Stage at diagnosis of colorectal cancer in the Middle East and Northern Africa: A population-based cancer registry study

Colorectal cancer (CRC) is the 2nd most common cancer and 3rd most common cause of death in the Middle East and Northern Africa (MENA) region. We aimed to explore CRC stage at diagnosis data from population-based cancer registries in MENA countries. In 2021, we launched a Global Initiative for Cancer Registry Development (GICR) survey on staging practices and breast and CRC stage distributions in MENA. According to the survey results, population-based data on TNM stage for CRC were available from six registries in five countries (Kuwait, Morocco, Oman, Turkiye, UAE). The proportion of cases with unknown TNM stage ranged from 14% in Oman to 47% in Casablanca, Morocco. The distribution of CRC cases with known stage showed TNM stage IV proportions of 26-45%, while the proportions of stage I cancers were lowest in Morocco (<= 7%), and highest (19%) in Izmir, Turkiye. Summary extent of disease data was available from six additional registries and four additional countries (Algeria, Bahrain, Iraq, Qatar). In summary, the proportions of CRC diagnosed with distant metastases in Oman, Bahrain and UAE were lower than other MENA countries in our study, but higher than in European and the US populations. Harmonising the use of staging systems and focusing stage data collection efforts on major cancers, such as CRC, is needed to monitor and evaluate progress in CRC control in the region. The Middle East and Northern Africa (MENA) region faces an increasing prevalence of lifestyle risk factors for colorectal cancer. The authors collected colorectal cancer stage data (TNM and/or SEER) from 12 population-based cancer registries in nine MENA countries. About one third of cases were diagnosed with distant metastases. The metastatic cancer proportions were lower in Oman, Bahrain, and the United Arab Emirates compared to other MENA countries, but still less favourable than in Europe and the United States. Harmonising the use of staging systems and focusing data collection on major cancers is needed to inform colorectal cancer control in MENA. image