Academic journal article Iranian Journal of Public Health

Comparison of Age- Standard Incidence Rate Trends of Gynecologic and Breast Cancer in Iran and Other Countries

Academic journal article Iranian Journal of Public Health

Comparison of Age- Standard Incidence Rate Trends of Gynecologic and Breast Cancer in Iran and Other Countries

Article excerpt


Cancer occurrence is highly influenced by environment, genetic, gender, age, race, socioeconomic status, education, culture, obesity, and all life style related factors which might result in incidence rate change of these cancers in every population (1, 2). Main gynecologic cancers (ovary, endometrium and cervix) besides breast cancer are responsible for 1.6% of total human cancers in the world (3).

Breast, endometrium and ovary are cancers with high incidence in the developed and western countries, North Europe and North America. Lower incidence in the less developed regions including Asian countries is observed (3-5). There are suggestions regarding different survival of ovarian cancer, adjusted by available diagnostic and therapeutic modalities. More attention to confounding factors are needed, for instance undiagnosed late stage ovarian cancer cases leading to dead affect involved diagnosed cancer population into more early stage and lower age population (6). Cervical cancer incidence is among the 3 most common female cancers in 90% of the countries in the world (7).

Breast and gynecologic cancer incidence rates are the consequence of many factors. A common well known etiology for breast, ovarian and endome- trial cancer is parity, with lower incidence in mul- tiparous women (8-11). Ovarian cancer risk is less in multiparous and oral contraceptive user females. Risk factors of ovarian cancer include age, white race, nulliparity, positive family history of ovarian, endometrial and breast cancer (12-14).

Cervical cancer is more common in the regions with low socioeconomic status (15).

Study of incidence trend might clarify epidemio- logic and clinical points to be studied more and used as and documented background for decision making and necessary interventions. In the pre- sent study change of incidence rate in breast, ovar- ian, endometrial and cervical cancer in a 4-5 year period of time in different countries including Iran is compared.

Materials and Methods

Data of 2004 national cancer registry of Iran, pub- lished by the Iranian Ministry of Health regarding all reported breast, ovarian, endometrial and cervi- cal cancers were included in this comparative study (16). Iranian national cancer registry report, as pathology based registry has presented crude incidence rates.

These data are not standardized by population in 2004, so comparing it with those of the other countries is not possible. From 2008, age standard data of Iran is presented in GLOBOCAN data- base.

So, in the first step, results of breast, ovarian, en- dometrial and cervical cancer patients were stand- ardized with standard world population. All re- ported female cancers of breast, cervix, ovary, and endometrium were included in the analysis. Since other gynecologic cancers are rare their crude in- cidence rates were not included in the study. Data of each of cancers in 2004 was separately pro- ceeded to age- standard incidence rate according to the world standard population of the same year. In the second step, results of Age- standard inci- dence rates (ASR) of the 4 above mentioned can- cers in Iran, 2004 besides ASR of 6 other coun- tries including USA, Australia, Japan, India, Africa and Thailand, 2004 were compared to ASR re- ports of all above mentioned cancers in 2008, GLOBOCAN database.

The main variables are ASR of breast, ovarian, endometrial and cervical cancer cases in different countries which are presented in two time cutoff (2004 and 2008), in order to clarify the trend of disease in these time periods in different regions. Cancer registry data of Iran is pathology based which include 80% of cancer cases (16).

This 80% coverage might make results biased. Published data of the Iranian ministry of health and care is ethically available for study and private data of patients is not included.


About 24498 female cancer patients were reported in 2004 Iran, including 1923 (7. …

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