Ali Mokdad stands in the heart of Beirut. Cars and trucks and motorcycles rumble everywhere.
"If you look at a car passing by, you see smoke coming out of it — that's illegal in Lebanon. But nobody enforce[s] it," says Mokda, the chief strategy officer of population health at the University of Washington.
As a result, Beirut has terrible air quality and is often submerged under a blanket of exhaust. And it's not just in the big cities — vehicles belch pollution across the country.
It's one reason that cancer is surging in Lebanon. Mokdad co-authored a global survey that revealed that the tiny nation on the Mediterranean is experiencing the fastest increase in cancer incidence and mortality anywhere in the world. According to the study, published in The Lancet, the frequency of new cancer cases in Lebanon has increased by an astounding 162% from 1990 to 2023, with cancer-related deaths increasing by 80% over that same period. In 2023, for every 100,000 people in the country, there were 233.5 new cancer cases.




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