Cancer surveillance in the Eastern Mediterranean region: a 10-year International Agency for Research on Cancer–WHO Regional Office for the Eastern Mediterranean collaboration

 

Cancer Surveillance in the Eastern Mediterranean Region: A 10-Year IARC–WHO EMRO Collaboration

 Introduction

Cancer surveillance is essential for informed policy-making, prevention strategies, and treatment services. In the Eastern Mediterranean Region (EMR)—a diverse region comprising 22 countries with a combined population of approximately 700 million—the cancer burden is rapidly increasing. Recognizing this, the International Agency for Research on Cancer (IARC) and the World Health Organization’s Regional Office for the Eastern Mediterranean (WHO EMRO) launched a decade-long collaboration in 2013 to build and strengthen cancer surveillance systems across the region. 

📈 Overview and Context

  • From 2013 through 2023/24, IARC and WHO EMRO collaborated to build sustainable and high‑quality cancer surveillance systems across the Eastern Mediterranean Region (EMR), serving 22 countries and territories and a population of ≈700 million Wikipedia+12IARC+12EMRO+12IARC+4PubMed+4EMRO+4.

  • A policy review published in The Lancet Oncology (online 3 March 2025) reports on this decade of joint work, cancer patterns, progress made, persistent challenges, and future plans IARC+3IARC+3EMRO+3.

Key Achievements of the Collaboration

  • Technical support: Through the Global Initiative for Cancer Registry Development (GICR), support was delivered to 20 EMR countries, with tailored site visits and recommendations to 12 member countries EMRO+3IARC+3EMRO+3.

  • Training & capacity building:

    • Conducted five workshops (basic and advanced topics) with over 100 cancer registry professionals trained, including three regional GICRNet trainers EMRO+3IARC+3EMRO+3.

    • Registry teams from five EMR countries received in‑person training at the Izmir Cancer Registry in Türkiye, coordinated via the IARC Regional Hub and WHO country offices PubMed+4IARC+4EMRO+4.

Why It Matters: Regional Cancer Landscape

  • Cancer incidence in the region is projected to nearly double—from ~782 000 in 2022 to ~1.8 million by 2050—due to demographic shifts alone, with many countries facing low cancer control capacity and stark inequalities IARC+2PubMed+2IARC+2.

  • Common cancers differ by sex and setting:

    • In women, breast cancer is the most frequent across all EMR countries, with cervical cancer more prevalent in lower‑income countries.

    • In men, lung, colorectal and prostate cancers represent a substantial share—especially in higher‑development countries Wikipedia+15IARC+15reddit.com+15.

Challenges & Ongoing Barriers

  • Despite progress, gaps remain in governance, policy maker awareness, resource availability, and electronic data systems, including mortality data coverage Wiley Online Library+1PubMed+1.

  • Population‑based cancer registries (PBCRs) participating in national planning and screening evaluation—but less involved in palliative care or rehabilitation planning Wiley Online Library+1PubMed+1.

Strategic Priorities Looking Ahead

  • The 5th IARC–WHO Regional Office Joint Action Plan (2023) focuses on:

    • Expanded training and capacity building.

    • Co‑development of resources.

    • Improved use and sharing of cancer indicators for planning and advocacy.

    • Enhanced assessment of the main causes of cancer across the region EMROEMRO.

🔍 Summary Table

AreaHighlights
Coverage & Reach20 countries supported, 12 with tailored advice, over 100 professionals trained
Training ApproachFive workshops plus on‑site practicums at Izmir hub
Cancer Burden~782 000 new cases in 2022 projected to nearly 1.8 M by 2050
Registry UseHigh in planning and screening; low in palliative planning
Key BarriersWeak governance, limited data systems, under‑resourcing
Future FocusCancer causes assessment, indicator usage, stronger capacity


 Objective of the Collaboration

The goal was to support EMR countries in developing sustainable, high-quality population-based cancer registries (PBCRs). These registries help in monitoring trends, evaluating control programs, and guiding national cancer plans.

 Key Strategies and Implementation

  • Global Initiative for Cancer Registry Development (GICR):
    Served as the core platform for technical and strategic support.

  • Technical Assessments and Consultations:
    Conducted tailored evaluations in 12 countries to guide improvements in registry operations.

  • Capacity Building and Training:

    • Five regional workshops (basic and advanced) held.

    • Over 100 cancer registry professionals trained.

    • Three regional GICRNet trainers certified.

    • Hands-on training in Türkiye’s Izmir Cancer Registry for five EMR countries.

  • Resource Development:
    Jointly created educational tools, protocols, and software packages for registry implementation.

 Regional Cancer Trends and Challenges

  • Current Burden:
    ~782,000 new cancer cases were reported in the EMR in 2022.
    By 2050, this figure is expected to more than double, reaching 1.8 million, mainly due to population growth and aging.

  • Common Cancers:

    • Women: Breast cancer dominates across the region.

    • Men: Lung, colorectal, and prostate cancers are leading in higher-income nations.

    • Cervical cancer remains a concern in lower-resource countries.

  • Persistent Barriers:

    • Limited mortality data and electronic health infrastructure

    • Underfunded national cancer control programs

    • Weak integration of registry data into policy and planning

    • Minimal registry involvement in palliative care and rehabilitation frameworks

 Achievements and Impact

  • Significant growth in cancer registry coverage and data quality across the EMR.

  • Countries increasingly using registry data for screening programs, national cancer control planning, and evaluation.

  • Establishment of regional cooperation and a foundation for long-term cancer surveillance sustainability.                                                                                                                                                              


 Future Directions (2023–2030 Strategy)

The 5th Joint IARC–WHO EMRO Work Plan outlines strategic priorities:

  1. Expanded training and mentoring for new and existing registries

  2. Improved use of cancer indicators for advocacy and planning

  3. Focus on identifying cancer causes and disparities in the region

  4. Digital transformation and data integration with national health systems

  5. Greater registry involvement in all stages of cancer control, including palliative care

 Conclusion

The 10-year collaboration between IARC and WHO EMRO has laid a strong foundation for cancer surveillance in the Eastern Mediterranean Region. While notable progress has been made in data collection, training, and policy influence, sustained investment and political commitment are crucial. The future calls for equity-focused, technology-enabled, and policy-integrated cancer surveillance systems that can fully support the region's fight against the rising cancer burden.

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