Marrakech – Moroccan researchers have documented residues of five anticancer medications in wastewater and groundwater linked to an oncology hospital in Oujda, eastern Morocco, drawing on water samples collected during 2023 and a risk assessment published this year.
The findings appear across two peer-reviewed studies. The first, published in the Journal of Ecological Engineering on August 1, reported the water measurements.
The second, published in Discover Environment on September 24, used those measurements to assess potential ecological risks.
Both were authored by Aouatif Azaal, Abdelali Ouasrhir, Hamid Madani, Youssef Smiri, and Bouchra El Guerrouj. The September paper builds its analysis on concentrations reported in the earlier work, so it is primarily a risk assessment rather than evidence of a new contamination event.
The five compounds examined were cyclophosphamide, ifosfamide, 5-fluorouracil, doxorubicin, and etoposide. Researchers collected samples in June and December 2023 from wastewater associated with Oujda’s Hassan II oncology center, treated wastewater discharged toward Oued Bounaim, and groundwater.
The groundwater sample came from a well roughly 200 meters from the hospital, at a depth of 100 to 120 meters. Across the analyzed samples, concentrations ranged from 5.866 to 428.58 micrograms per liter.
The medications were not detected uniformly across every water type. In the treated wastewater discharged toward Oued Bounaim, cyclophosphamide, ifosfamide, and 5-fluorouracil were found at comparatively high concentrations of 467.036, 392.274, and 342.067 micrograms per liter, respectively, while doxorubicin was not detected or fell below detection limits.
The groundwater results showed a similarly uneven picture. There, researchers found cyclophosphamide, ifosfamide, and 5-fluorouracil at notable concentrations of 95.72, 72.267, and 26.436 micrograms per liter, respectively.
Doxorubicin appeared at a low concentration of 5.989 micrograms per liter, while etoposide was not detected or fell below the limit of detection. These differences show the contamination profile varied by compound and by location rather than appearing as a single consistent pattern.
Several limitations shape how the results should be read. Only one groundwater well was sampled, and the researchers acknowledge that this restricts conclusions about contamination across Oujda or its groundwater resources more broadly.
The hospital has also not been definitively confirmed as the source of the groundwater contamination. The September study explicitly calls for repeated sampling and hydrogeological evidence before attributing the contamination to any particular source.
Equally important is the scope of the risk assessment itself. The September analysis concerns primarily ecological hazards, including potential effects on aquatic organisms. It does not establish that Oujda’s municipal drinking-water network contains these drugs, nor does it demonstrate that residents face a health risk from tap water.
The distinction between the two studies clarifies what the research actually shows. The earlier paper detected and measured the compounds. The later paper applied those maximum measured concentrations to estimate ecological risk. Neither reports a fresh 2026 detection, and the measurements themselves date to 2023.
Taken together, the two studies document the presence of anticancer drug residues in water compartments connected to a major oncology facility, while stopping short of broader claims about public water safety or a single identifiable source. The researchers frame their work as a basis for further monitoring rather than a final determination.
The research comes amid a growing cancer crisis. Globally, the studies cite an increase from 19,976,499 cases in 2022 to an estimated 53,504,187 by 2027. In Morocco, cancer cases were estimated at 63,609 new diagnoses in 2022, a figure expected to reach 154,884 by 2027.
The authors note that this growing burden points to greater use of anticancer drugs, which in turn raises the likelihood of their entry into the water cycle.
The epidemiological data from the Hassan II oncology center shaped which compounds the researchers tracked. Between 2019 and 2021, breast cancer accounted for 43% of regional cases, followed by lung cancer at 12%, colon cancer at 10%, and stomach, cervical, and prostate cancers at 8%, 7%, and 7%, respectively. Rectal cancer made up 5% and ovary and rectum 4%.
The most frequently administered drugs over that period were 5-fluorouracil, cyclophosphamide, and ifosfamide, which guided their selection as target compounds for the water analysis.
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