Tehran University of Medical Sciences

Science Communicator Platform

Stay connected! Follow us on X network (Twitter):
Share this content! On (X network) By
Pre-Diagnostic Risk Factors for Brain Cancer Incidence and Survival: Insights From the Golestan Cohort Study Publisher Pubmed



Rezanejadasl P1 ; Parhizkar Roudsari P2 ; Rezaei N2 ; Sharafkhah M2 ; Roshandel G3 ; Poustchi H4 ; Sepanlou S2 ; Malekzadeh R2, 4
Authors
Show Affiliations
Authors Affiliations
  1. 1. Non-Communicable Diseases Research Center, Department of Biostatistics and Epidemiology, School of Public Health, Alborz University of Medical Sciences, Karaj, Iran
  2. 2. Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Shariati Hospital, North Kargar Ave, Tehran, Iran
  3. 3. Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
  4. 4. Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran

Source: BMC Cancer Published:2025


Abstract

Background: Brain cancer is an important public health concern in terms of its burden and the cost of its treatment. Evidence on determinants of brain cancer incidence and survival are sparse and inconsistent. We aimed to explore the pre-diagnostic factors for brain cancer incidence and survival in northeastern Iran. Methods: Data for the current study were derived from the Golestan Cohort Study, the largest cohort study in the Middle East on over 50,000 participants aged 40 to 75 years with a median follow-up of 15 years. Minimally adjusted and multiple Cox proportional hazards models were used to investigate the association of demographic and behavioral risk factors with brain cancer incidence and survival. Results: Out of the 49,783 cancer free participants recruited at baseline, 77 patients were diagnosed with brain cancer and 62 patients were deceased till the end of the follow-up. Annual cancer mortality rate was 0.31 (95% Confidence Interval: 0.24 – 0.39), one-year survival was 38%, and the median survival was 0.72 years. In the multiple model, Turkmen ethnicity (Hazard Ratio = 0.42 (0.23–0.76)), urban residence (HR = 0.46 (0.25–0.84)), overweight or obesity (HR = 0.48 (0.25–0.93)), and history of animal contact (HR = 0.43 (0.19–0.96)) were associated with a better survival. Patients diagnosed with brain cancer had higher prevalence of hypertension, opium use, and smoking compared to cancer free participants. Conclusions: Our results indicate a complex interplay of demographic and life style risk factors influencing both the incidence and prognosis of brain cancer. Further research is mandated to inform policy makers of potentially effective preventive initiatives to reduce the burden of this cancer. © The Author(s) 2025.
Related Docs
View other Related Docs
1. Survival Assessment and Pre-Diagnostic Risk Factors for Lung Cancer Incidence: Insights From the Golestan Cohort Study, PLoS ONE (2025)
2. Pars Cohort Study of Non-Communicable Diseases in Iran: Protocol and Preliminary Results, International Journal of Public Health (2017)
3. Association Between Prediagnostic Risk Factors and Survival After Colorectal Cancer Diagnosis in Golesten Cohort Study, Scientific Reports (2025)
4. Dental Health and Lung Cancer Risk in the Golestan Cohort Study, BMC Cancer (2024)
5. The Iranian Study of Opium and Cancer (Iropican): Rationale, Design, and Initial Findings, Archives of Iranian Medicine (2021)
6. Long-Term Opiate Use and Risk of Cardiovascular Mortality: Results From the Golestan Cohort Study, European Journal of Preventive Cardiology (2021)
7. Cardiovascular Disease Mortality and Years of Life Lost Attributable to Non-Optimal Systolic Blood Pressure and Hypertension in Northeastern Iran, Archives of Iranian Medicine (2015)
8. Individual and Combined Effects of Environmental Risk Factors for Esophageal Cancer Based on Results From the Golestan Cohort Study, Gastroenterology (2019)
Experts (# of related papers)
View all Related Experts
Hossein Poustchi (81)
Reza Malekzadeh (75)
Other Related Docs
9. Joint Effect of Diabetes and Opiate Use on All-Cause and Cause-Specific Mortality: The Golestan Cohort Study, International Journal of Epidemiology (2021)
10. Major Dietary Protein Sources in Relation to Pancreatic Cancer: A Large Prospective Study, Archives of Iranian Medicine (2016)
11. Hypertension and Mortality in the Golestan Cohort Study: A Prospective Study of 50 000 Adults in Iran, Journal of Human Hypertension (2016)
12. Oral Health and Risk of Upper Gastrointestinal Cancers in a Large Prospective Study From a High-Risk Region: Golestan Cohort Study, Cancer Prevention Research (2021)
13. Incident Cancers Attributable to Using Opium and Smoking Cigarettes in the Golestan Cohort Study, eClinicalMedicine (2023)
14. The Application of Six Dietary Scores to a Middle Eastern Population: A Comparative Analysis of Mortality in a Prospective Study, European Journal of Epidemiology (2019)
15. Opium Use and Risk of Pancreatic Cancer: A Prospective Cohort Study, Cancer Epidemiology Biomarkers and Prevention (2018)
16. The Carcinogenicity of Opium Consumption: A Systematic Review and Meta-Analysis, European Journal of Epidemiology (2023)
