Cancer research in the United Arab Emirates from birth to present: A bibliometric analysis

Abstract

Background

Accumulating evidence indicates that the incidence of cancer is increasing in the United Arab Emirates (UAE). This analysis aimed to determine the current cancer research output in the UAE to guide future national research.

Methods

The Scopus database was searched for cancer-related bibliographic data from the UAE. The number of publications, citation analysis, co-authorship of the author, institution, and country, keyword co-occurrence, and reference co-citations were analyzed using the R-studio bibliometrics package and VOSviewer software.

Results

A total of 1678 journal articles were retrieved from 1981 to 2022. Cancer research in the UAE (UCR) is increasing at a rate of 14.64% (R-squared = 0.75; F = 46.477; P<0.001). The UAE had a 0.06% participation rate in terms of the number of original articles. The rate of international co-authorship is 40.23%. The U.S.A., U.K., Egypt, Saudi Arabia, India, and Canada had more than 100 co-authored documents from 156 countries that collaborated with the U.A.E.

Conclusions

Compared to other nations, the UAE has fewer publications on cancer, although the number is growing. The current report provides an up-to-date and in-depth summary of the trends in UCR. This project is an excellent place for researchers interested in conducting data-mapping work in this field.

1. Introduction

Cancer remains a major public health concern. It is a complicated illness that significantly burdens people, families, the healthcare system, and society. One in five people worldwide will develop cancer at some point in their lives, and one in eight men and one in eleven women will die from it [[1], [2], [3]]. Cancer accounts for 15% of all the fatalities worldwide. More than half of all cancers (56.8%) and nearly two-thirds of all cancer-related deaths (64.9%) occur in less developed parts of the world. According to the World Health Organization, cancer is the second leading cause of death globally, after heart disease. By 2030, it is predicted that there will be 13.2 million cancer deaths worldwide and 21.4 million new cancer cases, with the majority of these cases occurring in developing nations [[1], [2], [3], [4]].

The UAE economy has grown at one of the fastest rates in the 20th century [5,6]. The economic, sociodemographic, and lifestyle changes resulting from this expansion are accompanied by an epidemiological rise in cancer rates. Cancer is the third leading cause of death in the UAE. Later research in the UAE connected this rise in cancer to exposure to a number of risk factors, such as sedentary lifestyles and lack of physical activity [7,8], consumption of high-calorie and poorly nutritive meals [9], obesity [10], smoking [11], and higher air pollution levels [12]. A total of 4299 cases, comprising 4123 (95.91%) invasive cancer cases and 176 (4.09%) in situ cases, were diagnosed in the UAE in 2017. There were 1929 males and 2370 females (55,1% female to male). 4210 cancer cases were recorded in 2016, showing an increase from 2016 to 2017. Breast cancer accounted for 20.23% of all cancer cases in the UAE in 2017, making it the most prevalent type of cancer. The most prevalent malignancies in the UAE are breast cancer, followed by colon cancer (10.24%), thyroid cancer (9.99%), leukemia (7.62%), skin cancer (5.04%), non-lymphoma Hodgkin's disease (4.17%), and prostate cancer (3.76%) [6,13].

In the United Arab Emirates, cancer services are expanding, and there is a need to guarantee that the practice is evidence-based [14]. Although medical care has advanced significantly, there is still a lack of cancer quality control in the UAE and cancer treatment varies widely among cancer clinics. A thorough review of cancer research in the UAE (UCR) may be used to identify the degree of compatibility of publications with government policies and the most frequent cancers, as well as to compare UCR progress with that of other nations [15,16]. By understanding the present UCR outputs, it will be feasible to direct future research to solve the identified gaps and guarantee its applicability to decision makers at numerous impact levels. Such activities can promote evidence-based practice, which is vital for decision making in healthcare [14,15]. Bibliometric studies have been conducted in numerous countries [[16], [17], [18], [19], [20]], aiming to assist decision-makers in maximizing the utilization of national research outcomes. Previous research has provided a comprehensive analysis of the historical use of bibliometrics in medicine and has highlighted its normative application in healthcare research. It emphasizes the benefits of bibliometrics in analyzing extensive amounts of publications, identifying historical roots, and understanding the production patterns of research literature in the medical field [17]. Therefore, the objectives of this scientometric study were to determine the current cancer research output in the United Arab Emirates (UAE) and to provide guidance for future national research initiatives. With the increasing incidence of cancer in the UAE, understanding the status of cancer research is crucial. However, there is a research gap in comprehensively analyzing the landscape of cancer research in the country. Through a comprehensive bibliometric analysis, this study aimed to assess the number of publications, conduct citation analysis, explore co-authorship patterns, and identify collaborations with other countries. By examining scholarly outputs of cancer-related research, including clinical, epidemiological, and basic research, this study sought to characterize the current research landscape, identify trends over time, and shed light on any existing research gaps. The findings of this analysis can inform researchers, policymakers, and stakeholders in developing and prioritizing cancer research agendas in the UAE, ultimately contributing to the advancement of cancer prevention, diagnosis, and treatment strategies in the country. By addressing this research gap and providing insights into the current state of cancer research, this study offers valuable guidance for future research initiatives in the UAE.

2. Materials and methods

2.1. Database selection

Bibliometric assessments contextualize these publications against the database, which is also dependent on the coverage, and are reflections of the coverage of their underlying databases in that the coverage effectively dictates what is included in the study [18]. Elsevier launched Scopus in 2004. According to Elsevier, Scopus provides the “most comprehensive overview of the world's research output” and is maintained by a group of subject matter experts. Scopus aims to create the most feasible database of excellent research articles [19]. In this study, the Scopus database was used to gather UCR-related bibliographic data. In contrast to WoS, which prioritizes numbers above quality, Scopus seeks a compromise between Elsevier and Clarivate Analytics [20,21]. The Scopus database was used to gather UCR-related bibliographic data.

2.2. Sample size

Bibliometric analysis should be used when there are many bibliometric data, because the literature review is too broad for manual examination. Moreover, if fewer than 200 documents exist, bibliometric analysis cannot be evaluated [22]. This method is unreliable because the mean effects of class-weighted citations for bibliometric studies with smaller sample sizes vary significantly. This study used trial and error methods and keyword filtering, and the sample size was sufficient for bibliometric analysis of the UCR.

