🇪🇬 Cancer in Egypt

The National Cancer Registry Program's report for 2008 to 2011 gives an age-standardised incidence (world standard) of 166.6 per 100,000 for both sexes, 175.9 in men and 157.0 in women, excluding non-melanoma skin cancer. Liver cancer was 23.81% of cancers with a rate of 43.6, breast 15.41% (24.3), bladder 6.94% (13.5), brain and nervous system 5.29% (8.5), non-Hodgkin lymphoma 4.64% (7.5) and lung 4.22% (7.5). In men, liver was 33.63% (61.8) and bladder 10.71% (21.1), then lung, non-Hodgkin lymphoma, brain and prostate (9.3); in women breast was 32.04% (48.8) and liver 13.54% (24.4), then brain, ovary, non-Hodgkin lymphoma and thyroid. Liver cancer was most common in Lower Egypt, where its rate was 56.8 per 100,000 and its share 29.6%, and least common in Upper Egypt (13.1 and 8.2%). Applying the same age-specific rates to Egypt's growing and ageing population gives 114,985 new cancers in 2013, 144,255 in 2020, 168,723 in 2025 and 331,169 in 2050, which the authors attribute increasingly to ageing.

The National Cancer Registry Program of Egypt, established in 2008, stratified the country into Lower, Middle and Upper Egypt and set up a population-based registry in one governorate of each: Damietta in the Nile delta (registration years 2009 to 2011), Minya in Middle Egypt (2009) and Aswan in Upper Egypt (2008), each located in the Ministry of Health cancer centre of the governorate. Together they covered 20.9% of the population; Greater Cairo and Alexandria were not included, which the authors put down to the difficulty of collecting data on a population that moves in and out daily. The paper's map shows five peripheral registries in the national network; the report used these three. Doctors abstracted records from the cancer centres and from national tertiary centres such as the National Cancer Institute of Cairo University, the paediatric oncology hospital in Cairo and the South Egypt Cancer Institute in Assiut, and from the Health Insurance Organization, the government-subsidised treatment programme and death records; the national identity number was used to remove duplicates, and death-certificate-only cases were almost 8%. Before the programme, the authors write, the only published incidence rates came from a single delta governorate, Gharbiah, whose last internal report was for 2002. They caution that their rates rest on a short initial phase of registration and a model that applies regional rates to the whole country.

The 2026 economic evaluation of the Presidential Initiative for Women's Health, written by Ministry of Health and Population staff with Egyptian oncologists, states in its background that Egyptian patients have a mean age at diagnosis of approximately 50.4 years against a median of 63 in the US SEER database, and that 20% of Egyptian patients were younger than 40 against 5% in SEER, citing earlier Egyptian studies. It notes that most Egyptian patients present with locally advanced or metastatic disease, with an average delay of about seven months between symptoms and treatment, 61% of it attributed to patient-related factors. The programme's own data, set out under screening below, show the stage at which cancers were found after five years of the initiative. These background figures are cited from other studies in the paper and were not re-derived by OnCo.

The General Authority for Health Insurance, the Health Insurance Organization, dates from Presidential Decree 1209 of 1964; Law 2 of 2018 lists that decree, and the separate insurance laws for students, children below school age, female breadwinners and farmers, among those that cease to apply in each governorate as the new system arrives. The government-subsidised route, al-ilaj ala nafaqat al-dawla, is decided by the Ministry of Health and Population's specialised medical councils: the ministry's spokesman reported 4,022,923 treatment decisions in 2025, costing 30,837,413,000 Egyptian pounds, for 2,472,064 people, across specialties that include oncology, with 7,010 patients assessed by video link; OnCo read that statement as reported by Al Mal News, because the ministry's website did not answer. The national registry programme counted patients in both the insurance organisation's and the subsidised programme's records, and its authors write that with the rising cost of cancer treatment most patients would seek government financial support. The breakdown of state-expense decisions by cancer was not published in the statement.

