Salimzadeh Hamideh, Delavari Farnaz, Sauvaget Catherine, Rezaee Negar, Delavari Alireza, Kompani Farzad, Rezaei Nazila, Sheidaei Ali, Modirian Mitra, Haghshenas Rosa, Chegini Maryam, Gohari Kimiya, Zokaiee Hossein, Farzadfar Farshad, Malekzadeh Reza
Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
Arch Iran Med. 2018 Feb 1;21(2):46-55.
Gastrointestinal (GI) neoplasms are among the most common cancers in Iran. This study aimed to measure annual trends in mortality rates from GI cancers in Iran between 1990 and 2015.
This study was part of an ongoing study termed the 'National and Subnational Burden of Diseases' study in Iran. Data used in this study was obtained from the Iranian Death Registration System (1995 to 2010) and from 2 major cemeteries in Tehran (1995 to 2010) and Isfahan (2007 to 2010). All-cause mortality rates were estimated using the spatio-temporal model and the Gaussian process regression model. Age-standardized mortality rates (ASMR) per 100 000 person-years was calculated using data from Iran and the standard world population for comparison.
Among GI cancers, gastric cancer represented the leading cause of mortality followed by cancers of the esophagus, liver, and colorectal cancers with the ASMR of 20.5, 5.8, 4.4, and 4.0 per 100 000 persons-years, respectively, between 1990 and 2015. While a decreasing trend occurred in mortality of esophageal, gastric, and colorectal cancers, particularly in the recent decade, we recorded an upward pattern and steady rise in mortality rates from liver, pancreatic, and gallbladder cancers during the study period. The ASMR of all studied causes were enhanced by advancing age and were found to be more prominent in adults aged 50 or older. Among all age-groups, higher death rates were detected in males versus females for all studied cancers except for gallbladder and biliary tract cancers.
Gastric cancer mortality is still high and death rates from several other GI cancers are increasing in the nation. Interventions for cancer prevention, early detection, and access to high quality cancer treatment services are needed to reduce GI cancer burden and death rates in Iran and in the region.
胃肠道肿瘤是伊朗最常见的癌症之一。本研究旨在衡量1990年至2015年伊朗胃肠道癌症死亡率的年度趋势。
本研究是伊朗一项正在进行的名为“国家和次国家疾病负担”研究的一部分。本研究中使用的数据来自伊朗死亡登记系统(1995年至2010年)以及德黑兰的2个主要墓地(1995年至2010年)和伊斯法罕(2007年至2010年)。使用时空模型和高斯过程回归模型估计全因死亡率。使用伊朗的数据和标准世界人口计算每10万人年的年龄标准化死亡率(ASMR)以供比较。
在胃肠道癌症中,胃癌是主要死因,其次是食管癌、肝癌和结直肠癌,1990年至2015年期间每10万人年的ASMR分别为20.5、5.8、4.4和4.0。虽然食管癌、胃癌和结直肠癌的死亡率呈下降趋势,特别是在最近十年,但我们记录到在研究期间肝癌、胰腺癌和胆囊癌的死亡率呈上升模式且稳步上升。所有研究病因的ASMR随着年龄增长而升高,并且在50岁及以上的成年人中更为突出。在所有年龄组中,除胆囊和胆道癌外,所有研究癌症的男性死亡率均高于女性。
胃癌死亡率仍然很高,该国其他几种胃肠道癌症的死亡率正在上升。需要采取癌症预防、早期检测以及获得高质量癌症治疗服务的干预措施,以减轻伊朗及该地区的胃肠道癌症负担和死亡率。