Incidence of Cancer in Adolescents and Young Adults in Jordan, 2000-2017.

PURPOSE: The epidemiology of cancer in adolescents and young adults (AYAs) is distinct and underinvestigated. Therefore, we investigated the incidence of cancer in AYAs in Jordan. PATIENTS AND METHODS: We accessed all records submitted to the Jordan Cancer Registry between 2000 and 2017. We included all patients, age 15-39 years, who were ordinarily resident in Jordan. We then calculated frequencies, age-adjusted incidence rates (AAIRs), and annual percentage changes (APCs) and performed subgroup analyses by biologic sex, age subgroups, and site (SEER AYA site recode/WHO 2008). We also performed site-specific trend analyses using joinpoint models. RESULTS: We identified 14,115 eligible patients, of whom 1,531 (10.8%), 4,278 (30.3%), and 8,306 (58.8%) were 15-19, 20-29, and 30-39 years old at diagnosis, respectively. The numbers of male and female AYAs were 5,792 (41.0%) and 8,323 (59.0%), respectively. The crude number of cases increased from 654 in 2000 to 954 in 2017 (APC, 2.6%). The overall AAIR ranged from 32.3 in 2000 to 24.3 in 2017 (APC, -1.7%). The AAIR was 27.6 over the full study period and was higher in females (34.1) than in males (21.6). Carcinomas, lymphomas, and leukemias were the most common cancers. The incidence rates of the majority of cancers trended downward over the study period. CONCLUSION: The incidence of cancer in AYAs in Jordan is relatively low and declining. However, the absolute number of cases is increasing because this downtrend does not offset the effect of a high population growth rate; almost a 1,000 cases of cancer are now diagnosed every year, which represents a significant increase in the burden of cancer in a developing country with limited healthcare resources.

Spatial and temporal characteristics of cancer in the period from 2004 to 2013 in the Hashemite Kingdom of Jordan.

Cancer in Jordan is a major public health problem and the second leading cause of death after heart disease. This study aimed at studying the spatial and temporal characteristics of cancer in Jordan and its 12 governorates for the period 2004-2013 to establish a baseline for future research and identification of cancer risk factors paving the way for developing a cancer control plan in the country. Numerical and graphical summaries, time-series additive seasonal decomposition, the method of least squares, and spacetime scan statistics were applied in a geographic information systems environment. Although the results indicate that the cancer incidence in Jordan is comparatively low, it is increasing over time. In the 10-year study period, a total of 44,741 cases was reported with a mean annual crude incidence rate of 68.4 cases/100,000, mean annual age-adjusted incidence rate of 111.9 cases/100,000, and a monthly rate increase of 1.2 (cases/100,000)/month. This study also revealed that the spatial and temporal characteristics of cancer vary among the governorates. Amman, which includes the capital city and hosts more than one-third of the population of the country, reported 61.0% of the total number of cases. Amman also reported the highest annual crude incidence rate (105.3 cases/100,000), the highest annual age-adjusted incidence rate (160.6 cases/100,000), and the highest rate of increase (0.7 (cases/100,000)/month) forming a high-rate cluster. Excluding the three governorates Amman, Balqa, and Ma'daba, low-rate clusters were found with regard to the remaining governorates. All governorates, except Irbid and Mafraq, showed significant rates of increase of cancer incidence. However, no clear seasonality pattern with respect to cancer incidence was discerned.

The Epidemiology and Trend of Cancer in Jordan, 2000-2013.

OBJECTIVES: This study aimed to determine the overall incidence, trend, and epidemiology of cancer among Jordanians from 2000 to 2013 using data extracted from Jordan's Cancer Registry (JCR). METHODS: All cancer cases among Jordanians registered between 2000 and 2013 were analyzed using CanReg software and SPSS. The overall crude incidence rates (CIRs) and the age standardized rates (ASRs) of cancer per 100,000 were calculated. RESULTS: A total of 58788 cancer cases were registered during the period 2000-2013. Of those, 28545 (48.6%) were males and 30243 (51.4%) were females. About three-quarters (77.3%) of the registered patients were ≥ 40 years in age. Overall, the average crude cancer incidence rate was 82.8/100,000 population during the 14-year study period. On the other hand, the ASR was 126/100,000 during the same period (124.2 /100,000 for males and 128.4 /100,000 for females). The cumulative top cancers among males were colorectal, lung, lymphoma, urinary bladder, and prostate, respectively, while those among females were breast, colorectal, lymphoma, thyroid, and uterine. The number of cancer cases has increased from 3370 in 2000 to 5409 in 2013 (60.5% increase over the 14 years). The percentage of increase was 68.4% in females and 52.5% in males. The ASR has also increased from 113.6 per 100,000 in 2000 to 142.1 per 100.000 in 2013 with a 25.1% of increase during the 14 years. CONCLUSION: Over the 14-year study period, incidence of cancer in Jordan has increased. However, it remains lower than that in other Eastern Mediterranean and Western countries. We recommend initiating screening programs for the most common types of cancer in Jordan that have valid screening tests to detect cancer during its early stages and reduce overall morbidity and mortality.

Colorectal Cancer in Jordan: Survival Rate and Its Related Factors.

Objectives. To estimate the survival rate of colorectal cancer (CRC) and determine its predictors among Jordanian patients who were diagnosed in the period of 2005-2010. Methods. This study was based on Jordan cancer registry. All CRC cases that were registered in cancer registry during 2005-2010 were analyzed using the survival analysis. The last date for follow-up was 1st Oct 2016. Results. A total of 3005 patients with CRC were registered during 2005-2010. The overall 5-year and 10-year survival rates for patients with CRC were 58.2% and 51.8%, respectively. The 5-year survival rate decreased significantly from 60.4% for the age <50 years to 49.3% for the age ≥70 years (p < 0.005). The 5-year survival rate was 72.1% for the localized stage, 53.8% for the regional stage, and 22.6% for the distant metastasis. In the multivariate analysis, the only factors that were significantly associated with survival were age, grade, stage, and location of tumor. Conclusions. The overall 5-year and ten-year survival rates for CRC were 58.2% and 51.8%, respectively. Increased age, poor differentiation, advanced cancer stage, and right-sided cancers were associated with lower survival rates. Screening strategies are needed for early detection of colon adenomas and colorectal cancer in Jordan.