Host and environmental factors for gastric cancer in Babol, the Caspian Sea Coast, Iran

Stomach cancer, the fourth most common cancer and the second leading cause of cancer-related death through the world, is very common in parts of Iran. Geographic variation in the incidence of stomach cancer is due to many different factors. The aim of this study was to assess the geographical and spatial distribution of stomach cancer in Iran using data from the cancer registry program in Iran for the year 2009. The reported incidences of stomach cancer for different provinces were standardized to the world population structure. ArcGIS software was used to analyse the data. Hot spots and high risk areas were determined using spatial analysis (Getis-Ord Gi). Hot and cold spots were determined as more than or less than 2 standard deviations from the national average, respectively. A significance level of 0.10 was used for statistical judgment. In 2009, a total of 6,886 cases of stomach cancers were reported of which 4,891 were in men and 1,995 in women (standardized incidence rates of 19.2 and 10.0, respectively, per 100,000 population). The results showed that stomach cancer was concentrated mainly in northwest of the country in both men and women. In women, northwest provinces such as Ardebil, East Azerbaijan, West Azerbaijan, Gilan, and Qazvin were identified as hot spots (p<0.1). In men, all northwest provinces, Ardabil, East Azerbaijan, Gilan, Qazvin, Zanjan and Kurdistan, the incidences were higher than the national average and these were identified as hot spots (P<0.01). As stomach cancer is clustered in the northwest of the country, further epidemiological studies are needed to identify factors contributing to this concentration.

Section: Discussionmentioning

confidence: 99%

Spatial Analysis of Stomach Cancer Incidence in Iran

Pakzad¹,

Khani²,

Pakzad³

et al. 2016

“…Crude mortality rates are estimated at 15.5 and 8.4 per 10 5 in males and females (Mousavi et al, 2009). However Iran accounts as a medium-risk region for GC, but some north and northwest regions (like Guilan and Ardabil Provinces) constitute hot points for GC, even in some northern regions (Babol) the GC mortality rate for women (26.9/10 5 ) is higher than Japanese women (20.9/10 5 ) which is the most endemic country for GC (Ghadimi et al, 2007). Approximately all of recent reviews regarding GC in Iran have had consensus that surveillance programs for early detection of GC in highly selected groups may improve the overall prognosis of patients (Mousavi et al, 2009;Malekzadeh et al, 2009).…”

Section: Discussionmentioning

confidence: 99%

“…More than 89% of adults > 40 years in Ardabil were reported to be positive for H. Pylori infection (Malekzadeh et al, 2004;Sotoudeh et al, 2008). In Babol, positive rates of H. Pylori infection based on URT were 78% and 82% for men and women, respectively (Ghadimi et al, 2007). In our endoscopic screening survey, all participants underwent biopsies for RUT and also five defined biopsies which are currently under histopathologic evaluations and will be reported in the recent future.…”

mentioning

confidence: 99%

Endoscopic Findings in a Mass Screening Program for Gastric Cancer in a High Risk Region - Guilan Province of Iran

Ghanaei

Sokhanvar²,

Joukar³

et al. 2012

Background & Objectives: Gastric cancer is a leading cause of cancer-related deaths in both sexes in Iran. This study was designed to assess upper GI endoscopic findings among people > 50 years targeted in a mass screening program in a hot-point region. Methods: Based on the pilot results in Guilan Cancer Registry study (GCRS), one of the high point regions for GC -Lashtenesha-was selected. The target population was called mainly using two methods: in rural regions, by house-house direct referral and in urban areas using public media. Upper GI endoscopy was performed by trained endoscopists. All participants underwent biopsies for rapid urea test (RUT) from the antrum and also further biopsies from five defined points of stomach for detection of precancerous lesions. In cases of visible gross lesions, more diagnostic biopsies were taken and submitted for histopathologic evaluation. Results: Of 1,394 initial participants, finally 1,382 persons (702 women, 680 men) with a mean age of 61.7±9.0 years (range: 50-87 years) underwent upper GI endoscopy. H. pylori infection based on the RUT was positive in 66.6%. Gastric adenocarcinoma and squamous cell carcinoma of esophagus were detected in seven (0.5%) and one (0.07%) persons, respectively. A remarkable proportion of studied participants were found to have esophageal hiatal hernia (38.4%). Asymptomatic gastric masses found in 1.1% (15) of cases which were mostly located in antrum (33.3%), cardia (20.0%) and prepyloric area (20.0%). Gastric and duodenal ulcers were found in 5.9% (82) and 6.9% (96) of the screened population. Conclusion: Upper endoscopy screening is an effective technique for early detection of GC especially in high risk populations. Further studies are required to evaluate cost effectiveness, cost benefit and mortality and morbidity of this method among high and moderate risk population before recommending this method for the GC surveillance program at the national level.

“…Mousavi et al (2009) by studying reports of incidence and mortality from 2003 to 2008, demonstrated that gastric cancer is the most prevalent cancer in men and they anticipated a sharp increase in incidence rate in future, considering the registry system evolution and change in lifestyle toward a western culture (Mousavi et al, 2009). Similar to most other cancers, the incidence in men is by far higher than in women (Eskandar et al, 2006;Ghadimi et al, 2007). and due to late diagnosis, it is mostly diagnosed in the advanced stages of the disease (Eskandar et al, 2006).…”

Section: Introductionmentioning

confidence: 99%

Trend Analysis of Gastric Cancer Incidence in Iran and Its Six Geographical Areas During 2000-2005

Haidari

Nikbakht²,

Pasdar³

2012

Objective: gastric cancer is the fourth most common cancer worldwide . While it is one of the most common cancers in Iran, there are only limited data regarding incidence trends in the country. This study is the first of its type to investigate trends across six geographical areas during 2000-2005 using cancer registry data. Materials and methods: The registered data for gastric cancer cases in National Cancer Registry System were extracted from the Ministry of Health and Medical Education, Center for Disease Control & Management, code C16. First, according to WHO population, the sex-standardized incidence rate in both sexes and then the trends of incidence rate during 2000-2005 were investigated separately for different geographical areas of the country. Results: the incidence rates of gastric cancer in Iran and its six geographical areas during 2000-2005 were increasing albeit with differences in their slopes. The overall incidence rate increased from 2.8 in 2000 to 9.1 per 100,000 persons per year in 2005, rising from 4.1 to 13.2 in men. The average six-year incidence of gastric cancer in the central and northwestern border of Caspian Sea was 7.8 per 100,000 persons per year, while it was 0.9 per 100,000 persons per year in the border of the Persian Gulf. Generally the incidence rate in men was higher than in women. Conclusion: Iran is one of the high-risk areas for gastric cancer. Increase in incidence might continue in the future partly because of improvement in cancer registry systems as well as increase in risk of this cancer.