2.3. Search strategy and inclusion criteria

The current study intended to capture publications on cancer research by UAE-affiliated authors, including studies carried out in the UAE as well as international collaborations and research conducted externally. This allows for a comprehensive view of academic productivity, networks, and contributions to the global knowledge base on cancer by researchers linked to the UAE institutions. An essential aspect of bibliometric research is the selection of keywords for use in database searches. More data can be obtained and analyzed, which will result in discoveries that can be built upon to gain a deeper comprehension of performance, knowledge structure, hot spots, and other bibliometric analysis indicators. The keywords related to UCR were extracted [TITLE-ABS-KEY (“cancer” OR “neoplasm,” “tumor” OR “tumor” OR “carcinoma” OR “adenocarcinoma” OR “leukemia” OR “leukemia” OR “sarcoma” OR “lymphoma” OR “malignant” OR “oncology” OR “metastasis” OR “oncogene” OR “chemotherapy”) AND (LIMIT-TO (DOCTYPE, “ar”)) AND (LIMIT-TO (AFFILCOUNTRY, “United Arab Emirates”)) AND (LIMIT-TO (LANGUAGE, “English”)) AND (EXCLUDE (PUBYEAR, 2023))] using MesH browser [23]. Preliminary findings included articles, reviews, letters, notes, editorials, erratums, conference papers, short surveys, book chapters, conference reviews, data papers, and retractions. The current study included only original journal articles. English written documents with no time frames were included. Excluding non-English papers and retaining only original papers in bibliometric analysis are important for accurate interpretation, increased data availability, consistency, comparability, relevance to the research question, and promoting reproducibility. By focusing on English papers, researchers can overcome language barriers, access a larger pool of literature, ensure consistency in analysis, align themselves with the research scope, and facilitate verification by the scientific community [18,24]. Articles with more than 25 authors were excluded from mapping analysis. The final data were downloaded into a spreadsheet in CSV and BibTex formats. Data were extracted in November 27, 2022. The steps used to capture the UCR articles are shown in Fig. 1.

Fig. 1.

Data search for UCR related studies.

2.4. Data analysis, mapping and visualization

The performance of the UCR was evaluated using the Scopus platform's integrated analyzer, which can determine the volume of annual research and citations. Bibliographic mapping was conducted using the VOSviewer and Bibliometrix platforms [25,26]. VOSviewer is a program that is used to generate and display bibliometric networks. These networks may be constructed through citation, bibliographic coupling, co-citation, or co-authorship relationships and may include journals, researchers, or individual articles. VOSviewer also includes text-mining tools for creating and visualizing co-occurrence networks of key phrases collected from the scientific literature. The total link strength (TLS) was calculated using VOSviewer software. The Bibliometrix interface in the R package (Biblioshiny) was used to obtain the findings of this study.

2.5. Statistical analysis

Data were entered and statistically analyzed using IBM SPSS version 23. Annual production was analyzed using linear regression. The regression coefficient (R2) and p-value are reported.

3. Results

3.1. Overview of UCR

The period of UCR from 1981 to 2022 amounted to 1678 original articles (Table 1) in cancer research. All other research papers were excluded from the bibliometric analysis. The original articles were published using 872 sources and included 66,511 cited references. The annual growth rate has reached 14.64%, with an average age of 5.26 for the document. Growth in the number of UCR-related publications and years was significantly related (P < 0.001), with R2 = 0.755, indicating a strong relationship (Fig. 2). Therefore, the UCR increased significantly (R-squared = 0.755; F = 46.477; P<0.001). A total of 10,228 researchers have published these papers. Most countries share knowledge with the UAE regarding cancer research (Fig. 3). The United States, Egypt, United Kingdom, Saudi Arabia, India, Canada, France, and Germany are among the most prolific countries in the UCR. The University of Sharjah provided the highest funding for cancer research (84/1678).

Table 1.

Main information.

Description	Results
Timespan	1981:2022
Number of articles	1678
Sources (Journals)	872
Documents	1678
Annual growth rate %	14.64
Document average age	5.26
Average citations per documents	15.81
References	66,511
Document contents
Keywords Plus (ID)	14,831
Author's Keywords (DE)	4296
Authors
Authors	10,228
Authors of single-authored documents	32
Authors collaboration
Single-authored docs	43
Co-authors per documents	8.51
International co-authorships %	40.23

Fig. 2.

Annual publication trends of the UCR (1981-2022). Y-axis: number of articles published. X-axis: years since the first article was published on the topic of this paper. The growth in the number of UCR-related publications and years was significantly related (P < 0.001), with R² = 0.755, indicating a strong relationship.

Fig. 3.

Global distribution of the UCR (1981–2022). Countries with a dark blue color were the most productive. Countries outside the blue category did not make any contributions to the research in this particular area. This figure was generated using Bibliometrix and BibTex data file. (For interpretation of the references to color in this figure legend, the reader is referred to the Web version of this article.)

3.2. Mapping of collaboration

Scientific collaboration mapping was performed for all research constituents such as authors, organizations, and countries related to the UCR. Of all the documents included in this study, 43 had only one author. The average number of co-authors for each document was 8.51. By contrast, 40.23% of the documents were attributed to international co-authorship. Articles with more than 25 authors were excluded from mapping analysis. 7742 authors participated in the articles, with less than 25 contributors. Of the 7742, only 23 met the threshold of 15 authors. The TLS of the co-authorship links with other scholars was calculated for each of the 23 scholars. The scholars with the highest TLS are shown in Fig. 4. The authors mapped them into four clusters using VOSviewer software. The most collaborative authors at UCR, based on their Total Link Strength (TLS) values, included Attoub S. (TLS = 36), Arafat K. (TLS = 33), Bajbouj K. (TLS = 30), Hamad M. (TLS = 26), Haque S. (TLS = 23), Hussain A. (TLS = 23), and Iratni R. (TLS = 23). These authors demonstrated strong collaboration within the research community at the UCR, contributing to the advancement of knowledge in their respective fields. TLS serves as a measure of the strength of collaborative links between authors, considering factors such as co-authorship. Their collaborative efforts play a significant role in fostering research collaboration and enhancing the academic environment in UCR. Further details of the most collaborative authors are provided in Supplementary Table 1. The University of Sharjah is the most collaborating organization with considerable UCR links. The U.S.A., U.K., Egypt, Saudi Arabia, India, and Canada had more than 100 co-authored documents from 156 countries that collaborated with the U.A.E. Countries with more than 15 articles were mapped using network (Fig. 5A) and overlay (Fig. 5B) visualization methods. These actively collaborating countries were divided into four clusters representing European, Asian, American, and Islamic groups. In Fig. 5B, frames with different colors indicate the dynamics of collaboration.