17. Dietary Protein Sources and All-Cause and Cause-Specific Mortality: The Golestan Cohort Study in Iran, American Journal of Preventive Medicine (2017)
18. Exposure to Polycyclic Aromatic Hydrocarbons, Volatile Organic Compounds, and Tobacco-Specific Nitrosamines and Incidence of Esophageal Cancer, Journal of the National Cancer Institute (2024)
19. All-Cause and Cause-Specific Mortality in Middle-Aged Individualswithpositivehbsag:Findingsfromaprospective Cohort Study, Archives of Iranian Medicine (2022)
20. Mortality From Respiratory Diseases Associated With Opium Use: A Population-Based Cohort Study, Thorax (2017)
21. Household Fuel Use and the Risk of Gastrointestinal Cancers: The Golestan Cohort Study, Environmental Health Perspectives (2020)
22. Comparing Anthropometric Indicators of Visceral and General Adiposity As Determinants of Overall and Cardiovascular Mortality, Archives of Iranian Medicine (2019)
23. Mortality and Cancer in Relation to Abo Blood Group Phenotypes in the Golestan Cohort Study, BMC Medicine (2015)
24. Incidence, Early Case Fatality and Determinants of Stroke in Iran: Golestan Cohort Study, Journal of Stroke and Cerebrovascular Diseases (2022)
25. Fifty Years of Research and One Conclusion: Opium Causes Cancer, Archives of Iranian Medicine (2020)
26. The Contribution of Metabolic Risk Factors to Cardiovascular Mortality in Golestan Cohort Study: Population Attributable Fraction Estimation, International Journal of Cardiology: Cardiovascular Risk and Prevention (2024)
27. Adherence to the Dietary Approaches to Stop Hypertension (Dash) Diet and Risk of Total and Cause-Specific Mortality: Results From the Golestan Cohort Study, International Journal of Epidemiology (2019)
28. Population Attributable Fraction of Dietary Risk Factors for Cancer Mortality With a Focus on Gastrointestinal Cancers in a Population Based Cohort Study, Scientific Reports (2025)
29. Red Meat Consumption and Risk of Nonalcoholic Fatty Liver Disease in a Population With Low Meat Consumption: The Golestan Cohort Study, American Journal of Gastroenterology (2021)
30. Volatile Organic Compounds and Mortality From Ischemic Heart Disease: A Case-Cohort Study, American Journal of Preventive Cardiology (2024)
31. Household Fuel Use and Cardiovascular Disease Mortality, Circulation (2016)
32. Exposure to Volatile Organic Compounds and Chronic Respiratory Disease Mortality, a Case-Cohort Study, Respiratory Research (2025)
33. Prevalence and Determinants of Opioid Use Disorder Among Long-Term Opiate Users in Golestan Cohort Study, BMC Psychiatry (2023)
34. The Protocol of a Population-Based Prospective Cohort Study in Southwest of Iran to Analyze Common Non-Communicable Diseases: Shahrekord Cohort Study, BMC Public Health (2018)
35. Opium Use and the Risk of Liver Cancer: A Case–Control Study, Cancer Prevention Research (2023)
36. Chronic Hepatitis B Infection Is Not Associated With Increased Risk of Vascular Mortality While Having an Association With Metabolic Syndrome, Journal of Medical Virology (2016)
37. Meat Consumption and Risk of Esophageal and Gastric Cancer in the Golestan Cohort Study, Iran, International Journal of Cancer (2022)
38. Hazards of Cigarettes, Smokeless Tobacco and Waterpipe in a Middle Eastern Population: A Cohort Study of 50 000 Individuals From Iran, Tobacco Control (2017)
39. Oral Health and Mortality in the Golestan Cohort Study, International Journal of Epidemiology (2017)
40. Dietary Amino Acids Intake and All-Cause and Cause-Specific Mortality: Results From the Golestan Cohort Study, Nutrition Journal (2024)
41. Causes of Premature Death and Their Associated Risk Factors in the Golestan Cohort Study, Iran, BMJ Open (2018)
42. Sex and Smoking Differences in the Association Between Gastroesophageal Reflux and Risk of Esophageal Squamous Cell Carcinoma in a High-Incidence Area: Golestan Cohort Study, International Journal of Cancer (2023)
43. Spatial Environmental Factors Predict Cardiovascular and All-Cause Mortality: Results of the Space Study, PLoS ONE (2022)
44. Association Between Incident Type 2 Diabetes and Opium Use: Mediation by Body Mass and Adiposity, American Journal of Epidemiology (2023)
45. Dietary Advanced Glycation End Products and Risk of Overall and Cause-Specific Mortality: Results From the Golestan Cohort Study, International Journal of Environmental Research and Public Health (2023)
46. Associations Between Biomarkers of Exposure and Lung Cancer Risk Among Exclusive Cigarette Smokers in the Golestan Cohort Study, International Journal of Environmental Research and Public Health (2021)
47. Dairy Food Intake and All-Cause, Cardiovascular Disease, and Cancer Mortality: The Golestan Cohort Study, American Journal of Epidemiology (2017)
48. Lead Poisoning Among Asymptomatic Individuals With a Long-Term History of Opiate Use in Golestan Cohort Study, International Journal of Drug Policy (2022)
49. Burden of Disease Scenarios for 204 Countries and Territories, 2022–2050: A Forecasting Analysis for the Global Burden of Disease Study 2021, The Lancet (2024)
50. National and Subnational Burden of Brain and Central Nervous System Cancers in Iran, 1990–2019: Results From the Global Burden of Disease Study 2019, Cancer Medicine (2023)