Access to Breast Cancer Treatment and Reconstruction in Rural Populations: Do Women Have a Choice?

et al. 2020

Preprint

Abstract Background: Breast and prostate cancers are the most common gender-specific malignancies. In developing countries, screening of all population at risk of cancers is impractical because of the healthcare resource limitations. Thus, determining the high-risk areas of Cancers might be an important step to conduct a screening program at high-risk areas. This study explores potential high-risk clusters in the incidence pattern of breast and prostate cancers in southern Iran. Methods: This cross-sectional study was conducted in the province of Kerman, South Iran. Patient data were aggregated at the county and district levels and the incidence rate per 100,000 people for both breast and prostate cancer were calculated. We used the natural break classification with five classes to produce descriptive maps. A spatial clustering analysis ( Anselin Local Moran’s I ) was used to identify potential clusters and outliers in the pattern of these cancers from 2014 to 2017. Results: The Age-Standardised Incidence Rate of breast cancer showed an increase from 29.93 to 32.27 cases per 100,000 people and prostate cancer from 13.93 to 15.47 cases per 100,000 during 2014–2017. Cluster analysis at the county level identified high-high clusters of breast cancer in the North-West of the province for all years, but the analysis at the district level showed high-high clusters for only two of the years. Furthermore, cluster analysis at the county and district levels of prostate cancer also identified high-high clusters in the North-West of the province for two years. Conclusions: North-West Kerman had a significantly higher incidence rate of both breast and prostate cancer. These findings may help to design tailored screening and surveillance systems. Furthermore, this study generates new hypotheses to test potential relationships between environmental risk factors and incidence of cancers in areas with higher cancer risk.

Section: Resultsmentioning

confidence: 94%

Section: Resultsmentioning

confidence: 99%

Spatio-temporal Mapping of Breast and Prostate Cancer in South Iran During 2014-2017

et al. 2020

Preprint

“…Previous studies highlight that poor access to health care services lead to poor health outcomes (54,55), such as increased incidence of cancer (27,56). The high incidence of gender-speci c cancers in some regions of the study area may be due to their considerable distance from the provincial capital with limited cancer screening programmes.…”

Section: Discussionmentioning

confidence: 94%

“…Further investigations are needed to assess the drivers in the high-risk areas identi ed in north-western Kerman. They might be associated with environmental factors and lifestyles (12), poor access to cancer-speci c services (27), hereditary reasons (10) and/or socio-economic inequalities (28,29).…”

Section: Discussionmentioning

confidence: 99%

Spatio-temporal mapping of breast and prostate cancers in South Iran from 2014-2017

et al. 2020

Preprint

Background: The most common gender-specific malignancies are cancer of the breast and the prostate. In developing countries, cancer screening of all at risk is impractical because of healthcare resource limitations. Thus, determining high-risk areas might be an important first screening step. This study explores potential high-risk clusters in the incidence pattern of breast and prostate cancers in southern Iran.Methods:This cross-sectional study was conducted in the province of Kerman, South Iran. Patient data were aggregated at the county and district levels and the incidence rate per 100,000 people both for cancer of the breast and the prostate were calculated. We used the natural-break classification with five classes to produce descriptive maps. A spatial clustering analysis (Anselin Local Moran’s I) was used to identify potential clusters and outliers in the pattern of these cancers from 2014 to 2017.Results:The age-standardised incidence rate of breast cancer showed an increase from 29.93 to 32.27 cases per 100,000 people and that of prostate cancer from 13.93 to 15.47 cases per 100,000 during 2014-2017. Cluster analysis at the county level identified high-high clusters of breast cancer in the North-West of the province for all years, but the analysis at the district level showed high-high clusters for only two of the years. Furthermore, cluster analysis at the county and district levels of prostate cancer also identified high-high clusters in the North-West of the province for two of the years.Conclusions:North-western Kerman had a significantly higher incidence rate of both breast and prostate cancer, which should help in designing tailored screening and surveillance systems. Furthermore, this study generates new hypotheses to test potential relationships between environmental risk factors and incidence of cancers in areas with higher cancer risk than the average.

“…Further investigations are needed to assess the drivers in the high-risk areas identi ed in north-western Kerman. They might be associated with environmental factors and lifestyles (12), poor access to cancer-speci c services (29), hereditary reasons (10) and/or socio-economic inequalities (30,31).…”

Section: Discussionmentioning

confidence: 99%

Spatio-temporal mapping of breast and prostate cancers in South Iran from 2014-2017

et al. 2020

Preprint

Background:The most common gender-specific malignancies are cancers of the breast and the prostate. In developing countries, cancer screening of all at risk is impractical because of healthcare resource limitations. Thus, determining high-risk areas might be an important first screening step. This study explores incidence patterns of potential high-risk clusters of breast and prostate cancers in southern Iran.Methods:This cross-sectional study was conducted in the province of Kerman, South Iran. Patient data were aggregated at the county and district levels calculating the incidence rate per 100,000 people both for cancers of the breast and the prostate. We used the natural-break classification with five classes to produce descriptive maps. A spatial clustering analysis (Anselin Local Moran’s I) was used to identify potential clusters and outliers in the pattern of these cancers from 2014 to 2017.Results:There were 1,350 breast cancer patients (including, 42 male cases) and 478 prostate cancer patients in the province of Kerman, Iran during the study period. After 45 years of age, the number of men with diagnosed prostate cancer increased similarly to that of breast cancer for women after 25 years of age. The age-standardised incidence rate of breast cancer showed an increase from 29.93 to 32.27 cases per 100,000 people and that of prostate cancer from 13.93 to 15.47 cases per 100,000 during 2014-2017. Cluster analysis at the county level identified high-high clusters of breast cancer in the north-western part of the province for all years studied, but the analysis at the district level showed high-high clusters for only two of the years. With regard to prostate cancer, cluster analysis at the county and district levels identified high-high clusters in this area of the province for two of the study years.Conclusions:North-western Kerman had a significantly higher incidence rate of both breast and prostate cancer than the average, which should help in designing tailored screening and surveillance systems. Furthermore, this study generates new hypotheses regarding the potential relationship between increased incidence of cancers in certain geographical areas and environmental risk factors.