Law 2 of 2018 makes the system mandatory and based on social solidarity, separates financing from provision (article 2: the Universal Health Insurance Authority may not provide treatment), and creates a separate healthcare authority to run facilities and an accreditation authority. Article 40 lists co-payments at the point of service, set in Table 3: 10% of the price of medicines up to 1,000 Egyptian pounds, rising to 15% in the tenth year, 10% of imaging and of laboratory tests up to 750 pounds a case, and 5% of an inpatient stay up to 300 pounds, each written as not applying to chronic diseases and tumours, and it states that persons with chronic diseases and tumours are exempted from paying them. The insured's benefits include treatment abroad when treatment is impossible in Egypt and available abroad, on a committee's report. In November 2025 the authority's executive director said the system covered 3,861 medicines, exempted cancer patients from any fees, and that its biggest challenge was making essential medicines, especially cancer medicines, available at affordable prices; she also said it had cut out-of-pocket spending on health from 62% in 2018 to 53.8% in 2022, a national figure the authority did not attribute to a source. In May 2025 the authority contracted Gustave Roussy International Egypt to treat its beneficiaries with cancer from June 2025.

Article 3 of the law annexed to Law 151 of 2019 gives the Egyptian Authority for Unified Procurement, Medical Supply and Technology Management the exclusive task of procurement of pharmaceuticals and human medical appliances for all government bodies and authorities, for a fee of no more than 7% of the net value bought; the law defines those bodies as the Ministry of Health and Population and its hospitals, government universities and their hospitals, other ministries' hospitals, and government educational and research institutions. The Universal Health Insurance Authority's health economics unit reported that in 2025 it studied six new medicines for clinical and economic value, made three price comparisons of new medicines against listed equivalents, completed three rapid economic studies for its board, and reviewed its protocols for biological and cancer medicines; it added 59 medicines in 2025 for a list of 4,796. A 2026 evaluation of the breast programme used a cost-effectiveness threshold framework that its authors describe as developed for Egypt by national consensus, linking the threshold to gross domestic product per person: two times GDP per person, 164,588 pounds per quality-adjusted life year on 2022 figures, for the gain in that study.

Law 151 of 2019, published in the Official Gazette on 25 August 2019, established the drug authority and the unified procurement authority together; article 2 of the promulgating law states that the drug authority replaces the National Organization for Drug Control and Research (created in 1976), the National Organization for Research and Control of Biologicals (1995) and other bodies with jurisdiction over medical products. WHO announced on 20 December 2024 that Egypt had reached maturity level 3 for medicines regulation after a benchmarking finalised in November 2024, building on maturity level 3 for vaccines in March 2022, and describes Egypt as the first country in Africa to reach that level for both. WHO's scale runs to level 4, and it notes that authorities at level 3 or 4 may qualify as WHO-listed authorities after further assessment. The authority's registration guideline sets pricing within the registration process: for biological products, pricing of fast-track and reliance products is to be determined within 30 working days of a complete pricing file, and 60 for normal-track products.

The authority's guideline on registration of biological products through reliance pathways (EDREX.GL.Bioinn.002), version 2.0, issued 29 June 2026 and effective 30 June 2026, sets level 1 at 20 working days, for products approved by the EMA and/or FDA where the applicant submits the unredacted assessment report, post-approval documents and questions and answers with the reference authority, and level 2 at 40 working days with the complete common technical document only. The product must be identical in formulation, manufacturing sites and indications, must not have been rejected or withdrawn by any regulator for safety or efficacy, and must be registered and marketed in the reference country; the guideline states that reliance does not mean dependence and that approval by the reference authority does not oblige the EDA to approve. Version 1.0 of 2022 had set 30 and 60 days. The biological products guideline (version 5, effective 21 June 2026) sets totals of 120 working days for the normal track and 90 for the fast track, which covers orphan medicines, products in shortage and those for serious epidemic diseases without alternatives. These are targets; the authority's own figures for how long cancer medicines actually take were not found and are named under gaps. Small-molecule medicines follow a separate guideline OnCo did not read.

