Epidemiology and Incidence of Retinoblastoma in the Middle East: A Nationwide Study in Lebanon

Background: Retinoblastoma, although a rare pediatric cancer, can lead to disastrous outcomes if not managed early. This mishap often happens in developing countries. Conversely, early diagnosis and treatment of retinoblastoma in developed countries were associated with a surge in RB1 gene carriers. Aim: The authors aimed to evaluate the incidence of retinoblastoma in the Lebanese population aged between 0 and 19 years according to age, sex, and other variables and compare the age-standardized incidence rates with regional and worldwide countries. Methods: Data were retrieved from the National Cancer Registry (NCR) of the Ministry of Public Health (MOPH). Subsequently, incidence rates, age-standardized rates, and fictional incidence rates excluding the emigrant population were calculated. Retinoblastoma trends were found using the Joinpoint regression program software. Results: From the 38 cases of retinoblastoma recorded in the nine years cohort, 29 cases occurred in the 0-4 age group, and age-standardized rates were 2.8 and 3.6 per million person-years for the 0-19 and 0-14 age groups, respectively. When the refugee population was excluded, the ASR 0-19 almost doubled from 2.8 per million person-years to 5.16 per million person-years. Joinpoint regression revealed that retinoblastoma trends were divided into two segments showing a decrease from 2005 until 2011 and a rising trend in 2011-2015. When compared to other countries in the region, Lebanon had low-intermediate 0-19 ASRs. Conclusion: Retinoblastoma incidence in Lebanon is in the lower margin of the worldwide average and could be underestimated due to the underdiagnosis in the refugee population. Efforts are being deployed to overcome the financial barriers in the treatment of retinoblastoma by coordinating with neighboring Arab countries.