Humaid O. Al-Shamsi, MD; Nadia Abdelwahed, MD; Aydah Al-Awadhi, MD; Mohamed Albashir, MD; Amin M. Abyad, MD; Saeed Rafii, MD; Mehdi Afrit, MD; Bilal Al Lababidi, MD; Ibrahim Abu-Gheida, MD; Yoginee Pundlik Sonawane, MD; Neil A. Nijhawan, MD; Urfan Ul Haq, MD; Norbert Dreier, MD; Thanda Lucy Ann Joshua, MD; Faryal Iqbal, MS; Tamer Yacoub, MD; Faisal A. Nawaz, MD; Dima Abdul Jabbar, MD; Syed Hammad Tirmazy, MD; Dalia M. El-shourbagy, MD; Dina Hamza, MD; Mohamed Omara, MD; Sawsan Abdul Salam Al Madhi, MD; Hassan Ghazal, MD; Humaa Darr, MD; Muharrem Oner, MD; Zoi Vlamaki, MD; Abdul Rahman El Kinge, MD; Dorai Ramanathan, MD; Mohammed Judah, MD; Taghreed Almahmeed, MD; Mudhasir Ahmad, MD; Sai Babu Jonnada, MD; Nahla Almansoori, MD; Aly A. Razek, MD; Annett Al-Hamadi, MD; Nahed Balalaa, MD; Faek Jamali, MD; Ramanujam Anugonda Singarachari, MD; Abdelrahman Labban, MD; Kaltar Das, MD; Ernest J.T. Luiten, MD, PhD; Tamer Abdelgawad, MD; Falah Al-Khatib, MD; Sadir Alrawi, MD; and Hassan Jaafar, MD

This cohort study examines the implementation of a microbiologic screening pilot program in Al Zahra Hospital in the United Arab Emirates for identifying presymptomatic COVID-19 in patients with cancer.

Introduction Breast cancer is the most common cancer diagnosed in women in the Unites States (276,480 new cancer cases as per 2020 estimates) and accounts for 15.3% of all new cancer cases in the US [1]. Based on 2013-2015 data, approximately 12.9 percent of women will be diagnosed with female breast cancer at some point during their lifetime [1]. Rates for new female breast cancer cases have been rising on average 0.3% each year over the last 10 years [1]. The median age at diagnosis is 61 [2].

BACKGROUND:The role of somatic mutations in breast cancer prognosis and management continues to be recognized. However, data on the molecular profiles of Arab women are limited.MATERIALS AND METHODS:This was a cross-sectional study based on medical chart review of all Arab women diagnosed with breast cancer at a single institution between 2010 and 2018 who underwent next-generation sequencing with Ampliseq 46-Gene or 50-Gene.RESULTS:A total of 78 Arab women were identified, with a median age at diagnosis of 52.3 years (range: 37-82 years; 38.5% ≤50 years). The majority of patients had stage III or IV disease (74.4%). Next-generation sequencing revealed the following somatic mutation rates: TP53, 23.1%; ATM, 2.6%; IDH1, 2.6%; IDH2, 3.8%; PTEN, 7.7%; PIK3CA, 15.4%; APC, 7.7%; NPM1, 2.5%; MPL, 1.3%; JAK2, 2.5%; KIT, 7.7%; KRAS, 3.8%; and NRAS, 3.8%.CONCLUSION:Our study illustrates frequencies of somatic mutations in Arab women with breast cancer and suggests potential variations from estimates reported in the Western population. These data calls for larger epidemiologic studies considering the evolving role of such mutations in prognostication and personalized management.

BackgroundThe COVID-19 pandemic has caused a global health crisis. Numerous cancer patients from non-Western countries, including the United Arab Emirates (UAE), seek cancer care outside their home countries and many are sponsored by their governments for treatment. Many patients interrupted their cancer treatment abruptly and so returned to their home countries with unique challenges. In this review we will discuss practical challenges and recommendations for all cancer patients returning to their home countries from treatment abroad.MethodExperts from medical, surgical and other cancer subspecialties in the UAE were invited to form a taskforce to address challenges and propose recommendations for patients returning home from abroad after medical tourism during the SARS-COV-19 Pandemic.ResultsThe taskforce which consisted of experts from medical oncology, hematology, surgical oncology, radiation oncology, pathology, radiology and palliative care summarized the current challenges and suggested a practical approaches to address these specific challenges to improve the returning cancer patients care.Lack of medical documentation, pathology specimens and radiology images are one of the major limitations on the continuation of the cancer care for returning patients. Difference in approaches and treatment recommendations between the existing treating oncologists abroad and receiving oncologists in the UAE regarding the optimal management which can be addressed by early and empathic communications with patients and by engaging the previous treating oncologists in treatment planning based on the available resources and expertise in the UAE. Interruption of curative radiotherapy (RT) schedules which can potentially increase risk of treatment failure has been a major challenge, RT dose-compensation calculation should be considered in these circumstances.ConclusionThe importance of a thorough clinical handover cannot be overstated and regulatory bodies are needed to prevent what can be considered unethical procedure towards returning cancer patients with lack of an effective handover. Clear communication is paramount to gain the trust of returning patients and their families. This pandemic may also serve as an opportunity to encourage patients to receive treatment locally in their home country. Future studies will be needed to address the steps to retain cancer patients in the UAE rather than seeking cancer treatment abroad.