Law 214 of 2020, published in the Official Gazette on 23 December 2020, regulates clinical medical research on humans in Egypt. It creates the Supreme Council for Review of the Ethics of Clinical Medical Research, on which the drug authority is represented, and requires institutional review boards to be registered with it. Approval of both the drug authority and the Supreme Council is required for research using new medicinal or biological compounds, new indications, or devices never used in humans and not approved by the international bodies named in the executive regulations. The law requires the opinion of the General Intelligence Agency where research is conducted with foreign entities and for jointly conducted international studies, and states that if no response is received within 60 days of the notice, the application is deemed accepted. For medical interventions originating outside Egypt, the third and fourth phases are allowed after the authority and the Supreme Council review the results of the first and second phases conducted in the country of origin; for endemic diseases that do not exist in the country of origin and for rare diseases, research may begin in Egypt from the second phase with the Supreme Council's approval. OnCo read the English translation the drug authority publishes, which is scanned.

The programme's 2026 economic evaluation, using national programme data from July 2019 to September 2024, reports 53,453,745 recorded screening and service encounters among about 23.8 million unique women; services are delivered free through primary care units, referral hospitals and mobile units, and confirmed cases receive free treatment through the national health insurance system or state-funded programmes. Of 58,494 women referred to pathology, 44,149 were examined and 14,345 (24.5%) did not attend; 30,225 cancers were confirmed. Of those, 8.8% were stage I, 52.5% stage II, 26.4% stage III and 12.3% stage IV, so 61.3% were found at stage I or II, against 41.6% in Ministry of Health records of cancers found outside the campaign. The authors warn that the wider figure of about 70 million services reported by October 2025 should not be read as 70 million women screened. The evaluation estimated that the initiative gains quality-adjusted life years at lower societal cost than opportunistic detection; it is a model using survival inputs from other settings, its publication was funded by Roche Egypt, and Egyptian long-term outcome data are not yet available.

WHO's Eastern Mediterranean office announced on 9 October 2023 that Egypt had diagnosed 87% of people living with hepatitis C and treated 93% of those diagnosed, above WHO's gold tier targets of 80% and 70%, and that prevalence had fallen from 10% to 0.38% in just over a decade. It records that Egypt set up the National Committee for Control of Viral Hepatitis in 2006, that a countrywide campaign offering free testing and treatment began in 2014 and was reinforced in 2018 by the President, and that the 100 million seha campaign tested over 60 million people and treated more than 4.1 million, with locally manufactured direct-acting antivirals giving a 99% cure rate. OnCo read WHO's page through an Internet Archive copy of 20 October 2026, because the EMRO site returned a server error.

A 2018 Markov model in BMJ Global Health simulated Egypt's hepatitis C-related liver cancer epidemic from 2009 to 2050 with and without the sofosbuvir-based national treatment programme introduced in 2015, using parameters from published studies and expert opinion. Under the new programme the number of hepatitis C-related liver cancer cases was projected to peak earlier and lower, at about 29,000 in 2025, with incidence peaking at about 14 per 100,000 in 2022, and about 956,000 cases were averted between 2015 and 2050. That is a forecast, not a count: Egypt's registry has not published national incidence after 2011, so the fall cannot yet be measured against the registry's own baseline. IARC's 2024 estimate of 23,287 liver cancers, an age-standardised rate of 24.0 against the registry's 43.6 in 2008 to 2011, is a modelled figure and does not test the forecast either. WHO's validation in October 2023 rests on testing and treatment coverage, not on cancer outcomes.

The National Cancer Institute's Arabic home page describes it as a non-profit teaching, training and research institution of Cairo University, offering free treatment to all groups and ages, receiving 25% of all new cases in Egypt each year, with about 40 specialist clinics, more than 1,000 patients a day, more than 4,000 major operations a year and more than 63,000 radiotherapy sessions a year; it is raising donations for a new hospital in Sheikh Zayed. Children's Cancer Hospital Egypt 57357 describes itself as established in 2007, inspired by St. Jude in Memphis, to give every child with cancer care free of charge and without discrimination, with 300 inpatient beds and 2,559 staff including 423 physicians; it states it is the largest paediatric oncology hospital in the world by capacity. Its history traces the idea to a 1995 Ramadan advertising campaign for donations to the National Cancer Institute, proposed by the head of the institute's children's department, which raised 28.5 million pounds in the month, against donations of no more than one million a year before. OnCo read 57357's pages through Internet Archive copies, because its site blocks scripts.

