Cancer control research priorities in Arabs living in the United States: a systematic review

Authors: Chebli P, Watson K, Al-Kodmany A, & Molina Y

Category: Cancer Health Disparities, Cancer Health Disparities
Conference Year: 2018

Abstract Body:
Background:Our systematic review aims to synthesize the literature on cancer in the Arab American (ArA) population and develop recommendations for future cancer control and prevention research on ArAs. Methods:A systematic review was performed using PubMed, Web of Sciences, CINAHL, Embase, Cochrane, and GoogleScholar. Titles explicitly mentioning Arabs and cancer were eligible for abstract review. Abstracts were eligible if cancer prevention or control with ArAs was discussed, if published in English, with no restriction on publication date. Results:The systematic review identified 2,322 articles. Of those, 77 abstracts, and 46 full-length articles were reviewed. Of the 46 full-length articles, 45 were peer-reviewed publications, 40 articles were observational studies, sample sizes ranged from 106 to 1,652, and sampling strategies included local community sampling or secondary analysis of population-based databases. Overall, ArAs have higher incidence of leukemia, bladder and thyroid cancers compared to other groups. Most commonly studied cancer sites were breast (37%), cervical (24%), and colorectal (13%). No article focused on prevention, 65% focused on screening, 2% on diagnostic follow-up, 13% on treatment/survivorship, and 10% of cancer burden. Observational studies largely focused on barriers and facilitators to cancer screening uptake, with the most common barriers being low English proficiency, religious beliefs, cancer stigma, unawareness of screening need, and difficulty navigating the U.S. health system. Intervention studies attempted to improve knowledge (57%) or to promote cancer screening (29%); 57% used pre- post designs and only 1 was a randomized trial. All interventions demonstrated significant impacts on knowledge and screening rates. Conclusion:Cancer burden and behavioral risk factors in ArAs are difficult to ascertain without the inclusion of an “Arab” ethnicity category on population-based surveys. Epidemiological studies with a sociodemographic focus are needed to examine access, awareness and uptake of screening and treatment in ArA populations to guide the development of targeted interventions. From a clinical perspective, treatment adherence and confirmation of treatment effects with ArAs are needed to optimize treatment outcomes.

Keywords: Cancer disparities, Arab Americans, minority health