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Esophageal and Gastric Cancer Incidence Trends in Golestan, Iran: An Age-Period-Cohort Analysis 2004 to 2018 Publisher Pubmed



Ghasemikebria F1 ; Semnani S1 ; Fazel A2 ; Etemadi A3 ; Amiriani T1 ; Naeimitabiei M2 ; Hasanpourheidari S1 ; Salamat F1 ; Jafaridelouie N1 ; Sedaghat S4 ; Sadeghzadeh H4 ; Akbari M5 ; Mehrjerdian M6 ; Weiderpass E7 Show All Authors
Authors
  1. Ghasemikebria F1
  2. Semnani S1
  3. Fazel A2
  4. Etemadi A3
  5. Amiriani T1
  6. Naeimitabiei M2
  7. Hasanpourheidari S1
  8. Salamat F1
  9. Jafaridelouie N1
  10. Sedaghat S4
  11. Sadeghzadeh H4
  12. Akbari M5
  13. Mehrjerdian M6
  14. Weiderpass E7
  15. Roshandel G1
  16. Bray F8
  17. Malekzadeh R9
Show Affiliations
Authors Affiliations
  1. 1. Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
  2. 2. Cancer Research Center, Golestan University of Medical Sciences, Gorgan, Iran
  3. 3. Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, United States
  4. 4. Deputy of Public Health, Golestan University of Medical Sciences, Gorgan, Iran
  5. 5. Deputy of Treatment, Golestan University of Medical Sciences, Gorgan, Iran
  6. 6. Department of Pathology, Golestan University of Medical Sciences, Gorgan, Iran
  7. 7. Office of the Director, International Agency for Research on Cancer (IARC), Lyon, France
  8. 8. Cancer Surveillance Branch, International Agency for Research on Cancer (IARC), World Health Organization (WHO), Lyon, France
  9. 9. Digestive Oncology Research Center, Digestive Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran

Source: International Journal of Cancer Published:2023


Abstract

Golestan province in the northeast of Iran is part of the Asian esophageal cancer belt and is known as a high-risk area for esophageal (EC) and gastric cancers (GC). Data on incident cases of EC and GC during 2004 to 2018 were obtained from the Golestan Population-based Cancer Registry (GPCR). The age-standardized incidence rates (ASRs) were calculated and presented per 100 000 person-years. The estimated annual percentage change (EAPC) with 95% confidence interval (95% CI) were calculated. We also fitted age-period-cohort (APC) models to assess nonlinear period and cohort effects as incidence rate ratios (IRRs). Overall, 3004 new cases of EC (ASR = 15.7) and 3553 cases of GC (ASR = 18.3) were registered in the GPCR. We found significant decreasing trends in incidence rates of EC (EAPC = −5.0; 95% CI: −7.8 to −2.2) and less marked nonsignificant trends for GC (EAPC = −1.4; 95% CI: −4.0 to 1.4) during 2004 to 2018. There was a strong cohort effect for EC with a consistent decrease in the IRR across successive birth cohorts, starting with the oldest birth cohort (1924; IRR = 1.9 vs the reference birth cohort of 1947) through to the most recent cohort born in 1988 (IRR = 0.1). The marked declines in EC incidence rates in Golestan relate to generational changes in its underlying risk factors. Despite favorable trends, this population remains at high risk of both EC and GC. Further studies are warranted to measure the impact of the major risk factors on incidence with a view to designing effective preventative programs. © 2023 UICC.
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