(The opinions expressed in this article are those of the author and do not necessarily reflect those of Al-Fanar Media).
People in the Middle East are developing various types of cancer at relatively young ages compared to people in the West, says a medical researcher at the University of Sharjah who finds the differences alarming and has been studying them for years.
“I was struck by the too many cases of cancer, including colon cancer, breast cancer, skin cancer, liver cancer, prostate cancer and many others, often in young people less than 50 years old,” said the researcher, Wael M. Abdel-Rahman.
By comparison, he said, in the West these diseases “hit people 20 years later, on average.”
In addition, Abdel-Rahman has found that in the Middle East, “cancers were often diagnosed at an advanced stage and responded poorly to chemotherapy, and therefore tended to have a poor prognosis. Many of these patients died shortly after the time of the diagnosis.”
In the West, cancer is usually diagnosed at an early stage, providing the best chance for a cure, he said.
Abdel-Rahman has studied differences in cancer outcomes across different ethnic groups for more than a decade in academic career has taken him to prominent research institutions in the Middle East and the West.
He is currently a professor in the College of Health Sciences at the University of Sharjah, where his research interests include environmental causes of cancer and the molecular basis of cancer. He holds medical and master’s degrees from Zagazig University, in Egypt, and a Ph.D. in molecular pathology from the University of Edinburgh.
He has also conducted extensive research at the University of Cambridge and the University of Helsinki, where he studied morphological changes in cells and tissues.
While some clinicians working in Middle Eastern countries once attributed the huge gap in cancer incidence and diagnosis between the East and the West as simply being part of “ethnic variations”, Abdel-Rahman believes environmental factors also play a significant role.
“My research that compared colon cancer in Finland and Egypt highlighted differences in molecular features, and epigenetic changes which suggested different environmental factors,” he said.
For example, he attributes prevalence of colon cancer to a variety of environmental toxins, besides age and genetics. Lifestyles also have an impact, he said.
A Quest to Explain Differences
Professor Abdel-Rahman embarked on his research to characterize the molecular differences between cancers in the Middle East and the West in the hope that it might explain the differences in the incidence of cancer and the age at which it struck patients.
“I started to explore this possibility in depth and at the molecular levels to understand these phenotypes and apply such knowledge in evidence-based programs for cancer prevention,” he said.
In an early paper on this topic, published in 2011 with co-authors at the University of Helsinki, Abdel-Rahman and his colleagues compared colorectal tumors in patients from Egypt and Western countries. The paper’s major conclusion was that the cancers hitting different parts of the world differed at “molecular levels, too.”
The Finnish team’s findings indicated a higher colon cancer incidence in North Europe and Finland compared to North Africa and Egypt, Abdel-Rahman said. However, “the problem in Egypt is the increasing incidence of young-age cancers and the overall increase over time.”
Focus on Environmental Factors
The divergence pointed to differences in environmental exposures to toxins and potential carcinogens like benzene, asbestos, nickel, vinyl chloride, radon and cadmium. The results led Abdel-Rahman and his colleagues to “focus on the role of environmental contaminants in cancer development.”
Environmental factors, he maintains, have made both colorectal and breast cancer more threatening and more prevalent.
Abdel-Rahman has led or contributed to numerous other studies that shed light on the causes and development of cancer in the West and the Middle East and the impact of exposure to environmental contaminants.
These include a 2017 article reviewing recent scientific literature with a bearing on the differences in cancer age and incidence between the two parts of the world.
A later study, published in 2020, dealt with environmental contaminants that have been linked to breast cancer. These included bisphenol A (BPA), which is found in a wide range of plastic products, including food and beverage containers, shatterproof windows, and water supply pipes.
The study, in which Abdel-Rahman is a co-author, looked at the molecular basis through which long-term exposure to BPA and other contaminants could harm normal breast cells and lead to cancer development.
In a more recent co-authored article, Abdel-Rahman and colleagues found that BPA may also cause harmful effects that can lead to cancer of the colon and rectum.
Stemming from his research findings, Abdel-Rahman is currently campaigning for restricting the use of plastic bags because of their “well-known harmful effects”.
Obesity and Cancer
Abdel-Rahman is also studying the relationship between obesity and cancer, in an effort to determine whether obesity can predispose normal cells to become cancer cells.
“Many different types of cancers are associated with excess body weight,” he said. These include cancers of the breast, colon and rectum, ovary, pancreas and thyroid, as well as multiple myeloma.
According to the World Health Organization, obesity is a worldwide problem. WHO statistics from 2016 showed that more than 1.9 billion adults were overweight, and 650 million of them were obese, including 39 million children under the age of five.
Obesity is increasingly a concern in the Middle East, particularly the Gulf region, other scientists have noted.
Besides its association with various cancers, obesity is also an important risk factor for chronic diseases like diabetes mellitus, hypertension, cerebral and cardiovascular diseases, osteoarthritis, and breathing disorders.
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