{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,30]],"date-time":"2025-12-30T05:26:35Z","timestamp":1767072395432,"version":"3.48.0"},"reference-count":54,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2025,12,28]],"date-time":"2025-12-28T00:00:00Z","timestamp":1766880000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000921","name":"COST (European Cooperation in Science and Technology","doi-asserted-by":"crossref","award":["CA23151"],"award-info":[{"award-number":["CA23151"]}],"id":[{"id":"10.13039\/501100000921","id-type":"DOI","asserted-by":"crossref"}]},{"name":"national funds through FCT\u2014Funda\u00e7\u00e3o para a Ci\u00eancia e Tecnologia, I.P., within the scope of the Cardiovascular R&D Center","award":["UIDB\/00051\/2020"],"award-info":[{"award-number":["UIDB\/00051\/2020"]}]},{"name":"national funds through FCT\u2014Funda\u00e7\u00e3o para a Ci\u00eancia e Tecnologia, I.P., within the scope of the Cardiovascular R&D Center","award":["UIDP\/00051\/2020"],"award-info":[{"award-number":["UIDP\/00051\/2020"]}]},{"name":"Institute of Biomedicine","award":["LA\/P\/0053\/2020"],"award-info":[{"award-number":["LA\/P\/0053\/2020"]}]},{"name":"Institute of Biomedicine","award":["UIDB\/04501\/2020"],"award-info":[{"award-number":["UIDB\/04501\/2020"]}]},{"name":"Institute of Biomedicine","award":["POCI-01-0145-FEDER-007628"],"award-info":[{"award-number":["POCI-01-0145-FEDER-007628"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diseases"],"abstract":"<jats:p>Cancer is one of the biggest health burdens for women in the Middle East and North Africa (MENA), with the incidence of breast, cervical and colorectal cancer on the rise. Although preventive measures such as the HPV vaccination and population-based screening are available, access to them remains very unequal. Women in rural, low-income and refugee communities face additional barriers, cultural stigmatisation, low health literacy, gender norms and fragile health systems, leading to delayed diagnoses and poorer outcomes. This review summarises the results of 724 peer-reviewed publications to assess the current situation of cancer screening in MENA and Mediterranean countries. The studies were classified into four dimensions: cancer type (breast, cervical, colorectal), behavioural constructs (awareness, uptake, education), vulnerability factors (e.g., migrants, refugees, low-literacy groups), and geography (indigenous MENA populations versus diaspora and Mediterranean immigrant communities). The results show large inequalities in access and participation due to fragmented policies, socio-cultural resistance and infrastructure gaps. Nevertheless, promising approaches are emerging: community-led outreach, mobile screening programmes, AI-assisted triage and culturally appropriate digital health interventions. Comparisons between the local and diaspora populations make it clear that systemic and cultural barriers persist even in well-equipped facilities. Closing the screening gap requires a culturally sensitive, digitally enabled and policy aligned approach. Key priorities include engaging religious and community leaders, promoting men\u2019s engagement in women\u2019s health and securing sustainable funding. With coordinated action across all sectors, MENA countries can build inclusive screening programmes that reach vulnerable women and reduce preventable cancer mortality.<\/jats:p>","DOI":"10.3390\/diseases14010010","type":"journal-article","created":{"date-parts":[[2025,12,28]],"date-time":"2025-12-28T23:54:36Z","timestamp":1766966076000},"page":"10","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Cancer Screening and Prevention in MENA and Mediterranean Populations: A Multi-Level Analysis of Barriers, Knowledge Gaps, and Interventions Across Indigenous and Diaspora Communities"],"prefix":"10.3390","volume":"14","author":[{"given":"Sebahat","family":"Gozum","sequence":"first","affiliation":[{"name":"Department of Public Health Nursing, School of Nursing, Akdeniz University, Antalya 07070, T\u00fcrkiye"}]},{"given":"Omar F.","family":"Nimri","sequence":"additional","affiliation":[{"name":"Public Health\u2014Epidemiology at Jordan Center for Disease Control, JCDC, Jordan Cancer Society, Amman 11954, Jordan"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4019-6290","authenticated-orcid":false,"given":"Mohammed Abdulridha","family":"Merzah","sequence":"additional","affiliation":[{"name":"Department of Public Health and Epidemiology, Faculty of General Medicine, University of Debrecen, H-4028 Debrecen, Hungary"},{"name":"Department of Community Health, Polytechnic College-Karbala, Al-Furat Al-Awsat Technical University, Kufa 54001, Iraq"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3636-5805","authenticated-orcid":false,"given":"Rui","family":"Vitorino","sequence":"additional","affiliation":[{"name":"Institute of Biomedicine\u2014iBiMED, Department of Medical Sciences, University of Aveiro, 3810-193 Aveiro, Portugal"},{"name":"Cardiovascular R&D Centre\u2014UnIC@RISE, Department of Surgery and Physiology, Faculty of Medicine, University of Porto, 4099-002 Porto, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2025,12,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2320","DOI":"10.1002\/ijc.35325","article-title":"Current and future burden of female breast cancer in the Middle East and North Africa region using estimates from GLOBOCAN 2022","volume":"156","author":"Zahwe","year":"2025","journal-title":"Int. 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