Fig. 4.

Visualization of international collaboration in UCR based on co-authorship. Authors with more than 15 articles were mapped into four clusters using VOSviewer. Based on the TLS values, Attoub emerged as the leading collaborative author in UCR.

Fig. 5.

Visualization of International Collaboration Based on Co-authorship. Countries with more than 15 articles were mapped using network (5 A) and overlay (5 B) visualization methods. Frames with different colors indicate the dynamics of collaboration. (For interpretation of the references to color in this figure legend, the reader is referred to the Web version of this article.)

3.3. The impact of UCR: citation analysis

Dawood, S. (Dubai Hospital, Dubai, U.A.E.); Attoub, S. (U.A.E. University), Horto&bacute;agyi, G. N. (University of Texas, Anderson Cancer Center, U.S.A.), and Amin. A. (United Arab Emirates University, Al Ain, United Arab Emirates) are the most cited authors with than one thousand citations. The top-cited sources are listed in Table 2. The University of Sharjah, Sharjah, U.A.E., is the top-cited organization (Table 2). The average number of citations per document is 15.81.

Table 2.

Top-cited organizations and sources.

Organizations	Documents	Citations
University Of Sharjah, Sharjah, UAE	155	2025
Department Of Medical Oncology, Dubai Hospital, UAE	25	998
Cleveland Clinic Abu Dhabi, Abu Dhabi, UAE	12	797
United Arab Emirates University, Al Ain, UAE	13	438
University Of Manchester, Manchester, UK	8	361
Northwestern University, USA	5	278
Cancer Research Center, Hamad Bin Khalifa University, Qatar	6	275
Tawam Hospital, Al Ain, UAE	8	210
Department Of Pathology, UAE	10	188
Department Of Radiology, Sheikh Khalifa Specialty Hospital, UAE	6	146
Source	Documents	Citations
Scientific Reports	38	870
Annals of Oncology	8	655
Clinical Cancer Research	6	632
PLOS One	33	608
JCI Insight	11	540
Cancer	9	474
Molecules	33	428
Asian Pacific Journal of Cancer Prevention	27	304
Nature Communications	9	270
International Journal of Molecular Sciences	22	234

Table 3 presents the most frequently cited documents [[27], [28], [29], [30], [31], [32], [33], [34], [35], [36]]. A kaleidoscope of research themes unfolds within the most highly cited UCR articles, showcasing the breadth and depth of cancer research in the United Arab Emirates. One investigation assesses saffron's potential as an anticancer agent across diverse carcinomas, while another adopts a population-centric approach, delving into disease variations, hospitalization rates, and mortality amongst middle-aged adults across various countries. Zooming in on breast cancer, a study probes survival disparities between patients with de novo and relapsed diagnoses, another elucidates prognoses based on HER2 status in patients harboring central nervous system metastases, and a third explores the prognostic and staging potential of circulating tumor cells. The realm of treatment strategies is also addressed, with a randomized clinical trial comparing laparoscopic and open resection for rectal cancer, and another study elucidating the anti-cancer properties of apigenin, a plant-derived compound. Expanding beyond immediate therapeutics, researchers shed light on the underlying mechanisms of cancer progression, examining how CD36-mediated metabolic adaptations bolster regulatory T-cell survival and tumor function. Taken as a whole, these highly cited articles provide invaluable insights into cancer biology, prognostication, therapeutic approaches, and advancements within the UAE's cancer research landscape, paving the way for future progress in cancer prevention, diagnosis, and treatment.

Table 3.

Most-globally cited documents*.

Author	Source	DOI	Total Citations	TC per Year	Normalized TC
Fleshman J, 2015,	JAMA	10.1001/jama.2015.10529	701	87.63	19.94
Hu R, 2011,	Clinical Cancer Research	10.1158/1078-0432.CCR-10-2021	276	23.00	6.14
Dagenais GR, 2020,	Lancet	10.1016/S0140-6736 (19)32,007-0	258	86.00	19.23
Wang H, 2020,	Nature Immunology	10.1038/s41590-019-0589-5	180	60.00	13.42
Dawood S, 2010,	Annals Of Oncology	10.1093/annonc/mdq220	177	13.62	5.83
Dawood S, 2008,	Annals Of Oncology	10.1093/annonc/mdn036	153	10.20	2.90
Lodge MA, 2012,	Journal Of Nuclear Medicine	10.2967/jnumed.111.101733	151	13.73	5.91
Ujiki MB, 2006,	Molecular CANCER	10.1186/1476-4598-5-76	146	8.59	6.92
Dawood S, 2008,	Cancer	10.1002/cncr.23,852	140	9.33	2.65
Amin A, 2011,	Hepatology	10.1002/hep.24,433	137	11.42	3.05

TC: Total Citation; DOI: Digital Objective Identifier. * [[27], [28], [29], [30], [31], [32], [33], [34], [35], [36]].

3.4. Conceptual mapping and co-word analysis and emerging themes

A conceptual structural map of UAE cancer literature is shown in Fig. 6. This represents the co-word analysis performed on bibliographic data retrieved from the Scopus database. A total of 14,831 all keywords and 4296 author's keywords were extracted. Of the authors' keywords, only 47 met the threshold for 10 occurrences. To provide an opportunity for other terms to emerge, the term “UAE” was excluded from the analysis. This decision was made to avoid potential bias and allow for a more comprehensive exploration of the research landscape in the field of cancer. By excluding the term “UAE,” we aim to capture a wider range of relevant terms and concepts related to cancer research, potentially uncovering new insights and trends within a broader context. As shown in Fig. 6, author's keywords were clustered into five assemblies based on VOSviewer with TLS and 414 and 213 links. The term “Breast cancer” anchored the red cluster with a TLS of 87 and 154 links in the map. Apoptosis (TLS = 121; links = 30) is the most frequent term in the green cluster, while “chemoprevention” (TLS = 53; links = 12) anchored the blue cluster. Cluster four (yellow) was led by the term “chemotherapy.” The purple cluster was formed by the terms “molecular docking” and “anti-proliferative activity” with a TLS of nine and two, respectively. Among all the clusters (Table 4), the most frequents terms are “breast cancer,” “apoptosis,” “anticancer,” “chemotherapy,” “colorectal cancer,” “doxorubicin,” “cytotoxicity,” “prostate cancer,” “lung cancer,” “prognosis,” “autophagy,” “p53,” “cisplatin,” and “oncology.”

