Abstract
Cancer is a problem of both global and local concern. We
determined the geo-epidemiological and spatial distribution of the
10 most common cancers in Iran. We used the data of the Iranian
Cancer Registry for the year 2014 analysing the prevalence of
112,131 registered cancer cases with the aim of detecting potential
geographical underlying causes. The geographic distribution of
cancers is reported as standardized incidence rates at the provin-
cial level considering risk with respect to sex and age. A geograph-
ical information systems (GIS) approach based on Anselin Local
Moran’s index method was used to map clusters and spatial auto-
correlation patterns. The mean age of the patients was 55.6
(±17.8) and 61.7 (±18.2) for females and males, respectively, in
the database which showed 46.1% (n=51,665) of all cases to be
female. Analysis of the spatial distribution of cancers showed sig-
nificant differences among the different provinces. Stomach and
breast cancers were the most prevalent cancers in men and
females, respectively. The highest incidence rates of stomach can-
cer were found in Ardabil and Zanjan provinces, with 48.38 and
48.08 per 100,000 population, respectively, while Tehran and
Yazd provinces had the highest incidences of breast cancer, 51.0
and 47.5 per 100,000 population, respectively. Strong clustering
patterns for stomach and breast cancers were identified in the
north-western provinces and in Semnan Province, respectively.
These patterns indicate a diversity of geo-epidemiological con-
tributing factors to cancer incidence in Iran.
Introduction
Cancer is a universal public health burden lacking a common
pre-emptive approach. The global burden of disease study in 2017
(GBD 2017) reported 24.5 million incident cancer cases world-
wide (Global Burden of Disease Cancer Collaboration, 2019).
Bray et al. (2018) in their study refer to GLOBOCAN, which is
another body providing estimates of cancer incidence, and report
that the incidence rates of cancer and the related deaths in Asia are
48.4% and 57.3%, respectively (The Lancet, 2018). According to
previous studies, in developed countries, the prevalence of cancers
is predicted to reach 45% by the year 2025 (Kamangar et al.,
2006). Notably, in low- and middle-income countries, population
growth and aging are the major contributors to the increase of can-
cer incidence (Global Burden of Disease Cancer Collaboration,
2019). Besides, more than 70% of all the cancer-related deaths
occur in countries whose populations have a medium to the low-
level standard of living as well as limited resources for the preven-
tion, diagnosis, and treatment of cancer (Mousavi et al., 2008).
In Iran, aging and increased related risk factors are known as
Correspondence: Marzieh Nojomi, Preventive Medicine and Public
Health Research Center, Psychosocial Health Research Institute,
Community and Family Medicine Department, School of Medicine,
Iran University of Medical Sciences, Postal code: 1449614542, Tehran,
Iran. Fax: +98.2186703350.
E-mail: mnojomi@iums.ac.ir
Key words: Cancer; epidemiology; spatial analysis; cluster analysis;
Iran.
Acknowledgements and funding: this research was supported by the
Elite Researcher Grant Committee under award number of 982858 from
the National Institute for Medical Research Development (NIMAD),
Tehran, Iran. We would like to thank the Iranian national population-
based cancer registry secretariat and Cancer Office of the Ministry of
Health of Iran for their complete collaborations.
Conflict of interests: the corresponding author reports grants from the
National Institutes for Medical Research Development (NIMAD), dur-
ing performing the study. All the other authors declare no conflict of
interests.
Received for publication: 7 June 2020.
Revision received: 12 November 2020.
Accepted for publication: 15 November 2020.
©Copyright: the Author(s), 2021
Licensee PAGEPress, Italy
Geospatial Health 2021; 16:904
doi:10.4081/gh.2021.904
This article is distributed under the terms of the Creative Commons
Attribution Noncommercial License (CC BY-NC 4.0) which permits any
noncommercial use, distribution, and reproduction in any medium, pro-
vided the original author(s) and source are credited.
Geo-epidemiological reporting and spatial clustering of the 10 most
prevalent cancers in Iran
Ebrahim Babaee,
1
Gholamreza Roshandel,
2,3
Meysam Olfatifar,
4
Arash Tehrani-Banihashemi,
1
Arezou Ashaari,
1
Marzieh Nojomi
1,5
1
Department of Community Medicine, Preventive Medicine and Public Health Research Centre, Iran
University of Medical Sciences, Tehran, Iran;
2
Golestan Research Centre of Gastroenterology and
Hepatology, Golestan University of Medical Sciences, Gorgan, Iran;
3
Iranian National Population-Based
Cancer Registry Secretariat, Cancer Office, Deputy of Health, Ministry of Health, Tehran, Iran;
4
Gastroenterology and Liver Diseases Research Centre, Research Institute for Gastroenterology and Liver
Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran;
5
Department of Sociology &
Anthropology, Nipissing University, North Bay, ON, Canada
[page 80] [Geospatial Health 2021; 16:904]
Geospatial Health 2021; volume 16:904
Non-commercial use only