Of the 24 trials in OnCo's ClinicalTrials.gov data that list Egypt, the industry and cooperative-group trials include Roche's ALEX, ALINA and lidERA and its giredestrant trial in HER2-positive breast cancer, AstraZeneca's EMERALD-3 and adjuvant durvalumab trial in liver cancer, Novartis's BOLERO-2, Day One's FIREFLY-2 in children's low-grade glioma, Boehringer Ingelheim's LUME-Meso, and the EORTC 22033, CLOCC, PETACC-3 and IBCSG triptorelin trials. The university trials are run in Egypt alone: Tanta University registered trials of sulfasalazine in metastatic colorectal cancer (whose status ClinicalTrials.gov listed as unknown in October 2026), ketotifen against oxaliplatin nerve damage and memantine with rosuvastatin for neuroprotection; Ain Shams University alpha-lipoic acid against mucositis and short-course radiotherapy in rectal cancer; Menoufia University FOLFIRINOX before chemoradiotherapy in rectal cancer; Minia University four pancreatic surgery trials; and an investigator-sponsored trial tests mebendazole after surgery for colon cancer. Most of the university trials are small and still recruiting, and none of them has reported results in OnCo's records.

OnCo's OpenAlex extract, built on 8 September 2026, counts oncology works with at least one author in Egypt (whole counting) as 825 in 2021, 853 in 2022, 863 in 2023, 972 in 2024 and 893 in 2025, 4,406 in total, of which 2,958 are open access. The same file records 17,478 ClinicalTrials.gov studies of any condition with a site in Egypt, against 28,841 for the United Kingdom, whose oncology output in OpenAlex is about six times larger. The 11 single-country university trials in OnCo's cancer data show the kind of study involved, though OnCo has not measured what share of the 17,478 they represent. Academic cancer centres include the National Cancer Institute of Cairo University and the South Egypt Cancer Institute of Assiut University, whose staff wrote the national registry report, and the 57357 hospital. OnCo did not read Egyptian research funders' budgets for this page; they are named under gaps.

Searches of Europe PMC for Egyptian registry and incidence papers from 2016 to 2026 returned regional and hospital series (Alexandria, the Nile delta, rural uterine cancer) but no new national report. The Ministry of Health and Population's website, mohp.gov.eg, did not answer on 4 November 2026, so any registry material it holds was not read. A 2021 survey of cancer registries in the region lists a respondent for the Egypt National Population-Based Cancer Registry, but its text mentions Egypt's registry only to say it did not answer one question, and its data supplement, which holds the answers by registry, was not read. Egypt's own count of cancer deaths by site from death registration was not found either; IARC models Egypt's deaths from incidence.

The working-day targets on this page come from the authority's guidelines for biological products. Its site has a section of statistics and public assessment reports, which was not surveyed medicine by medicine for this page. The Universal Health Insurance Authority reports how many medicines it lists and studied, but not the time from registration to listing. The ministry's statement on treatment at state expense gives totals for 2025 without a breakdown for cancer.

The sources read for this page, the ministry's and the presidential initiatives' published evaluations and WHO's announcements, describe breast early detection and hepatitis C testing. The 100 Million Healthy Lives website and the Ministry of Health's site were not read (the ministry's did not answer), and the State Information Service page the breast evaluation cites for its October 2025 figure was not opened. Coverage of liver cancer surveillance among people cured of hepatitis C was also not found.

mohp.gov.eg did not answer; upa.gov.eg returned HTTP 403, so the procurement authority's tenders and cancer medicine lists are not described; 57357.org returned a Cloudflare block, so its pages were read from Internet Archive copies dated 13 March and 20 October 2026. WHO EMRO's page returned a server error and was read from the archive. The Law 2 figures and article numbers were read from the Andersen Egypt English translation, a law firm's translation, because the Arabic text the insurer publishes is a scanned file without a text layer that OnCo could not read by script; the Law 151 and Law 214 translations the drug authority publishes are scans read by OCR. The national budget of the Academy of Scientific Research and Technology and other research funders was not looked for. The Health Insurance Organization's current membership and its cancer spending were not found.