This case series examines the results of implementing a universal microbiologic screening strategy for asymptomatic patients with cancer for coronavirus disease 2019 at 1 institution in the United Arab Emirates.

With cancer being the third leading cause of mortality in the United Arab Emirates (UAE), there has been significant investment from the government and private health care providers to enhance the quality of cancer care in the UAE. The UAE is a developing country with solid economic resources that can be utilized to improve cancer care across the country. There is limited data regarding the incidence, survival, and potential risk factors for cancer in the UAE. The UAE Oncology Task Force was established in 2019 by cancer care providers from across the UAE under the auspices of Emirates Oncology Society. In this paper we summarize the history of cancer care in the UAE, report the national cancer incidence, and outline current challenges and opportunities to enhance and standardize cancer care. We provide recommendations for policymakers and the UAE Oncology community for the delivery of high-quality cancer care. These recommendations are aligned with the UAE government's vision to reduce cancer mortality and provide high quality healthcare for its citizens.

The burden of CRC among young adults has been recognized recently as an area that needs further research.Early onset colorectal cancer (EOCRC) is defined as a colorectal cancer that is diagnosed < 50 years of age.there is no consensus between studies if EOCRC is similar or if it has distinct molecular, clinical and epidemiologic features compared to adult onset CRC.EOCRC is usually characterized by an advanced stage at presentation, frequent high-grade cancers and poor prognosis.In the UAE there is anecdotal evidence that > 41% of UAE colon cancer patients are people younger than 50 years, and > 22% of the colon cancer cases are patients below the age of 40.Initiating screening earlier, at age 45 years, is a "qualified" recommendation from the American Cancer Society, yet there is no international recommendations to start earlier than 45 years of age.In the UAE the screening age has been set to start at the age of 40, largely due to the earlier data that shows that > 41% of UAE colon cancer patients are people younger than 50 years.Currently there are no published data regarding the outcome of early CRC screening in the UAE.Targeted surveillance, prevention, and treatment are needed to reduce the cancer burden in this underserved age group.

INTRODUCTION:The use of modern immunotherapy has been evolving over the past few years, and various new agents have been developed for new indications at multiple primary sites in oncology. It is important for physicians who are involved in cancer care to be aware and updated about new therapeutic agents and their indications, potential benefits, and side effects.PATIENTS AND METHODS:From October to November 2017, we conducted a survey on the awareness, understanding, attitude, and barriers associated with prescribing modern cancer immunotherapies among physicians in the Arabian Gulf countries. The study included practicing physicians who delivered chemotherapy; trainees were not eligible. A total of 460 physicians were contacted and invited to complete an online survey, of which approximately 74.8% did not respond, and 4 (3.4%) were excluded because they had not recently treated patients with cancer. 112 (24.3%) physicians completed the survey (completion rate = 25.2%). An online electronic survey questionnaire was developed via Planet Surveys. The survey was designed with multidisciplinary inputs of the study investigators practicing in the Arabian Gulf countries, piloted, and subsequently revised on the basis of feedback from 10 additional oncologists. The final survey included 23 questions and took 8-10 minutes for completion.RESULTS:All respondents were aware of modern immunotherapies, but 62.5% reported having limited experience in implementing them, whereas 31.3% reported good experience. The overall physicians' attitudes toward modern immunotherapy were favorable, with a mean score of 7.4 (scale of 1-10, with 10 being extremely favorable). Efficacy, clear indications, and good safety profile were perceived as key potential benefits. Cost, lack of experience, and lack of access to specific testing were the major barriers.DISCUSSION AND CONCLUSION:There was a high level of awareness and an overall positive attitude toward modern cancer immunotherapy among oncologists in the Arabian Gulf countries, but there was a limited experience in prescribing cancer immunotherapeutic agents. Efficacy, clear indications, and good safety profile were perceived as key potential benefits, whereas cost, lack of experience, and lack of access to specific testing prior to prescription were the major barriers. Patients were likely to be receptive to modern immunotherapy as a therapeutic option for cancer treatment. Long-term efficacy data, financial support programs, and educational activities for prescribers may increase the access to modern immunotherapy.

and cervical cancers in 2008.6 Dubai Health Authority (the secondlargest health district in UAE) introduced breast, cervical, and colon cancer screening in 2014.7 In September 2015, the Ministry of Health (covering the rest of the UAE health districts) launched an official cancer screening initiative, to raise awareness about cancer and about the importance of early detection through regular medical check-ups for colorectal, breast, and cervical cancers.8,9 All the above-mentioned screening efforts were aligned with the North American and European international guidelines regarding the age of onset and the frequency of screening of different cancers, including breast cancer screening.10,11 Mammography screening every 2 years has shown the greatest mortality reduction benefit in the age group of 50–69 years, and it is recommended by the European Union and numerous individual countries.12