🇹🇷 Cancer in Türkiye

The Türkiye Kanser İstatistikleri 2020 report, prepared by the cancer department of the General Directorate of Public Health and published in Ankara in 2025, gives a world-standardised incidence of 233.6 per 100,000 men and 162.8 per 100,000 women in 2020, and 198.2 for both sexes, against 264.9, 193.4 and 229.2 in 2019. The five commonest cancers in men in 2020 by standardised rate were lung (51.9 per 100,000), prostate (28.1), colorectal (24.1), bladder (19.1) and stomach (12.7); in women breast (43.4), thyroid (14.0), colorectal (13.3), lung (10.2) and uterine body (9.4). The report states that 30,004 people were diagnosed with lung cancer in 2020, that smoking-related cancers, above all lung cancer, are still very high in men, and that lung cancer incidence is rising in women. Thyroid cancer fell by 31% between 2019 and 2020 against about 13% for all cancers, which the report links to the pandemic, as SEER saw in the United States. Childhood leukaemias are the commonest childhood cancers, followed by lymphomas and central nervous system tumours, and childhood cancer incidence did not fall in 2020.

Cancer was made a notifiable disease in 1982, and active registration began with the İzmir cancer registry centre in 1992, then Antalya six years later. According to the 2020 report, population coverage in the national report was 23.4% until 2012, 47.9% after Gaziantep, Malatya, İstanbul and Mersin were added, and 50.6% in 2020 with 14 provinces after Kocaeli joined in 2016; active registration had started in all 81 provinces from the 2013 reference year. Certified cancer registry staff collect data from every public, university and private hospital in a province, from laboratories, death certificates and places such as nursing homes and palliative care centres, and send them to the registry centre at the provincial health directorate and then to the cancer department, which removes duplicates and builds the national data pool. Quality figures for 2020: 91.8% of cases were histologically verified and 3.3% were known from a death certificate only; 40.9% of 2020 cases had been registered within 12 months of the year's end and 70.9% within 24 months, against international targets of 90% and 95%. The department's statistics page, in its 15 October 2025 archived copy, lists annual reports from 2009 to 2020.

The 2020 report gives SEER summary stage at diagnosis for the commonest cancers: 59.0% of lung cancers had distant metastases, which the report notes means lung cancer is usually diagnosed late; 45.5% of breast cancers were localised; 62.3% of cervical cancers were localised; and 58.9% of ovarian cancers were at a distant stage. For 2019 the same report series gave 54.9% of lung cancers with distant metastases, 48.3% of breast cancers localised and 54.9% of cervical cancers localised. Stage was unknown for 28.9% of the cases in the 2020 database, so these shares describe the cancers whose stage was recorded. The report publishes incidence, not survival; Türkiye's population survival figures appear instead in the international CONCORD-3 study, which used data from nine Turkish registries (Ankara, Antalya, Bursa, Edirne, Erzurum, Eskişehir, İzmir, Samsun and Trabzon).

The Sosyal Güvenlik Kurumu Sağlık Uygulama Tebliği (SUT) states its purpose as setting out how people covered by general health insurance under Law 5510 benefit from the health services the institution finances, and the prices the Health Services Pricing Commission sets for them; its legal bases are Law 5502 on the Social Security Institution, Law 5510 and the general health insurance implementing regulation. The consolidated text on mevzuat.gov.tr read for this page includes amendments up to the Official Gazette of 2 October 2026. Care is provided by Ministry of Health hospitals, university hospitals and contracted private hospitals, which bill the institution through its MEDULA system under the SUT's rules. For people insured under article 60(1)(c), subparagraphs 1 to 3, of Law 5510, the SUT provides that patient contributions they have paid are refunded on request by the social assistance and solidarity foundations.

Section 1.9.1 of the SUT lets contracted foundation universities and second and third level private providers take an additional fee (ilave ücret) from patients up to a rate the institution sets; section 1.9.3 lists services for which no additional fee may be taken at all, among them emergencies, intensive care, burns, newborn care, transplants and cancer treatment (radiotherapy, chemotherapy and radioisotope treatments). Section 1.8.2 sets a contribution on outpatient medicines of 10% for people who receive a pension or income from the institution and their dependants and 20% for others, plus 3.76 lira per prescription for up to three boxes and 1.25 lira for each further box, in the text amended on 31 December 2025. Section 1.8.5 removes the medicine contribution for medicines used in inpatient treatment and, with a health report, for those on the exemption list EK-4/D. Section 4.1.11 requires hospitals to supply the chemotherapy medicines on list EK-4/H, so those are not bought by the patient at a pharmacy. Outpatient chemotherapy is dispensed one cycle at a time, or at most three months' supply, on a report showing the treatment protocol (section 4.2.14).

