Trend and projection of mortality rate due to non-communicable diseases in Iran: A modeling study

Abstract

Background Following the epidemiologic and demographic transition, non-communicable disease mortality is the leading cause of death in Iran. Projecting mortality trend can provide valuable tools for policy makers and planners. In this article, we have estimated the trend of non-communicable disease mortality during 2001–2015 and have projected it until 2030 at national and subnational levels in Iran. Methods The data employed was gathered from the Iranian death registration system and using the Spatio-temporal model, the trends of 4 major categories of non-communicable diseases (cancers, cardiovascular diseases, asthma and COPD, and diabetes) by 2030 were projected at the national and subnational levels. Results The results indicated that age standardized mortality rate for cancers, CVDs, and Asthma and COPD will continue to decrease in both sexes (cancers: from 81.8 in 2015 to 45.2 in 2030, CVDs: 307.3 to 173.0, and Asthma and COPD: from 52.1 to 46.6); however, in terms of diabetes, there is a steady trend in both sexes at national level (from 16.6 to 16.5). Age standardized mortality rates for cancers and CVDs, in males and females, were high in all provinces in 2001. The variation between the provinces is clearer in 2015, and it is expected to significantly decrease in all provinces by 2030. Conclusion Generally, the age standardized mortality rate from NCDs will decrease by 2030. Of course, given the experience of the past two decades in Iran, believing that the mortality rate will decrease may not be an easy notion to understand. However hard to believe, this decrease may be the result of better management of risk factors and early detection of patients due to more comprehensive care in all segments of society, as well as improved literacy and awareness across the country.

Premature mortality of gastrointestinal cancer in Iran: trends and projections 2001–2030

“…Also, obesity and diabetes have big impacts on fatty liver and ultimately liver cancer [ 28 , 29 ]. In a study by the same researchers who carried out the present study, it was shown that obesity and diabetes in Iran are on the rise and this trend will continue in the future which can be one of the factors contributing to the increased number of in liver cancer among Iranian population [ 30 ]. Another reason is the lack of vaccination among the age group of 30–70 year olds.…”

“…Gallbladder cancer is associated with obesity [ 31 ]. Given the increased obesity prevalence in both sexes [ 30 ], it can be considered as one of the factors in the increasing trend of gallbladder cancer mortality, especially among females. Since the prevalence of obesity in females is higher than in males, there may be another unknown risk factor in the incidence and mortality of this cancer that should be investigated in further studies.…”

Iran, sanctions, and the COVID-19 crisis

“…Hence, the country has a drug shortage for some of these medicines and those for chronic non-communicable diseases (NCDs) and older individuals. Iran has high rates of chronic non-communicable diseases such as cancer, diabetes, hypertension, etc 17,18 , which has a high financial burden. Even before the COVID-19 outbreak, Iran has difficulties for providing medications for these patients 19 .…”

“…Is should be noted that the Iran's population is aging (Figure 2 and supplementary figure 1) 49 . Also, the burden of chronic and NCDs are increasing in Iran 17,18 . Due to the high economic burden of medications and healthcare services in older individuals and NCDs…”

A multi-sectoral approach to combatting non-communicable diseases: Iran’s experience

“…High burden of NCDs and annual loss of thousands people due to non-communicable diseases as high political commitment to tackle NCDs in Iran [9]. Accordingly, Iran has established National Non-Communicable Diseases Committee (INCDC) through multi-sectoral mechanism and partnership of all sectors in the Ministry of Health and Medical Education and other related sectors and ministries, organizations, NGOs, and communities [10].…”