Fig. 6.

Visualization of keywords of UCR authors as a tool for conceptual mapping. The authors' keywords with more than ten occurrences were mapped using the network visualization method. Of the authors' keywords, only 47 met the threshold for ten occurrences. Authors' keywords were clustered into five assemblies based on VOSviewer with TLS and 414 and 213 links, respectively.

Table 4.

Most frequently occurred author's keywords.

Keyworda	Occurrences	TLS	Keyword	Occurrences	TLS
apoptosis	87	117	cytotoxicity	26	23
breast cancer	154	87	gemcitabine	12	23
anticancer	40	34	p53	19	23
chemotherapy	35	34	colon cancer	16	18
colorectal cancer	35	30	cisplatin	19	15
chemoprevention	16	29	dna damage	11	15
cell cycle	14	28	lung cancer	24	15
autophagy	19	27	metastasis	13	15
doxorubicin	34	26	reactive oxygen species	10	15
invasion	16	24	cox-2	10	14

^aKeywords were arranged in descending order based on TLS, not occurrence. TLS: Total Link Strength.

In addition to mapping keyword occurrences, it is imperative to observe the patterns of research topics, sources, and authors of cancer publications. Fig. 7 presents a threefold analysis of cancer publications from the UAE with author keywords in the middle, sources on the right, and authors on the left side of the figure. The figure shows that Molecules are the most hosting source for scholarly production related to cancer research in the UAE, followed by the International Journal of Molecular Medicine, Asian Pacific Journal of Cancer Prevention, Biomedicine, and Pharmacotherapy. Most UAE scholars have discussed breast cancer issues and induction of apoptosis using anticancer drugs. Trend topics have evolved over the past 20 years, as illustrated in Fig. 8. The topic “quality of life” has been trending for the past ten years. Keywords such as “deep learning,” “artificial intelligence,” and “tumor microenvironment” reflect trending topics, as shown in Fig. 8.

Fig. 7.

Three field plots: author (AU), keyword (DE), and source (SO). The thickness of the lines connecting authors using different keywords represents the idea of their scholarly production. The thickness of the lines connecting the keywords and sources represents the number of keywords from each author published for each source. Each rectangle represents an author, a keyword, or a source. The size of the rectangle represents the importance of nodes in the network. This figure was generated using Bibliometrix and BibTex data file.

Fig. 8.

Trends in the UCR over the last 20 years. The graph depicts the research topic's time span, with horizontal lines indicating the duration and blue circles representing the frequency of the term. This figure was generated using Bibliometrix and BibTex data files. (For interpretation of the references to color in this figure legend, the reader is referred to the Web version of this article.)

The thematic development of the UCR since 1981 is shown in Fig. 9. Using the authors' keywords, thematic evolution demonstrated the development of themes over time. “Biblioshiny” is used to achieve thematic progression, and two-time breaks result in three-time segments. To preserve a more accurate representation of topic evolution, the researcher's judgment determines how to divide the period. The first covers 1981–2016, the second covers 2017–2020, and the third covers 2021–2022:

Fig. 9.

Thematic evolution of UCR evolution of research over time. Thematic evolution analysis is one of the features provided by Bibliometrix that helps researchers understand the development and changes in research topics over time. This helps to draw insights into the development and trajectory of research topics in your field. The thickness of the lines connecting the keywords and sources represents the number of keywords from each author published in each source. Each rectangle represents an author, keyword, or source. The size of the rectangle represents the importance of nodes in the network. This figure was generated using Bibliometrix and BibTex data files.

1981–2016: During this period, research in the UAE focused on various aspects of cancer, including molecular docking studies, to understand the interactions between drug molecules and cancer targets. There has been significant exploration of different cancer types such as breast cancer, cervical cancer, gastric cancer, melanoma, and squamous cell carcinoma. Researchers have investigated the efficacy of different cancer treatments, including chemotherapy drugs, such as 5-fluorouracil and doxorubicin. They also studied the expression of specific genes and proteins related to cancer development, prognosis, and overall survival. Moreover, investigations of the toxicity and pharmacokinetics of anticancer drugs have been conducted to improve treatment strategies.

2017–2020: During this period, the research landscape in the UAE expanded to include studies on cytotoxicity, hepatocellular carcinoma (the most common type of liver cancer), and the impact of oxidative stress on breast cancer. Researchers have also explored the use of advanced imaging techniques, such as computed tomography (CT), for cancer diagnosis and monitoring. Deep learning techniques have emerged as tools to analyze large datasets and aid in cancer research, enabling the development of predictive models and identification of potential therapeutic targets. Additionally, investigations into the effects of environmental factors, such as Cd exposure, on cancer incidence and progression have gained attention. The focus on epidemiology has increased, allowing researchers to understand the prevalence and distribution of cancer cases in the UAE.

2021–2022: In this more recent period, research in the UAE continued to advance, with a particular emphasis on developing innovative anticancer therapies. Studies have explored the potential of targeted therapies and kinase inhibitors for specific cancer types, including breast cancer (mcf-7 cell line) and prostate cancer. The roles of exosomes, small vesicles released by cancer cells, cancer progression, and communication between cells have become the subject of investigation. Deep learning techniques have been further integrated into cancer research, aiding in the analysis of complex datasets and facilitating the development of personalized treatment approaches. The research was also extended to pediatric oncology, with studies focusing on hematopoietic cell transplantation and lymphomas in children.

Overall, the thematic evolution of cancer research in the UAE demonstrates an increasing focus on understanding the different aspects of cancer, ranging from molecular interactions and treatment efficacy to the application of advanced technologies and personalized approaches. These advancements have contributed to a broader understanding of cancer biology and the development of improved strategies for cancer prevention, diagnosis, and treatment in the UAE.

