Association between heavy metals and colon cancer: an ecological study based on geographical information systems in North-Eastern Iran

Kiani, Behzad; Amin, Fatemeh Hashemi; Bagheri, Nasser; Bergquist, Robert; Mohammadi, Ali Akbar; Yousefi, Mahmood; Faraji, Hossein; Roshandel, Gholamreza; Beirami, Somayeh; Rahimzadeh, Hadi; Hoseini, Benyamin

doi:10.1186/s12885-021-08148-1

Cited by 89 publications

(30 citation statements)

References 55 publications

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“…It provides a basis for health policymakers to determine priorities and distribute healthcare resources and decide intervention for disease prevention and control [ 14 ]. In cancer research field, studies have been performed to evaluate the association between environmental factors and cancer incidence based on spatial analysis [ 15 , 16 ]. These studies have reported the vulnerable areas for cancer incidence and suggested environmental factors that can be considered to resolve it by showing the inequality of cancer incidence and suggesting factors that can explain this imbalance.…”

Section: Introductionmentioning

confidence: 99%

Spatial epidemiologic analysis of the liver cancer and gallbladder cancer incidence and its determinants in South Korea

2021

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Background There have been reports on regional variation in prevalence of hepatitis B and C, and Clonorchis sinensis (C. sinensis) infection, which indicates potential of spatial variation in liver cancer and gallbladder cancer incidence in Korea. Therefore, we aimed to assess the regional variation of liver and gallbladder cancer incidence and its determinants based on the regional distribution of risk factors, including hepatitis B infection in Korea. Methods This study used an ecological study design and district-level cancer incidence statistics generated by the National Cancer Center. Spatial clusters of liver and gallbladder cancer incidence were detected based on spatial scan statistics using SaTScan™ software. We set the size of maximum spatial scanning window of 25 and 35% of the population at risk for analyses of liver and gallbladder cancer, respectively. Significance level of 0.05 was used to reject the null hypothesis of no cluster. We fitted the Besag-York-Mollie model using integrated nested Laplace approximations to assess factors that influence the regional variation in cancer incidence. Results Spatial clusters with high liver cancer incidence rates were detected in the southwestern and southeastern regions of Korea. High gallbladder cancer incidence rates are clustered in the southeastern region. Regional liver cancer incidence can be accounted for the prevalence of high household income (coefficient, − 0.10; 95% credible interval [CI], − 0.18 to − 0.02), marital status (coefficient, − 0.14; 95% CI, − 0.25 to − 0.03), the incidence of hepatitis B (coefficient, 0.87; 95% CI, 0.29 to 1.44), and liver cancer screening (coefficient, 0.06; 95% CI, 0.00 to 0.12), while gallbladder cancer incidence was related to the prevalence of high household income (coefficient, − 0.03; 95% CI, − 0.05 to 0.00) and living close to a river with a high prevalence of liver fluke infection (coefficient, 0.55; 95% CI, 0.14 to 0.96). Conclusions This study demonstrated geographic variation in liver and gallbladder cancer incidence, which can be explained by determinants such as hepatitis B, income, marital status, and living near a river.

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Section: Introductionmentioning

confidence: 99%

Spatial epidemiologic analysis of the liver cancer and gallbladder cancer incidence and its determinants in South Korea

2021

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“…Multiple risk factors contribute to CRC development. This has been assessed in Iran previously [ 70 – 72 ] and among the various factors affecting CRC incidence, the main reason for early-onset CRC development might be the various germline mutations that have come to light in the last two decades [ 18 , 73 ]. Our study, in addition to demographic and pathological characteristics, addressed the MMR status of early-onset CRCs.…”

