Zarean Elaheh, Amini Payam, Yaseri Mehdi, Hajihosseini Morteza, Azimi Tara, Mahmoudi Mahmoud
Modeling in Health Research Center, School of Public Health, Department of Epidemiology and Biostatistics, Shahrekord University of Medical Sciences, Shahrekord, Iran. Email:
Asian Pac J Cancer Prev. 2019 Feb 26;20(2):443-449. doi: 10.31557/APJCP.2019.20.2.443.
Background: Esophageal cancer (EC) and Gastric cancer (GC) have been identified as two of the most common cancers in the northeastern regions of Iran. The increasing rates of these types of cancers requires attention. This study aims to assess the potential risk factors for these two cancers and then determine shared risk factors between them in a population of Iranian patients using parametric survival models. Methods: This retrospective cohort study was conducted using 127 patients with EC and 184 patients with GC in East Azarbaijan, Iran who were diagnosed and registered during the years 2009-2010 in Iran’s National Cancer Control Registration Program and were followed for five years. Parametric survival models were used to find the risk factors of the patients. Akaike Information Criteria was used to identify the best parametric model in this study. Interaction analysis was used to determine shared risk factors between EC and GC. Results: The mean (±standard deviation) age of diagnoses for EC and GC were 66.92(±11.95) and 66.5(±11.5) respectively. The survival time ranges of GC patients was (0.07-70.33) and the survival time ranges were from 0.10 to 69.03 months for EC patients. Multivariable Log- logistic model showed that being married (OR=2.25, 95% CI: 1.33 - 3.81) for EC patients and Esophagectomy surgery for EC (OR: 1.62, 95% CI: 1.04 – 2.55) and GC (OR: 1.60, 95% CI: 1.02 – 2.53) had significant effects on survival. Age at the time of diagnosis, job status, and Esophagectomy surgery were statistically comparable regarding their magnitude of effect on survival of two cancers (all Ps>0.05). Conclusion: Esophagectomy surgery and being married were important risk factors in EC and GC. The log-logistic model was the most appropriate statistical approach to identify significant risk factors on survival of both cancers.
食管癌（EC）和胃癌（GC）已被确定为伊朗东北部地区最常见的两种癌症。这些类型癌症的发病率不断上升，需要引起关注。本研究旨在评估这两种癌症的潜在风险因素，然后使用参数生存模型确定伊朗患者群体中它们之间的共同风险因素。方法：这项回顾性队列研究使用了伊朗东阿塞拜疆省的127例食管癌患者和184例胃癌患者，这些患者于2009年至2010年期间在伊朗国家癌症控制登记计划中被诊断和登记，并随访了五年。使用参数生存模型来寻找患者的风险因素。在本研究中，使用赤池信息准则来识别最佳参数模型。交互分析用于确定食管癌和胃癌之间的共同风险因素。结果：食管癌和胃癌的平均（±标准差）诊断年龄分别为66.92（±11.95）和66.5（±11.5）。胃癌患者的生存时间范围为（0.07 - 70.33），食管癌患者的生存时间范围为0.10至69.03个月。多变量对数逻辑模型显示，食管癌患者已婚（OR = 2.25，95% CI：1.33 - 3.81）以及食管癌（OR：1.62，95% CI：1.04 – 2.55）和胃癌（OR：1.60，95% CI：1.02 – 2.53）的食管切除术对生存有显著影响。诊断时的年龄、工作状态和食管切除术在对两种癌症生存的影响程度方面在统计学上具有可比性（所有P>0.05）。结论：食管切除术和已婚是食管癌和胃癌的重要风险因素。对数逻辑模型是识别两种癌症生存的显著风险因素的最合适统计方法。