4. Discussion

This study aimed to analyze the current cancer research output in the UAE to provide guidance for future national research. Given the growing incidence of cancer in the UAE, this study aimed to assess the existing body of research in this field and to identify areas of focus and potential gaps. By understanding the current landscape of cancer research in the UAE, this study sought to inform and guide future research initiatives, ultimately contributing to the advancement of cancer prevention, diagnosis, and treatment in the country. Despite ongoing monitoring and early detection efforts, the incidence and mortality rates of diagnosed cancer in the UAE have been steadily increasing, highlighting the need for improved coverage within the population [6]. This study employed bibliometric analysis to examine the historical trends in UAE cancer research (UCR), a technique previously used to map cancer research landscapes in various regions [2,[37], [38], [39]] including Arabic countries [40]. We investigated the cancer-related scholarly output of UAE university scholars, encompassing not only clinical trials, but also observational and epidemiological studies. This analysis revealed 1678 original articles published on cancer research in the UAE between 1981 and 2022 (Table 1).

While UCR production demonstrates an upward trend (Fig. 2), its volume remains relatively low compared to that of other countries. For a comprehensive comparison, we conducted a similar search of the Scopus database using identical keywords, focusing on nations or regions within the same broad geographical area. This analysis ranked the UAE at the 63rd global level in terms of cancer research outputs. Several countries have significantly surpassed the UAE's scientific production in this field, including the USA (758,234 articles), India (64,741 articles), and Turkey (38,064 articles). Within the region, several nations outperformed the UAE: Iran (22,114 articles), Egypt (15,733 articles), Saudi Arabia (11,743 articles), and Malaysia (7562 articles). However, the UAE's output exceeded those of Palestine (249 articles), Yemen (288 articles), Bahrain (301 articles), Kuwait (1060 articles), and Qatar (1302 articles). Continued investment in educational institutions and research initiatives focused on molecular, cellular, basic, and translational research are expected to fuel a further increase in the number of scientific publications. Notably, the UCR's participation rate in international cancer research publications is 0.06%, compared to 1.52% for all Arab nations combined [2]. The results of the current study are consistent with previous bibliometric studies on cancer in the Arab world [40,41].

International cancer research collaborations propel progress. By merging expertise, resources, and diverse patient populations, they unlock faster discoveries and broader knowledge sharing. Developed nations accelerate research while sharing knowledge, empowering developing countries to gain experience and access to technology. This united front fosters global advancements in the fight against cancer [39,42,43]. Most countries share knowledge regarding cancer research with the UAE. The U.S.A., U.K., Egypt, Saudi Arabia, India, and Canada have the highest collaboration rate with the UAE (Fig. 5). This may have resulted from the UAE and other nations' shared understanding of the need for increased scientific cooperation at all levels. On the other hand, due to numerous linguistic, cultural, and geographical similarities, there is cooperation between UCR scholars and Arab nations such as Egypt and, more recently, Jordan. Dawood, S., affiliated with the Department of Medical Oncology, Dubai Hospital, Dubai, U.A.E., created strong networks with Kuwait [44], Oman [45], Egypt, Saudi Arabia [46], the UK [47], and the USA [48]. The current study's pattern of international collaboration aligns with previous bibliometric studies conducted on cancer in the Arab world, as indicated by Refs. [40,41].

Citation assessments are commonly used to assess the effectiveness of research constituents worldwide [32]. Highly cited articles in bibliometric studies are scientific papers that received a significant number of citations from other researchers. These articles are considered influential and important within their research fields, indicating that their findings or ideas have had a substantial impact and influenced subsequent research. Highly cited articles often represent seminal works or breakthrough discoveries with advanced knowledge in their respective fields. The citation count is a commonly used metric to assess the impact and influence of research articles [38,42,49]. In this study, with the most citations between 1981 and 2022, Fleshman [32] had the largest citation count in this study (Table 3), making it the most significant study in the UCR. The ACOSOG Z6051 randomized clinical trial aimed to compare the effect of laparoscopic-assisted resection versus open resection on pathological outcomes in patients with stage II or III rectal cancer. The study found that laparoscopic-assisted resection demonstrated non-inferiority to open resection in achieving a negative circumferential resection margin (CRM), a critical factor in successful rectal cancer surgery. The rates of negative CRM were comparable between the two groups, indicating that laparoscopic-assisted resection was as effective as open resection in achieving clear surgical margins. The secondary outcomes, including complete mesorectal excision (CME), tumor regression grade, and lymph node yield, showed no significant differences between the two surgical approaches. These findings support the consideration of laparoscopic-assisted resection as a viable alternative to open resection, offering similar pathological outcomes and potentially leading to reduced surgical morbidity and improved patient outcomes in stage II or III rectal cancer. A striking finding from Table 3 is that most studies involve researchers from the UAE collaborating with international colleagues. This highlights the strong culture of international cooperation in UAE cancer research. However, the limited number of solely Emirati studies (only 3) [27,29,30] suggests a need for further support for high-impact national research initiatives. The relevant authorities in could play a crucial role by establishing dedicated funding programs, fostering research networks, and promoting infrastructure development to address potential limitations and empower Emirati researchers to conduct independent, impactful studies.

Analysis of conceptual diversity in cancer research has been the focus of various international studies. In the context of the current study, several criteria and aspects have been identified that merit consideration regarding the thematic structure of UCR. This area also presents an interesting opportunity for further research, utilizing literature and author keywords to construct a thematic map of the UCR. To analyze the conceptual structure of the UCR, this study utilized the author's keywords with the highest total link strength (TLS) and their connections. These highly occurring keywords were then clustered into four assemblies using VOSviewer, representing the main components of the knowledge generated by the UCR. By employing these methods, this study aimed to gain insights into the thematic landscape of UCR and provide a comprehensive understanding of the main research components within this domain. This analysis serves as a foundation for exploring the breadth and depth of cancer research in the United Arab Emirates and identifying key areas of focus for future investigations.

In the thematic map of the UCR, the red cluster is anchored by the term “Breast cancer.” This cluster demonstrates a strong thematic connection to breast cancer research within the UCR, as indicated by a Total Link Strength (TLS) of 87 and 154 links. The theme of the red cluster also encompasses other terms such as colorectal cancer, skin cancer, gastric cancer, immunohistochemistry, COVID-19, prognosis, deep learning, oncology, epidemiology, prostate cancer, and magnetic resonance imaging. These terms represent additional topics and areas of research interest within the UCR, reflecting a diverse range of cancer-related studies being conducted in the UAE. Rapid care reprioritization had a major effect on oncological services, resulting in a discernible decrease in routine breast screening programs such as mammography and ultrasound. This is one of the most visible effects [36]. UAE has the highest rate of breast cancer diagnoses worldwide. It was anticipated that there would be 9.8 million people in the UAE in 2020, of whom 28% would be females aged between 25 and 54 years [37]. Breast cancer is the second most prevalent malignancy in women worldwide. To encourage women at risk of seeking medical care for this condition, it is especially crucial to increase their awareness of breast cancer. Breast cancer diagnosis can have life-changing effects. Healthcare workers must be aware of, and supportive of, the emotions, values, and beliefs that are components of health. The process of accepting and coping with neoplasms may be aided by valuing the support network available to women with the disease. In this regard, it is important to recognize the value of a healthcare team that can deliver high-quality awareness integrated with diagnostic services for different types of cancers, not just breast cancer. Further research is required to determine the long-term effects of cancer screening. Studies have indicated that the diagnostic interval, often known as delay, can be significantly protracted. Several studies have indicated that patient delays account for a significant proportion of the overall delay in seeking medical attention. Further investigation is required to better understand the role of general practice in facilitating or impeding timely access to diagnostic evaluations in symptomatic patients.

This cluster also facilitates the association between covid-19 and breast cancer [35]. Within the context of UCR, the terms immunohistochemistry, prognosis, deep learning, and magnetic resonance imaging are interconnected and contribute to advancements in cancer research. Immunohistochemistry plays a crucial role in UCR by enabling the detection of specific proteins in cancer tissues, which helps determine molecular characteristics and prognostic outcomes [49]. Deep learning, a subfield of artificial intelligence, can be applied to analyze immunohistochemistry images and assist in the diagnosis and treatment decision-making processes. Additionally, magnetic resonance imaging (MRI) plays a vital role in UCR by providing detailed images of tumors, aiding prognostic evaluations. Deep-learning techniques can enhance the analysis and interpretation of MRI scans and improve the accuracy of cancer diagnosis, treatment planning, and monitoring [43,50]. Together, these interconnected components of immunohistochemistry, prognosis, deep learning, and MRI contribute to advancing cancer research within UCR, leading to improved prognostic assessments and personalized treatment strategies.

Al-Shamsi highlighted the UAE's commendable management of the COVID-19 pandemic and its impact on cancer care. The UAE has been recognized as a role model in pandemic management, with low COVID-19-related mortality rates and notable achievements, such as conducting the first worldwide phase 3 COVID-19 vaccination clinical trial and achieving a 100% vaccination rate for the eligible population. Despite the challenges posed by the pandemic, the UAE has ensured the continuity of all medical services for acute and chronic conditions, including cancer care. The Emirates Oncology Society plays a vital role in facilitating uninterrupted cancer care through effective communication and educational initiatives. The UAE has made significant contributions to cancer care and COVID-19 research, with notable publications receiving high citations and recognition, including the first international recommendations for cancer care during the pandemic. These achievements have solidified the UAE's position as a leader in healthcare and research during these challenging times [51].

Traditional drug discovery for cancer, akin to sifting through sand, has been fraught with inefficiencies. However, the advent of molecular docking, a computational technique that simulates ligand-protein interactions, has revolutionized the process. By predicting the binding affinities and stabilities, this in silico approach prioritizes promising drug candidates and accelerates progress. Although there are limitations in perfect in vivo prediction and dynamic protein complexity, docking offers advantages such as faster discovery, improved specificity, and repurposing potential. As computational power evolves, the future of docking in cancer research appears bright, promising to unlock novel therapeutic avenues and ultimately conquer this formidable field. The purple cluster was formed by the terms “molecular docking” and “anti-proliferative activity” with a TLS of nine and two, respectively. Some UAE-based studies have demonstrated diverse applications of molecular docking in cancer drug discovery. Al-Soud et al. evaluated the anticancer activity of 4-nitroimidazole derivatives [52], while Amr et al. designed peptides targeting lactate dehydrogenase-A [53]. Mohamady et al. created a promising scaffold targeting c-Met and Pim-1 proteins [54] and Othman et al. explored novel phthalimide derivatives [55]. Finally, Rashdan et al. synthesized imidazo [2,1-b]thiazole conjugates with anti-proliferative activity [56]. All studies utilized docking to predict binding affinities, guide design, and explore potential therapeutic avenues, showing the versatility of this purple theme in accelerating the development of new cancer treatments.

Apoptosis, cell cycle, cisplatin, MCF-7, p53, anticancer, colon cancer, hepatocellular carcinoma, and DNA damage, and lung cancer are the backbone terms of the green cluster. The research focus of this knowledge domain spotted light on the discovery of new anticancer agents and utilization of in vitro cancer models [[38], [39], [40], [41], [42], [43], [44], [45]]. Researchers in UAE have investigated the apoptotic effects of various compounds on cancer cells. Researchers have found that these compounds induce apoptotic cell death in cancer cells, as evidenced by various markers such as MTT assay, DNA ladder formation, and induction of p53 protein [[57], [58], [59]]. The exploration of novel cancer therapeutics is of great significance in many nations. Nevertheless, the findings of the present investigation indicate that there has been no successful development or implementation of anticancer pharmaceuticals within the UAE for clinical purposes.

Chemotherapy, doxorubicin, drug delivery, cancer therapy, and ultrasound are the most frequent terms in yellow cluster (Fig. 6). This research theme explores the potential of combining drug delivery strategies and ultrasound techniques to optimize cancer therapy, with a specific emphasis on the widely used chemotherapeutic drug doxorubicin. Chemotherapy plays a critical role in cancer treatment; however, its effectiveness is limited by side effects and challenges related to drug delivery [46]. To overcome these limitations, UAE-based researchers are investigating targeted delivery systems, such as nanoparticles, liposomes, or micelles, to encapsulate doxorubicin and deliver it selectively to tumor tissues. These systems improve drug stability, enhance tumor accumulation, and reduce systemic toxicity. Ultrasound is emerging as a promising tool for cancer therapy and drug delivery. By utilizing high-frequency sound waves, ultrasound can enhance drug penetration into tumors, trigger drug release from delivery systems, and improve cellular uptake. UCR aims to optimize the therapeutic outcomes of doxorubicin and chemotherapy by exploring innovative drug delivery systems and ultrasound parameters [57,[60], [61], [62], [63], [64]]. The ultimate goal is to improve targeted drug delivery, enhance the efficacy of doxorubicin, and mitigate its side effects, thereby advancing cancer therapy.

Chemoprevention, pancreatic cancer, cervical cancer, oral cancer, cytotoxicity, and COX-2 are the top co-occurred terms in the blue cluster. Chemoprevention refers to the use of natural or synthetic compounds to prevent, inhibit, or delay cancer development. Pancreatic, cervical, and oral cancers are significant health concerns worldwide, and effective preventive strategies are crucial to reduce their incidence and improve patient outcomes. In this regard, chemoprevention is a promising approach. Studies in the UAE investigating chemopreventive agents for cancer have identified natural compounds which have shown potential in inhibiting tumor growth and inducing apoptosis in preclinical models. These agents target various molecular pathways involved in pancreatic cancer development, including inflammation, oxidative stress, and cell signaling [61,62,[64], [65], [66], [67], [68]]. In the context of cervical cancer, chemoprevention has focused primarily on human papillomavirus (HPV) infection, the primary cause of the disease. Chemoprevention studies in UAE have explored the role of some agents in oral cancer [69] and cervical cancer [61]. These agents target key molecular pathways involved in oral cancer progression, including inflammation and the cyclooxygenase-2 (COX-2) pathway. Inhibition of COX-2, a pro-inflammatory enzyme, attenuates the development and progression of oral cancer [61,67,70]. The emphasis on chemoprevention in this research theme highlights the importance of proactive strategies in cancer management. By identifying and utilizing compounds that can prevent or delay the onset of cancer, researchers aim to complement the existing treatments and improve patient outcomes. Chemoprevention has significant potential in reducing the burden of pancreatic, cervical, and oral cancers by targeting specific risk factors and molecular pathways involved in their development. Continued research in this field can lead to the development of effective preventive strategies and ultimately contribute to an overall reduction in cancer incidence and mortality.

UCR scholars have also kept pace with the impressive developments in cancer research related to the quality of life of cancer patients and deep learning. These are the trending research topics in various parts of the globe [9,37]. Research on the quality of life of cancer patients has gained significant attention in UCR over the past two decades, as depicted in Fig. 8. The well-being of cancer patients can be viewed as a delicate balance between the stress and burden associated with the cancer experience and the available resources for coping with and alleviating these challenges [6]. Numerous studies have been conducted to evaluate the unmet needs of cancer patients in the UAE with the aim of enhancing supportive care services and ultimately improving their overall quality of life [71,72]. A specific study conducted in the UAE revealed that cancer patients in the country face a wide range of unmet supportive needs, primarily centered on psychological requirements. Among the top 10 critical unmet needs identified in the surveyed patients, 50% were related to psychological issues, and it was observed that women expressed significantly higher psychological needs than men. These findings emphasize the urgent need to enhance mental health services for cancer patients. Encouraging and actively involving female patients with cancer in counseling services can be a proactive step in addressing some of their needs [71].

Deep learning, a powerful machine learning technique, has become a hot topic in UAE cancer research (UCR) due to its potential to transform various aspects and improve patient outcomes. This technology, involving training multi-layered artificial neural networks to analyze complex data, excels in handling large datasets and performing sophisticated tasks, proving itself a valuable tool in cancer research. A key area of application is medical imaging analysis. Deep learning algorithms excel at tasks such as tumor detection, segmentation, and classification in medical images [50]. Notably, studies in the UAE used deep learning to detect breast cancer in mammograms and predict patient survival in colorectal cancer based on histological images, demonstrating its potential for improved diagnosis and prognosis [73]. Genomics and molecular profiling have also benefitted from deep learning. This technology effectively analyzes large-scale genomic data, thereby facilitating the identification of genetic alterations, tumor subtype classification, and treatment response prediction [74]. For instance, a UAE study employed deep learning to predict breast cancer patients' responses to therapy based on gene expression data, highlighting its potential for personalized treatment decisions [75]. Furthermore, deep learning advances drug discovery by predicting the efficacy of potential drugs, identifying novel targets, and aiding virtual screening, potentially accelerating therapy discovery and optimizing treatment strategies. For example, a UAE study used deep learning to predict the anticancer activities of natural compounds [76]. Finally, deep learning can be applied to clinical decision support systems and precision medicine. By integrating patient-specific data, these models offer personalized treatment planning, risk prediction, and therapeutic response monitoring. One study in the UAE used such models to predict treatment outcomes for patients with lung cancer, demonstrating its potential for personalized care [77]. In conclusion, deep learning is revolutionizing UCR with its capabilities in various areas, offering exciting opportunities for improved diagnostics, treatment optimization, and personalized medicine in the UAE cancer research landscape.

The field of breast cancer research has evolved significantly over the years, with notable changes observed between 1981-2016 and 2017-2020 (Fig. 9). Earlier, the focus was primarily on breast cancer itself, with efforts aimed at understanding its causes, risk factors, and treatment options. Researchers have dedicated their efforts to studying breast cancer in general and exploring various aspects of the disease, including its biology, epidemiology, and clinical management [48]. However, in the more recent period from to 2017-2020, there was a shift towards a broader focus on cancer research as a whole. Although breast cancer remains a significant area of investigation, researchers have begun to explore commonalities and shared mechanisms across different types of cancer. This shift reflects the growing recognition of the need for interdisciplinary approaches and collaboration in cancer research [48,72,75,78]. During this period, there was a specific emphasis on breast cancer research in the UAE. This localized focus aimed to address the unique challenges and needs of breast cancer patients in the UAE, considering factors such as population demographics and access to healthcare resources [72]. Moving into 2021-2022, the research landscape expanded to include topics related to anticancer therapies, such as cancer therapy, and specific treatments, such as radiotherapy. The inclusion of terms like “MCF-7" suggests a focus on specific cell lines commonly used in breast cancer research [79]. Furthermore, there is evidence of a cross-disciplinary exploration of prostate cancer, indicating a broader investigation of cancer types beyond breast cancer alone [80]. Overall, the evolution of breast cancer research demonstrates a shift towards a more comprehensive and collaborative approach, encompassing not only breast cancer but also the broader field of cancer research. This transition reflects a growing understanding of the interconnectedness of various cancer types and the need for interdisciplinary efforts to advance knowledge and improve patient outcomes.

The field of UCR, specifically focusing on prognosis, has witnessed changes over different time periods (Fig. 9). From to 1981-2016, prognosis research primarily focused on understanding and predicting the outcomes of various cancer types. Melanoma, a type of skin cancer, was a specific area of interest during this period [30,81]. Moving into 2017-2020, research on prognosis expanded to encompass a broader examination of cancer as a whole. Researchers have begun to explore prognosis across different types of cancers, recognizing the importance of understanding and predicting outcomes in a comprehensive manner [49,77]. Transitioning to 2021-2022, there has been a shift in research focus towards broader cancer-related topics. The term “cancer” became a prominent area of investigation, reflecting a more generalized approach to studying the disease. Additionally, there has been an emergence of research related to prognosis in specific populations, such as children, indicating a growing interest in understanding and predicting outcomes in pediatric cancer patients. Moreover, the utilization of emerging technologies such as deep learning has gained attention in the context of prognosis research. Deep learning algorithms, a subset of artificial intelligence, have shown promise for analyzing complex data and predicting cancer prognosis based on various factors [74]. Furthermore, there has been a notable expansion of research to include cancer types other than melanoma, including prostate cancer. This indicates a broader exploration of prognosis across different types of cancers to improve patient care and treatment decision-making [82]. Overall, the evolution of prognosis research has demonstrated a progression from a focus on specific cancer types to a more comprehensive understanding of prognosis across various cancers. The integration of advanced technologies and the exploration of prognosis in diverse populations have contributed to ongoing advancements in cancer research and patient care.

4.1. Limitations

To map the UCR, this study only considered the Scopus database. The search was so limited to “the terms used” in the title, abstract, and keyword that it might have missed studies that used mildly different terms or had a similar focus. Some studies were excluded from the search because they used different types of search operators. The authors restricted their data search to English language documents. Significant research has been conducted in English-language journals to maximize global awareness and attention, such as the rationale behind such a choice. Thus, linguistic bias in English can be considered a limitation. The primary drawback of this study was that it included only the scientific articles found in the Scopus database. According to a co-occurrence assessment of author keywords, only 85% of the articles contained author keyword details provided by journals. The results of the UCR were generated in this study using conventional bibliometric analytical methods. Future studies could combine bibliometric analyses with different types of literature reviews. It is important to note that as new publications are added to scholarly databases, the conclusions of bibliometric studies are revised periodically. As a result, further research is highly valued because of the nature of the analytical approach. Future studies may further compare or combine the findings from several scholarly databases, such as Web of Sciences and Scopus. To develop a more thorough awareness of the research trends in this field, it is proposed that the search strategy be modified accordingly. The results may differ, even when using an exact search query string. Consequently, further research may restart the search to obtain new results. Additionally, the multi-method approach of the search strategy can be used to redefine the data search strategy for deeper analysis.

5. Conclusion

To the best of our knowledge, this study is the first attempt to demonstrate the current state of research and emerging worldwide patterns in UCR, using bibliometric methods. The findings reveal that while the annual cancer-related publications in the UAE are increasing, they still lag behind those of other countries. It is crucial for future scholars to foster broader collaboration among diverse nations to enhance their research output. Notably, the shift in emphasis from clinical research to therapeutic research and cancer genomics is evident, reflecting the evolving landscape of the UCR. This study highlights the importance of directing attention towards contemporary focal areas, such as targeted therapy, personalized medicine, and improved diagnostics. The UAE stands out with a wealth of clinical and laboratory cancer research studies facilitated significantly by international cooperation. Encouraging postgraduate students and experts from the UAE to work on local issues is likely to make a more substantial contribution. Despite the ongoing research since 1981, it is remarkable that Emirati researchers have continuously addressed global issues at the forefront of contemporary research. The UAE's increasing interest in cancer research can be attributed to several factors. However, challenges persist, and the contribution of the UAE to the field of oncology remains modest compared with global production. This document aims to provide comprehensive background information on cancer research, serving as a valuable resource for scientists, healthcare professionals, key donors, and decision makers. By delving into intricate details and recurring trends, it establishes a framework for future progress, laying the groundwork for advancements in this field.

Funding

The authors extend their appreciation to the Deputyship for Research & Innovation, Ministry of Education in Saudi Arabia, for funding this research work through project number ISP23-82.

Institutional review board statement

“Not applicable.”

Informed consent statement

“Not applicable.”

Data availability statement

The raw data that support the results of this study are attached as a supplementary file with this submission.

CRediT authorship contribution statement

Humaid Obaid Al-Shamsi: Writing – review & editing, Writing – original draft, Visualization, Validation, Supervision, Software, Resources, Formal analysis, Data curation, Conceptualization. Siddig Ibrahim Abdelwahab: Writing – review & editing, Writing – original draft, Visualization, Validation, Supervision, Software, Methodology, Formal analysis, Data curation, Conceptualization. Osama Albasheer: Writing – review & editing, Writing – original draft, Visualization, Validation, Supervision, Software, Resources, Data curation, Conceptualization. Manal Mohamed Elhassan Taha: Writing – review & editing, Writing – original draft, Visualization, Validation, Supervision, Software, Resources, Project administration, Methodology, Investigation. Ahmad Y. Alqassim: Writing – review & editing, Writing – original draft, Visualization, Validation, Supervision, Resources, Project administration. Abdullah Alharbi: Writing – review & editing, Writing – original draft, Visualization, Validation, Supervision, Resources, Project administration. Abdullah Farasani: Writing – review & editing, Writing – original draft, Visualization, Validation, Supervision, Resources, Project administration. Ahmed Abdallah Ahmed Altraifi: Writing – review & editing, Writing – original draft, Visualization, Validation, Supervision, Resources, Project administration. Isameldin E. Medani: Writing – review & editing, Writing – original draft, Visualization, Validation, Supervision, Resources, Project administration. Nasser Hakami: Writing – review & editing, Writing – original draft, Visualization, Validation, Supervision, Resources, Project administration. Amani Osman Abdelmola: Writing – review & editing, Writing – original draft, Visualization, Validation, Supervision, Resources, Project administration.

Declaration of competing interest

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Abbreviations

MS Excel

Microsoft Excel

UCR

Cancer research in UAE

CSV

comma-separated values

AR

Article

CP

conference paper

UAE

United Arab Emirates

Appendix A. Supplementary data

The following is/are the supplementary data to this article.