Genetic epidemiology of ovarian cancer in the 22 Arab countries: A systematic review

Ovarian cancer (OC) is a common disease among Arabs, with one of the highest incidences in the world. OC is underdiagnosed, underreported, and mostly reported with breast cancer. This study aimed to conduct a systematic review to estimate the published knowledge about the genetic epidemiology of OC in the 22 Arab countries. Therefore, we systematically searched seven literature databases (Web of science, PubMed, Science Direct, ProQuest, Embase, Scopus, and Google scholar) from the time of inception until June 2018 to collect all the information related to the incidence and pathogenic mutations spectrum for OC among Arabs. Our search strategy identified 3645 studies, of which 44 studies met our inclusion criteria, which cover the past 25 years (1993–2018). OC incidence among Arabs ranged from a low of 0.9/100,000/year in Saudi Arabia to a high of 8.0/100,000/year in Sudan. The total number of OC patients captured was 802; of these, 53 and five families carry 22 mutations in BRCA1/2 genes. Of these, eight mutations were unique to the Arab populations, and five mutations were commonly circulated among Arabs (BRCA1: c.5266dupC, c.5095C>T, c.68_69delAG, and c.4041_4042delAG; BRCA 2 c.1310_1313delAAGA). The ratio of BRCA1 (77.3%) mutations was higher than BRCA2 mutations (22.7%). This is the first systematic review to focus on the genetic epidemiology of only OC as an understudied disease that is common among Arabs. This study is expected to serve as a platform for further well-controlled genetic epidemiological studies for OC in the Arab world.