Section 4.1.9 of the SUT says the medicines the institution pays for are those on the Bedeli Ödenecek İlaçlar Listesi (EK-4/A) on its website, and that a medicine whose trade name and barcode are not on the list is not paid for under any circumstances; the institution's announcement 2026/43 of changes to the list was published on 4 November 2026. Section 4.2.14 sets the rules for cancer medicines: older cytotoxic medicines such as cisplatin, carboplatin and tamoxifen can be prescribed on a specialist's protocol report without regard to indication; a second group, including docetaxel, paclitaxel, capecitabine and irinotecan, needs a health board report; and targeted medicines carry conditions written medicine by medicine. Trastuzumab, for example, is paid for in HER2-positive metastatic breast cancer on a medical oncology health board report and stopped on progression, and in early breast cancer for 9 weeks, extended to a total of no more than 52 weeks on three-month reports that include an echocardiogram. Section 4.1.4 makes any use outside the approved indication or dose subject to a Ministry of Health off-label approval, patient by patient where the off-label guide does not cover it, and states that an indication in the licence that the commissions have not taken into reimbursement is not paid for.

The Sosyal Güvenlik Kurumu Genel Sağlık Sigortası Alternatif Geri Ödeme Yönetmeliği, in force since its publication on 12 May 2023 and replacing a regulation of 10 February 2016, defines an alternative reimbursement model as bringing a health service into payment according to the financial or medical benefit it brings, outside the standard rules, through models such as a discount rate other than the standard public discounts, a budget or patient-number limit, or a purchase guarantee. The commission has six full members: the President of the Social Security Institution as chair, the General Director of General Health Insurance, one member each from the Presidency of Strategy and Budget and the Ministry of Health and two from the Ministry of Treasury and Finance, these four at least at head-of-department level. It meets at least twice a year, in June and December, decides the model and the contract, whether to keep the price and model confidential at the company's request, and whether to exempt the medicine from patient contributions. The SUT refers to applications under this regulation and the İlaç Geri Ödeme Yönetmeliği as the route by which new indications are taken into reimbursement. Neither text sets a cost-effectiveness threshold.

Section 4.3 of the SUT allows medicines that cannot be obtained in Türkiye to be brought from abroad when the Ministry of Health approves that the medicine is not available domestically and its use is essential, and states that a protocol between the Turkish Pharmacists' Association (Türk Eczacıları Birliği) and the institution is in force for this; protocols with other parties authorised by the Ministry are possible. If the Ministry publishes a list of medicines that may be imported, no separate approval is needed for those. The institution pays only for imported medicines on the Yurt Dışı İlaç Fiyat Listesi (EK-4/C). To have a medicine added to that list, a health board report and a prescription issued at a third-level public provider must be submitted. A patient who obtains a listed medicine by their own means is reimbursed by bank transfer, up to what the same medicine costs the institution. The patient contribution for imported medicines is collected by the organisation that supplies them.

The TİTCK was established by Decree-Law 663 of 2 November 2011 as an agency of the Ministry of Health with its own budget. Under the Beşeri Tıbbi Ürünler Ruhsatlandırma Yönetmeliği of 11 December 2021 (article 12), applications may be made all year but the licensing process can only be started in February, May, August and November, taking the agency's licensing capacity into account. The agency checks a dossier for completeness within 30 days, the company has 30 days to fill any gaps, and a second check takes another 30 days. Article 14 then sets 210 days for the licensing process, with the clock stopped while the agency waits for information it has requested and excluding laboratory testing, assessment by outside bodies and public holidays. Article 15 lets the Priority Evaluation Board (Öncelik Değerlendirme Kurulu) move applications ahead of the queue for products that are first in treatment or diagnosis, innovative, or strategically needed for public health, within times set in the agency's prioritisation guideline. The board also decides which products may apply for a conditional or exceptional licence.

