Oesophageal cancer among the Turkomans of northeast Iran

Abstract

Summary A Caspian Littoral Cancer Registry survey in the early 1970s established northern Iran as one of the highest oesophageal cancer incidence regions of the world. To verify this, an oesophageal cancer survey was carried out between 1995 and 1997 in the Turkoman Plain at the southeastern corner of the Caspian Sea. Oesophageal balloon cytology screening was carried out on 4192 asymptomatic adults above age 30 years in one town and three adjoining villages with a total population of 20 392 people at risk. Oesophagoscopy was performed on 183 patients with abnormal cytological findings. The discovery of two asymptomatic small squamous cell cancers and one 'carcinoma-suspect' implied a prevalence ranging from 47.7 per 100 000 to 71.5 per 100 000. During a 1-year active surveillance, 14 patients were found with clinically advanced oesophageal squamous cell cancer, yielding age-standardized incidence rates of 144.09 per 100 000 for men and 48.82 per 100 000 for women. The very high frequency of oesophageal cancer reported for northern Iran 25 years ago stands confirmed. Differences in incidence rates, then and now, can be attributed to survey methods used and diagnostic criteria applied, but not to socioeconomic factors, which have remained relatively stable. Oesophageal balloon cytology is a practical method of mass screening for oesophageal cancer in Iran.

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Germline BRCA2 mutations and the risk of esophageal squamous cell carcinoma

“…The incidence of esophageal cancer in the Turkmen population is among the highest in the world, with an annual incidence rate of more than 100 per 100 000 (Mahboubi et al, 1973;Saidi et al, 2000). More than 90% of all esophageal cancers in Turkmen are squamous cell carcinomas (Islami et al, 2004).…”

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“…The high-incidence areas include the Henan 3 and Shanxi 4 provinces of China, the Caspian littoral of Iran, 5,6 Normandy in France 7 and some areas in South America. 8,9 Various factors are known to contribute to esophageal cancer but they are poorly understood.…”