World Cancer Day is observed on February 4^th of each year. This is a unified global initiative led by The Union for International Cancer Control (UICC) through raising global awareness, improving education, and stimulating personal, collective and governmental action.  More than a third of cancer cases can be prevented; another third can be cured if detected early and treated properly. By implementing resource-appropriate strategies in prevention, early detection and treatment, millions of lives can be saved every year.

  Facts on cancer in Jordan:

• The National Cancer Registry/ Directorate of non-communicable Diseases/ Ministry of Health is responsible for collecting data on cancer cases in order to determine patterns of the pandemic and thus providing a better and improved level of health care for patients. The National Cancer Registry issues periodic reports that improve the evidence-based decision-making process.
• Cancer is the second leading cause of death according to the Jordanian Cancer Registry, as nearly (10,006) new cancer cases were recorded in 2019 (76% of whom were Jordanians); more than half of the cancer cases recorded among Jordanians were women (52.1%) compared to (47.9%) among males.
• ‘The crude incidence rate’ for all cancer cases among Jordanians was 104 deaths approximately per 100,000 of the population (about 98 males and 110 females). The highest recorded rate of infections was in the central region due to its densely populated nature, at a rate of (71.2%) of the total cases recorded for Jordanians, and 11% in the northern region and 4.3% in the southern region.
• As for the distribution of registered cases in 2019 among Jordanians by age, 44.5% of cases were diagnosed among people aged 60 years and above; the percentage of males (57%) was greater than females in this age group, while females predominate in the age group 30-59 years at (61.7%). The distribution of new cancer cases by age also showed that 4.1% of the cases were for young people under 15.
• About 45% of cancer cases among Jordanian males occur in the following order respectively

• bladder and prostate (18.1%) (9% for each),
• colon and rectum (13.7%),
• lung, trachea, and bronchi (13%).

Cancer cases among Jordanian females occur in the following order respectively

• breast cancer about 38.5%
• colon and rectum (9.7%),
• thyroid gland (6.2%)  
• cervical cancer (4.3%).    

 As for children, the most common type of cancer was leukaemia (33.4%), followed by brain and cancer of the central nervous system (19.4%), and then lymphoma (15.9%).

• As for cancer mortality, the most common causes of death in males were tumours of the lung (27.8%), colorectal (11%), leukaemia (7.1%), and stomach (7.1%). Among females, breast cancer came first (14.6%), leukaemia came second (10.6%), followed by colorectal (10.4%) then lymph nodes (6.9%), and lung cancer (6.6%).
• Early detection of reproductive cancers in Jordan is still lagging behind; the percentage of women at childbearing age who had undergone self-examination or have been examined by a specialist to detect breast cancer (which is the most common type of cancer, about 40%) during the past year was (21%), and among females in their last years of reproductive life (27%). These percentages still prevail despite the powerful national campaigns to encourage early detection of this type of cancer throughout all governorates in the past years. Women attributed the two most important reasons for the lack of motivation to get a mammography (9% across the Kingdom) that first, there was no pressing need (50%) and second, the absence of illness and non-existence of symptoms (38%). The remaining many reasons were attributed to fear of the result of the examination, lack of support and encouragement from family and husband, distance from the service providers, health centres, expenses, and others.
• Although about 65% of women of childbearing age have heard and/ or know about the ‘cervical pap smear test,’ less than a quarter (24%) of previously married women of childbearing age have ever had a pap test; this percentage was one-third among women in their last years of their reproductive lives; the percentage dropped to 19% among women in the lowest levels of human well-being. It is worth noting that the vaccine to protect against cervical cancer is not on offer here in Jordan. The reason for this being is that testing to detect the Human papillomavirus (HPV) associated with this type of cancer and the vaccine to protect against it are quite expensive. Also, campaigns for early detection and/or screening for cancers that affect males do not exist at the same level of force and attentiveness as they do for females.
• The Higher Population Council diligently follows up on the implementation of the National Strategy for Reproductive and Sexual Health, which addressed all components of reproductive health (including cancer components of the reproductive system) and which was underscored at the 1994 International Conference on Population and Development, 1994. The strategy provides a reference framework to attain comprehensive integrated reproductive and sexual health services and information to contribute in fulfilling the sustainable development goals 2015-2030, especially the third goal concerned with health and well-being. HPC asserts that addressing this heavy burden requires a multi-sectoral, multi-disciplinary and evidence-based approach founded on universal health coverage for effective cancer prevention, early detection, diagnosis, treatment and palliative care, in addition to the importance of having national responses based on a comprehensive strategy to direct cancer prevention and combatting undertakings.

Global facts:

• Cancer is a major cause of death and a central obstacle to raising life expectancy worldwide. According to World Health Organization estimates, cancer is the second, if not first, cause of death before the age of 70 in 112 out of 183 countries, and the third or fourth cause of death in 23 other countries. It is estimated that one man out of five and one women out of six around the world are likely to develop cancer during their lifetime. It is also estimated that one out of every eight men and one out of every eleven women will end up dying from this disease.
• According to estimates of the Global Cancer Observatory, the number of new cancer cases recorded in the world in 2020 was (19,292,789) cases (52% of cases in males compared to 48% in females) with an infection rate of 222 per 100,000 males and 187 per 100,000 females compared to about 18.1 million cases recorded in 2018. Because Asia is densely populated, the highest new infections were recorded there, accounting for 49% of the total new infections worldwide, compared to 22.8% in Europe, 13.3% in North America and 5.7% in Africa. The number of people still living with cancer five years after being diagnosed (2015-2020) was approximately (50,550) million cases. It is projected that about 30 million new cases worldwide will be recorded in 2040.
• The most common type of cancer is breast cancer, accounting for 11.7% of the total new infections in 2020, followed by lung cancer at 11.4%, then colorectal cancer (10%). According to gender, lung cancer is the most common cancer among males 14 3%; breast cancer is the first among females, accounting for 24.5% of the total number of females diagnosed with cancer. Around 13% of cancer cases diagnosed worldwide are caused by carcinogenic infections, including the papilloma virus, which causes an increased risk of cervical cancer, and hepatitis C and B viruses, which lead to an increased risk of liver cancer.
• As for mortality rates, the number of cancer deaths recorded in 2020 was (9,958,133) deaths (55% of which were males), of which 58.3% were recorded in Asia, and (18%) of the deaths were among people with lung cancer and (9.4%) among those with colorectal cancer and (8.3%) among those with liver cancer. The lowest mortality rate was among people with prostate cancer (3.8%). The total number of cancer deaths worldwide is expected to rise by more than 60% in the next two decades, to 16 million people each year. Low-income countries and middle-income countries suffer most from this global health disaster, with death rates far more higher than in affluent areas.
• Health care gap: As regards the availability of treatment and care, only about 14% of cancer patients who need palliative care may have access to it. According to high or low income countries, comprehensive treatment and coverage are available in more than 90% of high-income countries, but available at less than 15% in low-income countries.