The amendment published in the Resmî Gazete on 24 September 2022 added article 37/A, headed Güven (reliance): previous assessments by other medicines authorities or by regional or international bodies with comparable standards may be taken into account in line with a guideline the agency publishes; and it amended article 14 so that the 210-day licensing period is 90 days for applications made under article 37/A. A December 2023 amendment added that an application is rejected on substance if information the agency requests is not supplied within 30 days. The only published measurement of actual times found for this page is a study in Frontiers in Pharmacology: for new active substances the median time from submission to approval rose from 529 calendar days in 2016 to 663 in 2018, while the agency's own review time fell from 408 to 326 days and company time rose from 137 to 268 days. That study predates the 2021 regulation and the reliance route, and no later official average for cancer medicines was found.

The Ministry of Health's screening page lists, for breast cancer, advice on monthly self-examination, a clinical breast examination every year and a mammogram every two years for women aged 40 to 69; for cervical cancer, an HPV DNA test every five years for women aged 30 to 65; and for colorectal cancer, a faecal occult blood test every two years and a colonoscopy every ten years for men and women aged 50 to 70. The department's list of Kanser Erken Teşhis, Tarama ve Eğitim Merkezleri (KETEM), dated 29 January 2025, names 318 centres in all 81 provinces, with their addresses and telephone numbers. The 2021 Turkey Cancer Control Programme states that screening mammography is free of charge under a Ministry regulation, that family physicians were integrated into screening in 2013, and that mobile screening units visit neighbourhoods, with films read centrally and women told of suspicious results. Cervical screening moved from smears to HPV testing in 2014, with reference laboratories in Ankara and İstanbul, and was extended to all 81 provinces the same year.

The 2021 Turkey Cancer Control Programme says that the smear-based cervical programme, run at KETEM centres for women aged 30 to 65 every five years, could not reach its 70% coverage target: 20% of the women planned to be screened were screened, which led to the December 2012 decision to switch to primary HPV testing. For colorectal cancer it states that coverage is between 30% and 40% and that a coverage of at least 70% must be achieved for screening to work, and among its targets it lists screening coverage of at least 70%. It does not give a national coverage figure for breast screening; it describes mammography as offered to women who come to KETEM centres, hospital breast clinics, private hospitals and oncology institutes after invitations through the media, family doctors and sometimes the system. These figures date from before the programme's 2021 publication, and no later national participation figure for any of the three programmes was found on the Ministry's pages.

The programme's results in Gynecologic Oncology report that women over 30 were invited for HPV DNA testing and conventional cytology, using a single-visit strategy to collect samples for both screening and triage (extended genotyping and a Pap smear). Of 4,099,230 women, 4.39% were HPV DNA positive; the commonest type was 16, then 51, 31, 52, 56 and 18, at every age and in every region. Cytology was normal in 69.2% and inadequate in 16.6%. The Turkish referral rule, colposcopy for HPV 16 or 18 or any smear abnormality of ASC-US or worse, gave a positive predictive value of 24.3% for CIN2 or worse. The authors describe it as the largest series in the world summarising real-world experience with primary HPV DNA screening and triage at a single visit, and conclude that it shows the method is feasible in developing countries with acceptable colposcopy referral rates. The 2021 cancer control programme adds that a new algorithm was introduced in 2020.

The 2021 Turkey Cancer Control Programme says the İzmir Cancer Registry Center was established in 1992 as Türkiye's first community-based registry, published its first data in 2001, and officially became a Regional Hub of IARC on 9 October 2013 under a protocol between the Public Health Agency of Turkey and IARC, within the Global Initiative for Cancer Registry Development, after the hub in Mumbai. It was commissioned to provide training, technical support and scientific advice for cancer registries in 30 countries in Asia, the Middle East and North Africa. The 2020 statistics report records that IARC's Cancer Incidence in Five Continents, which only includes registries that pass its quality assessment, carried İzmir and Antalya data in volume 9, added Trabzon and Edirne in volume 10, Bursa, Erzurum, Eskişehir and Samsun in volume 11, and Malatya and Gaziantep in volume 12, ten provinces in all.

The 2021 Turkey Cancer Control Programme describes the Bahçeşehir Community-Based Mammographic Screening Project: about 20,000 houses in Bahçeşehir and four surrounding neighbourhoods were visited and eligible women registered, then invited to a screening centre for examination by a breast surgeon and two-view digital mammography read by two independent radiologists. Between 2009 and 2019, 8,823 women aged 40 to 69 had 27,754 screenings, with participation around 85%, and 130 breast cancers were found, 51 (39.2%) in women aged 40 to 49; 17 (13.1%) were ductal carcinoma in situ, 81% of patients had breast-conserving surgery and 60% were at pathological stage 0 or I. The programme reports a 10-year survival of 96.9% for screen-detected patients against 76% for symptomatic patients in the Turkish Federation of Breast Diseases Societies registry, and an incremental cost-effectiveness ratio of 1,897 US dollars per life-year, 15% of 2014 income per head. Screen-detected and symptomatic patients differ in more than screening, so the survival comparison overstates what screening alone achieves.

