Cancer care in the Palestinian territories

The precise population of the Palestinian territories is disputed, but a 2017 estimate was 4 543 126 people, including 2 155 743 people in the West Bank and 1 795 183 in Gaza. The Palestinian territories rank 121st out of 233 countries and dependencies by population (its people comprise 0·07% of the world population). Palestinian health care has been a major concern since the 1994 Oslo agreement when the Palestinian Authority took over the administration of health care for the region. This effort has been supported by WHO and foreign donors, especially the US Government. Despite major political, economic and social challenges for the region, health care in Palestine is one of the best among Arab countries in terms of life expectancy and maternal, infant, and child mortality rates. Cancer is the second leading cause of death in Palestine at 14%, exceeded only by heart disease at 30%. The cancer burden in Palestine is expected to increase, reaching levels that further challenge the financial and infrastructural resources of the current health-care system, of which financial and political uncertainty exacerbate the problem. In this Review, we discuss the current state of cancer care in the Palestinian territories including epidemiology, screening, and prevention efforts, and infrastructural and workforce issues for the region. We also discuss examples of some encouraging progress that has been made for health in the region and the enormous challenges that the Palestinian health-care system still faces.