In and the Sabratha Cancer Registry in

In 2006 and 2007, the Sabratha Cancer Registry in western Libya, which had been set up in 2006 by the African Oncology Institute (AOI) in Sabratha, published two online reports on oral cancer (see Table 2b, Abusaa et al., 2006, 2007). This registry, which covers approximately 9% of Libyan population, consists of two units: a population-based cancer registry covering western Libya (Alegelat, Aljameil, Zwara, Sabratha, Zawia, Surman, Altawaila, Zulten, Rigdalen, Abukamash, and Alassa) and a hospital-based cancer registry at the African Oncology Institute. These reports revealed head and neck cancer accounted for 5% and 4.8% of all cancers patients, respectively in 2006 and 2007. The most common cancer site in 2006 was the oral cavity followed by the nasopharynx while in 2007 the nasopharynx was the most common site which was in agreement with the eastern Libya 2003 findings (Abusaa et al., 2006, 2007; El Mistiri et al., 2006). Fig. 2 shows the comparison of specific oral cavity and pharyngeal cancer site’s distribution between 2003 eastern and 2007 western Libya reports (Abusaa et al., 2007; El Mistiri et al., 2006).
As for the other geographic regions of Libya, there are no cancer registries either in the Tripoli region nor in the southern part of Libya, which combined account for nearly 60% of the total Libyan population. Consequently the descriptive picture of oral cancer in the Tripoli region and in the southern part of Libya remains unclear, and thus for the country as a whole the picture is quite incomplete. While a few cohort studies and case reports have been published about the Sulfo-NHS-Biotin of these two regions (Akhtar et al., 1993; Moona and Mehdi, 2001; Mohammed et al., 2013), the data from these two types of epidemiological studies do not permit meaningful comparisons with the current descriptive picture of oral cancer in the western and eastern regions of Libya.
In 2008–2009 (see Table 2a), three articles (Elarbi et al., 2009; El-Gehani et al., 2009; Subhashraj et al., 2009)—also by the Faculty of Dentistry at Benghazi—formed a series of reports describing the findings from one retrospective study on different benign and malignant oral tumors with the detailed distribution of biopsied lesion type from these articles reported in Table 3 and illustrated in Fig. 3. These articles reported on data from the medical reports and biopsy files of 2390 patients who had maxillofacial biopsies performed at the Department of Oral and Maxillofacial Surgery, Faculty of Dentistry at Benghazi during a period of 17years between 1991 and 2007. In this study, primary malignant tumors constituted 8% of all cases and premalignant epithelial lesions of mucosa and skin 6% of all cases, while benign odontogenic/non-odontogenic tumors constituted 16% of all cases. Of the primary malignant tumors (i.e., cancer cases), 82% were tumors of epithelial origin (carcinoma), 11% were tumors of immune system and 7% were tumors of mesenchymal origin (sarcoma). For malignant tumors, the male to female ratio was 1.4:1 and the mean age of these cancer patients was 46years for males and females combined. Squamous cell carcinoma (SCC) accounted for 41% of all primary malignant tumors, or 3.4% of all biopsied cases. Among the epithelial tumors, SCC was the most common neoplasm (50.6%), with a male: female ratio of 1.6:1 (El-Gehani et al., 2009; Subhashraj et al., 2009). One of these three articles reported on orofacial tumors in 213 Libyan children patients who had been treated at the Faculty of Dentistry at Benghazi over this time period. They found that malignant tumors constituted only 3.7% of the 213 cases, a finding they described as being low in comparison to other reports from Africa and Israel, which they attributed specifically to the low number of children found with Burkitt’s lymphoma in Libya (Elarbi et al., 2009).
Another retrospective study published in 2010 addressed the pattern of occurrence of oral SCC in Libya based upon the hospital records of all 122 patients subsequently diagnosed with oral SCC who had been referred to the Department of Oral and Maxillofacial Surgery at the Faculty of Dentistry at Benghazi in the period 1979–2004 from different regions of Libya (see Table 2a). The study found that tongue and floor of the mouth were the most common sites for SCC with ulceration and swelling being the most common clinical signs. It was noted that most of the patients presented for examination between 6 and 12months after their initial symptoms of SCC, and were found to be at TNM Stages III and IV and already exhibited tumor metastasis to lymph nodes and distant metastatic spread as the most common clinical stages at time of presentation to clinic. Among the 84.4% (n=103) of the oral SCC patients for whom tobacco smoking records were available, most were either regular or occasional tobacco smokers (Jaber and Abu-Fanas, 2010).