OnCo counts trial records whose ClinicalTrials.gov locations include Turkey (Türkiye): 568, of which 421 are phase 3, 79 phase 2, 42 phase 1/2 and 25 phase 2/3; 186 are recruiting, 197 active and not recruiting, and 126 have reported a positive result. Non-small-cell lung cancer is the first-listed cancer in 139 of them, followed by prostate (37), hormone receptor-positive breast (29) and myeloma (24). AstraZeneca sponsors 76 and Merck Sharp & Dohme 71 under its two spellings; no trial in this set is sponsored by a Turkish institution, which reflects what OnCo has recorded rather than all Turkish research. Across all conditions, ClinicalTrials.gov listed 27,197 studies with a location in Türkiye on 4 November 2026. OpenAlex, counting every paper with at least one Turkish author, records 1,842 oncology papers in 2021 and 2,209 in 2025 (OnCo's OpenAlex country file, built on 8 September 2026).

OnCo's records for the Hacettepe University Cancer Institute in Ankara and the İstanbul University Institute of Oncology describe institutes that combine medical, radiation and paediatric oncology with preventive oncology and epidemiology. OnCo's copy of the OECI membership list names Anadolu Sağlık Merkezi in Gebze, Dokuz Eylül Üniversitesi Onkoloji Enstitüsü in İzmir, and the Türkiye Kanser Enstitüsü, whose listed website is that of the Health Institutes of Türkiye (TÜSEB), as associate members. The Ministry's 2020 statistics report thanks by name the staff of the 14 provincial cancer registry centres behind the national figures: Ankara, Antalya, Bursa, Edirne, Erzurum, Eskişehir, Gaziantep, İstanbul, İzmir, Kocaeli, Malatya, Mersin, Samsun and Trabzon. Turkish research funding through TÜBİTAK and the Turkish Oncology Group's trials were not researched for this page.

The Ölüm ve Ölüm Nedeni İstatistikleri, 2024 bulletin (TÜİK, 19 June 2025), read from the Internet Archive's copy of 20 June 2025, reports 489,361 deaths in 2024: 36.0% from diseases of the circulatory system, 16.3% from benign and malignant tumours and 15.0% from diseases of the respiratory system. Of the deaths from tumours, 29.1% were from malignant tumours of the larynx, trachea, bronchus and lung, 8.0% from malignant tumours of the colon and 7.8% from malignant tumours of lymphoid and blood-forming tissue. The tumour share includes benign tumours, and the bulletin gives no count of cancer deaths, so none is calculated here. data.tuik.gov.tr now redirects to veriportali.tuik.gov.tr, which returned only a page asking for JavaScript to a plain request on 4 November 2026, so a bulletin for 2025 was not read. GLOBOCAN 2024's 113,805 deaths are derived from incidence, not from Turkish death certificates, so they should not be read as a count.

hsgm.saglik.gov.tr timed out on every request on 4 November 2026. The statistics page, screening page, KETEM list, duties page and contact page were read from Internet Archive copies made between 8 October and 7 November 2025, and the 2019 and 2020 statistics reports and the 2021 cancer control programme from the archive's stored PDFs. The Turkish edition of the cancer control programme (17 August 2021) came back truncated and unreadable, so the English edition of 18 April 2022 was used. Survival by cancer type is not published in the Ministry's annual report and is not on this page.

The last national screening coverage figures found are those in the 2021 cancer control programme (20% under the old cervical smear programme, 30% to 40% for bowel screening, none for breast). The share of the population covered by general health insurance was not found in a primary source. The SUT names the exemption list EK-4/D and the hospital chemotherapy list EK-4/H but publishes them separately on the institution's website, and they were not read, so this page does not say which cancer medicines are exempt from the outpatient contribution.

The licensing regulation sets 210 days, or 90 under the reliance route, for the licensing process itself, but a clock that stops for company responses is not the time a patient waits; the 2020 study found a median of 663 days for new active substances in 2018. Reimbursement then depends on the reimbursement and alternative reimbursement commissions, whose decisions appear as changes to the list of reimbursed medicines without a published assessment or date of application. The İlaç Geri Ödeme Yönetmeliği, which governs the standard reimbursement route, was not read for this page.