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Regional Disparities in Cancer Survival in Iran: Insight From a National Surveillance of Cancer Survival in Iran (Irancansurv) Publisher Pubmed



Nemati S1 ; Saeedi E1, 2 ; Lotfi F1 ; Nahvijou A1 ; Pirnejad H3 ; Cheraghi M4 ; Rezaeianzadeh A5 ; Dolatkhah R6 ; Bazarafshan A7 ; Golpazir A8 ; Yaghoobiashrafi M9 ; Abdi S1 ; Alvand S10 ; Ravankhah Z11 Show All Authors
Authors
  1. Nemati S1
  2. Saeedi E1, 2
  3. Lotfi F1
  4. Nahvijou A1
  5. Pirnejad H3
  6. Cheraghi M4
  7. Rezaeianzadeh A5
  8. Dolatkhah R6
  9. Bazarafshan A7
  10. Golpazir A8
  11. Yaghoobiashrafi M9
  12. Abdi S1
  13. Alvand S10
  14. Ravankhah Z11
  15. Mohebbi E1, 12
  16. Khosravi A13
  17. Etemadi A14
  18. Sheikh M15
  19. Roshandel G16
  20. Ghanbarimotlagh A17
  21. Partovipour E18
  22. Najafi F19
  23. Malekzadeh R20
  24. Mohagheghi MA1
  25. Zendehdel K1
Show Affiliations
Authors Affiliations
  1. 1. Cancer Research Center, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
  2. 2. Biostatistics Research Group, Department of Health Science, University of Leicester, Leicester, United Kingdom
  3. 3. Patient Safety Research Center, Clinical Research Institute, Urmia University of Medical Sciences, Urmia, Iran
  4. 4. Cancer Research Center, Cancer Registry Section, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
  5. 5. Shiraz Cancer Registry, Shiraz University of Medical Sciences, Shiraz, Iran
  6. 6. Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
  7. 7. HIV/STI Surveillance Research Center, and WHO collaborating Center for HIV, Institute for Futures studies in Health, Kerman Cancer Registry, Kerman University of Medical Sciences, Kerman, Iran
  8. 8. Kermanshah Cancer Registry, Kermanshah University of Medical Sciences, Kermanshah, Iran
  9. 9. Mazandaran Cancer Registry, Mazandaran University of Medical Sciences, Sari, Iran
  10. 10. Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Shariati Hospital, Tehran University of Medical Sciences, N. Kargar St, Tehran, Iran
  11. 11. Esfahan Cancer Registry, Esfahan University of Medical Sciences, Esfahan, Iran
  12. 12. Pathology and Stem Cell Research Center, Afzalipour School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
  13. 13. Deputy of Health, Ministry of Health and Medical Education, Tehran, Iran
  14. 14. Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, United States
  15. 15. International Agency for Research on Cancer (IARC/WHO), Genomic Epidemiology Branch, Lyon, France
  16. 16. Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
  17. 17. Department of Radiation Oncology, Imam Hossein Hospital, Shaheed Beheshti Medical University, Tehran, Iran
  18. 18. Iranian National Population-Based Cancer Registry Secretariat, Cancer Office, Deputy of Health, Ministry of Health, Tehran, Iran
  19. 19. Department of Epidemiology and Biostatistics, Kermanshah University of Medical Sciences, Kermanshah, Iran
  20. 20. Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran

Source: Cancer Epidemiology Published:2023


Abstract

Background and objectives: We aimed to investigate geographical disparity in cancer survival in 9 provincial population-based cancer registries in Iran from 2015 to 2016. Material and method: In the current study, data from 90,862 adult patients (aged >15 years) diagnosed with cancer were retrieved from 9 population-based cancer registries across Iran. Five-year survival rates were estimated by applying relative survival approaches. We also applied the international cancer survival standard weights for age standardization. Finally, we calculated the excess hazard ratio (EHR) for each province adjusted for age, sex, and cancer sites to estimate the excess hazard ratio of mortality compared to the capital province (Tehran). Results: The largest gap in survival was observed in more curable cancer types, including melanoma (41.4%), ovary (32.3%), cervix (35.0%), prostate (26.7%), and rectum (21.4%), while the observed geographical disparity in lethal cancers such as lung, brain, stomach, and pancreas was less than 15%. Compared to Tehran, we found the highest excess hazard of death in Western Azerbaijan (EHR=1.60, 95% CI 1.51, 1.65), Kermanshah (EHR=1.52, 95% CI=1.44, 1.61), and Kerman (EHR=1.46, 95% CI=1.38, 1.53). The hazard ratio of death was almost identical in Isfahan (EHR=1.04, 95% CI=1.03, 1.06) and Tehran provinces. Conclusion: Provinces with higher HDI had better survival rates. IRANCANSURV study showed regional disparities in cancer survival in Iran. Cancer patients in provinces with a higher Human Development Index (HDI) had a higher survival rate and lived longer compared to the patients in provinces with medium and low HDI regions. © 2023 Elsevier Ltd
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