Conducting cancer research in a conflict setting: a view from the occupied Palestinian territory

Cancer is now the third leading cause of death in low-income countries (65% of cancer deaths globally), accounting for over 4 million deaths every year. Despite this, research on cancer control and access to cancer care in low-income countries is limited and that in conflict settings rare. The acute and chronic nature of conflict and the vulnerability of populations caught within it, allow researchers only narrow windows of opportunity to gather and follow-up cancer data prospectively. This is usually accompanied by a lack of infrastructure and trained human resources, absence of reliable and timely data, eroded trust and poorly coordinated healthcare systems. These factors make it difficult for local researchers to conduct research, and even more difficult for international researchers to bring their skills into the setting due to movement restrictions and a lack of awareness of the local context, increasing the possibility of misjudging necessities. The problems of research in conflict go beyond the risk to the personal safety and mental health of research teams in conflict settings. Taken together, these factors could explain why opportunities for systematic data collection in conflict settings are limited despite being essential to reduce the gap in outcomes among patients with cancer living in low-income and conflict settings and those living in high-income countries. Drawing on 2 years of field research in Gaza in the occupied Palestinian territory (oPt), a conflict area in the Middle East, we present our observations from a study on breast cancer.