Colorectal cancer is less common in the Middle East and South Asia region than in the United States (Table 1). However, it is among the 10 most common cancer types in all the countries.1 The age-standardized incidence rate is below 10 per 100,000 in most countries in this region, and ranges between 10 to 40 per 100,000 in a few countries such as Turkey, Qatar, Kuwait, and Israel.1
In a study from Turkey, one third of patients were younger than 50 years, and the rectum was the most common site of occurrence (42.5%), followed by the sigmoid colon (23.2%).2 The epidemiologic features are similar in India.3 However, in a study from Qatar, the descending and sigmoid colon were the most common sites.4
Although the management of colorectal cancer should ideally be based on evidence-based medicine, standardized practices do not exist in other parts of the world. The social, cultural, and economic differences among the countries may be responsible for this lack of standard management. The paucity of local randomized trials from the region adds to the difficulty in following new developments and innovations. However, the need for guidelines that are compatible with evidence-based medicine and social, cultural, and economic realities of the MENA region cannot be denied. The NCCN–MENA project was established to address this need.
Colorectal Cancer Age Standardized Rate per 100,000 Population
Drs. İçli, Akbulut, Bazarbashi, Kuzu, Rasul, Strong, Syed, and Zorlu have disclosed that they have no financial interests, arrangements, or affiliations with the manufacturers of any products discussed in this article or their competitors. Dr. Mallath has disclosed that he has received research funding from GlaxoSmithKline, Amgen Inc., Merck & Co., Inc., and Pfizer Inc. Dr. Engstrom has disclosed that he is an advisory board member for Novartis Pharmaceuticals Corporation.
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