Section: Discussionmentioning

confidence: 99%

Colorectal Cancer in North-Eastern Iran: a retrospective, comparative study of early-onset and late-onset cases based on data from the Iranian hereditary colorectal cancer registry

et al. 2022

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Background The incidence rate of colorectal cancer (CRC) is increasing among patients below 50 years of age. The reason for this is unclear, but could have to do with the fact that indicative variables, such as tumour location, gender preference and genetic preponderance have not been followed up in a consistent mann er. The current study was primarily conducted to improve the hereditary CRC screening programme by assessing the demographic and clinicopathological characteristics of early-onset CRC compared to late-onset CRC in northeast Iran. Methods This retrospective study, carried out over a three-year follow-up period (2014–2017), included 562 consecutive CRCs diagnosed in three Mashhad city hospital laboratories in north-eastern Iran. We applied comparative analysis of pathological and hereditary features together with information on the presence of mismatch repair (MMR) gene deficiency with respect to recovery versus mortality. Patients with mutations resulting in absence of the MMR gene MLH1 protein product and normal BRAF status were considered to be at high risk of Lynch syndrome (LS). Analyses using R studio software were performed on early-onset CRC (n = 222) and late-onset CRC (n = 340), corresponding to patients ≤50 years of age and patients > 50 years. Results From an age-of-onset point of view, the distribution between the genders differed with females showing a higher proportion of early-onset CRC than men (56% vs. 44%), while the late-onset CRC disparity was less pronounced (48% vs. 52%). The mean age of all participants was 55.6 ± 14.8 years, with 40.3 ± 7.3 years for early-onset CRC and 65.1 ± 9.3 years for late-onset CRC. With respect to anatomical tumour location (distal, rectal and proximal), the frequencies were 61, 28 and 11%, respectively, but the variation did not reach statistical significance. However, there was a dramatic difference with regard to the history of CRC in second-degree relatives between two age categories, with much higher numbers of family-related CRCs in the early-onset group. Expression of the MLH1 and PMS2 genes were significantly different between recovered and deceased, while this finding was not observed with regard to the MSH6 and the MSH2 genes. Mortality was significantly higher in those at high risk of LS. Conclusion The variation of demographic, pathological and genetic characteristics between early-onset and late-onset CRC emphasizes the need for a well-defined algorithm to identify high-risk patients.

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“…There are evidences between heavy metals pollution in environments and CRC in Iran as a good example. [ 23 – 29 ]…”

Section: Discussionmentioning

confidence: 99%

Favorable colorectal cancer mortality-to-incidence ratios in countries with high expenditures on health and development index

et al. 2021

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Background: Global variation in the incidence and outcomes of colorectal cancer (CRC) is associated with many factors, among which screening policies and early treatment play substantial roles. However, screening programs and intense treatment are expensive and require good health care systems. For CRC, no clear association has yet been established between clinical outcomes and health care disparities.Method: We used the mortality-to-incidence ratio (MIR) of CRC as a measure of clinical outcomes for comparison with the Human Development Index (HDI), current health expenditure (CHE), and current health expenditure as a percentage of gross domestic product (CHE/GDP) using linear regression analyses. We included 171 countries based on data from the GLOBOCAN 2018 database.Results: We found that the regions with the lowest MIRs for CRC are Oceania and North America. A significant correlation was observed between incidence, mortality and HDI, CHE, and CHE/GDP among the countries enrolled. Furthermore, lower MIRs of CRC significantly correlated with higher HDI, CHE, and CHE/GDP (P < 0.001, P < 0.001, and P < 0.001, respectively).Conclusion : CRC MIRs tend to be most favorable in countries with high health care expenditures and a high HDI.Abbreviations: ASR = age-standardized rate, CHE = current health expenditure, CRC = colon rectal cancer, GDP = gross domestic product, HDI = Human Development Index, MIR = mortality-to-incidence ratio.

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Association between heavy metals and colon cancer: an ecological study based on geographical information systems in North-Eastern Iran

Cited by 89 publications

References 55 publications

Spatial epidemiologic analysis of the liver cancer and gallbladder cancer incidence and its determinants in South Korea

Spatial epidemiologic analysis of the liver cancer and gallbladder cancer incidence and its determinants in South Korea

Colorectal Cancer in North-Eastern Iran: a retrospective, comparative study of early-onset and late-onset cases based on data from the Iranian hereditary colorectal cancer registry

Favorable colorectal cancer mortality-to-incidence ratios in countries with high expenditures on health and development index

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