Age at diagnosis of breast cancer in Arab nations

The impression among Arab Physicians dealing with breast cancer is that it presents at an earlier age and at a more advanced stage as compared to western countries. However, the statistical data to support this impression is remarkably scarce. Method: We performed a comprehensive literature review of reports of breast cancer in Arab countries. Articles were identified from Saudi Arabia, Bahrain, Qatar, Kuwait, Emirate, Oman, Yemen, Iraq, Syria, Jordan, Lebanon, Egypt, Libya, Algeria, Tunis, Morocco, and Sudan. Results: Twenty eight articles were identified and reviewed. The average age at diagnosis of breast cancer was available in 18 articles; the average age was 48 (SD = 2.8), range 43-52, median 48.5 and mode 45 years among the 7455 patients included. The median age of diagnosis of breast cancer was available in 8 articles; here, the average age was 45.4 (SD = 4.8), range 40-54.5, median 44.5 years among the 5379 patients included. The percentage of patients that were younger than 50 years old was reported in 11 articles from 8 countries and included 5144 patients; 65.5% (SD = 11) were less than 50 years old (range 49-78%, median = 66%). Discussion: In this literature review, the average age at presentation of breast cancer in Arab countries appears to be a decade earlier than in western countries. If this is true, this has important implications for screening and cancer management strategies in these countries, including the ideal age at which to begin screening. Adoption of Western guidelines "without critical amendment" in planning breast cancer programs will waste resources without achieving desired outcomes. Determination of the true frequency and age of onset of breast cancer in Arab women should be an important research priority. (C) 2010 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.