Barriers to Cancer Research in Low- and Middle-Income Countries: Findings From the Arab Region and Beyond.

Abstract

Low- and middle-income countries (LMICs) account for nearly 70% of global cancer mortality, yet remain under-represented in oncology research. In the Middle East and North Africa, deficits in training, funding, infrastructure, regulation, and human capital restrict regionally led studies. This survey examined barriers through the experiences of cancer research professionals in Jordan and neighboring LMICs. We conducted a cross-sectional, web-based survey of clinicians, scientists, and allied professionals with ≥1 year of cancer research experience. Recruitment used institutional e-mails, social media, and snowball sampling. The 10- to 12-minute REDCap questionnaire covered demographics, training, funding, infrastructure, ethics/regulation, data access, collaboration, workforce, and government support. Quantitative data were summarized descriptively; open-text responses underwent thematic coding. Among 206 respondents (70.7% Jordan; 61% < 40 years; 66.3% female), 53.2% received research training at university but only 28.8% during residency; 77.9% judged programs inadequate. One third consistently struggled to obtain grants, and just 7.8% reported no difficulty. Infrastructure was limited: 38.3% had full laboratory access and 56.0% had full journal access. Only 48.7% rated national cancer data as good/excellent. International collaboration was reported by 57.0% but often impeded by bureaucracy. Human capital shortages were noted by 84.5%; 69.6% observed brain drain, and 68.2% lacked protected time. Government support was rated poor/very poor by 35.6% and excellent by 9.6%. Thematic analysis highlighted resource scarcity, bureaucratic inertia, and the absence of a national strategy. Cancer research in Jordan and LMICs is constrained by linked weaknesses in training, funding, infrastructure, regulation, data, and workforce. Reforms should embed experiential training and mentorship, diversify funding, expand shared facilities and data systems, streamline ethics processes, and strengthen career pathways with protected time and incentives, underpinned by coordinated policy commitment.