: Despite universal health coverage and investment in the health care system, low survival rates were reported in this study for both adults and children with cancer. These findings suggest that cancer care in refugees requires novel planning within national cancer control programs with global cooperation.
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu