A Survey of Cancer and Childhood Leukemia in Al-Rafai District, Di Quar Governorate, Iraq, 2021-2024, with Measurements of Elements in Hair Samples of Affected Individuals and Family Interviews. Preliminary Results and Recommendations for Further Research

There is considerable anecdotal evidence in Southern Iraq about increases in cancer rates. To follow up on growing community concerns about high levels of cancer in Al-Rafai District of Di Quar Governorate, a survey of cancer in an a priori defined sample population of the district was carried out. The method was based on a previous questionnaire study of cancer and infant mortality in Fallujah, Iraq, in 2010 [Busby et al. 2010, Alaani et al. 2011]. The questionnaire survey of Al-Rafai district involved visiting 517 families. Results showed a significant excess cancer risk, including all malignancies in males [26 obs. Exp. 8.74; RR = 3.86; CI 2.78, 5.36; p < 0.0000], all malignancies in females [57 obs; 7.92 exp. RR = 6.25; CI 4.86, 8.02; p < 0.0000], childhood cancer 0 - 14 [7 Obs, Exp 0.13; RR = 52.6; CI 21.15, 131.0; p < 0.0000], breast cancer [24 Obs. Exp 2.6; RR 8.97; CI 5.18, 15.54; p < 0.0000], child leukemia 0 - 19 [6 Obs, Exp. 0.021; RR = 281; CI 114, 693; p < 0.0000], a similar excess to that found in Fallujah in 2010, and lymphoma 6 Obs. 0.5 Exp. RR 11.95; CI 3.65, 39.11; p < 0.0000. Of interest was the existence of a cohort birth year peak in the leukemia rate in young men 0 - 19y of 2003-2004, when the USA war created high levels of uranium contamination. A parallel ICPMS analysis of hair samples in 18 women with cancer showed unusually high levels of heavy metals, including uranium, and other indicators of serious background contamination. Some preliminary results of the survey, including interviews with 100 affected families, are also summarised. Recommendations for further action are made.