Survival rates of patients with breast cancer in countries in the Eastern Mediterranean Region: a systematic review and meta-analysis

Background: Breast cancer is the fourth leading cause of death and disability in the Eastern Mediterranean Region (EMR); although the incidence is lower than in the developed regions, there has been an increasing trend in recent decades. Aims: Our aim was to calculate the pooled survival rate of patients with breast cancer in the EMR. Methods: We searched electronic databases from 1946 to 19 January 2018, without language restrictions. We used a random effect model to estimate pooled 1-, 3-, 5- and 10-year survival rates for patients with breast cancer. Chi-squared and I-2 index were used to assess between-study heterogeneity. Subgroup analysis and meta-regression were used to investigate the potential source of heterogeneity. Results: We found 80 articles eligible for inclusion in our review. The pooled 1-, 3-, 5- and 10-year survival rates in women with breast cancer in the EMR were 0.95, 0.80, 0.71, and 0.56, respectively. The I-2 index indicated considerable between-study heterogeneity (all I-2 > 50%). The 5-year survival rate in the male subgroup was 0.63. The 5-year survival rate of women with breast cancer in age groups <= 39, 40-64, and 65+ years were 0.74, 0.76 and 0.58, respectively. There was a statistically significant association between the Human Development Index (beta = 9, P = 0.01) and decade of study (beta = 8.2, P = 0.04) and 5-year survival rate. Conclusions: The survival rate of women with breast cancer in those countries in the EMR which have better health care systems improved in the past decade; women aged 40-64 years had the best survival rate.