Since war broke out in Syria in 2011, nearly 14 million Syrians have had to either flee their country or are still internally displaced. They face issues including poverty, unemployment, falling victim to child labor, and the continuing impacts of violence they’ve experienced. Another issue, uncovered by a new study, is disparities related to breast cancer.
Brigham and Women’s Hospital in Massachusetts teamed up with international partners to investigate breast cancer statistics for Syrians (including refugees) who have settled in Jordan, compared to the figures for Jordanian women. According to their paper published in JAMA Network Open, those from Syria were more apt to be diagnosed with metastatic cancer and to be diagnosed at a younger age.
Dr. Aditi Hazra, lead author and assistant professor in the Division of Preventive Medicine, says, “We know that there is stigma, a delay to accessing care, and competing interests for funding in regard to treating breast cancer in Syrian refugees. What this paper adds is a quantitative description of the tumor characteristics of refugee patients.”
The study involved 7,891 women, 375 of whom were Syrian refugees. The researchers found that among the Syrian refugees, late stage breast cancer was much more common, impacting nearly a quarter of patients. For Jordanian women, the figure was less than 12%.
Both Jordanian and Syrian women developed breast cancer at younger ages compared to women in high-income countries. However, the Syrian patients still tended to be younger than the Jordanians, with Syrians 49 and younger more apt to have bilateral breast cancer.
The researchers say possible reasons behind these disparities include trauma stemming from displacement, an interruption to routine screening, and delays in care.
When researchers began looking into cancer outcomes for Syrian refugees in 2014, they learned that patients had to apply for treatment funds from the United Nations High Commission for Refugees before they could access treatment. They were often deemed to be too unlikely to survive for treatment to work, so their applications were denied.
Dr. Hazra says, “Many of these refugees did not have access to early cancer detection. They were diagnosed late, and they were not going to receive care because of it. That seemed at odds with the idea of health as a human right.”
The team highlighted a few limitations of the study, including that there wasn’t data on cancer stage for 23% of cases and that treatment data was incomplete. However, they hope their study shines light on healthcare disparities for Syrian breast cancer patients and can help start a conversation to address it.Whizzco