Barati Hadis, Pourhoseingholi Mohamad Amin, Roshandel Gholamreza, Nazari Seyed Saeed Hashemi
Department of Epidemiology of School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
BMC Cancer. 2024 Dec 18;24(1):1538. doi: 10.1186/s12885-024-13289-0.
Cancer is a significant public health issue in Iran, and its incidence has been on the rise in recent years. The objective of this study is to predict the incidence of total cancer in Iran using a Bayesian age-period-cohort (APC) model.
Utilizing age-period-cohort modeling, this study assessed the multifaceted effects of age, period, and cohort on cancer incidence during the period spanning 2005 to 2017. Key metrics, including the net drift (representing the overall annual percentage change), local drift (indicating annual percentage changes within specific age groups), and longitudinal age curves (depicting expected age-specific rates over time), were computed. Moreover, the evaluation encompassed an analysis of period and cohort relative risks. To project the future age-standardized incidence rates of cancers from 2018 to 2027, Bayesian age-period-cohort analysis integrated nested Laplace approximations.
The age-standardized incidence rate and the absolute number of cancer cases in Iran showed an upward trend. The net drift was 1.79% (95% confidence interval, CI: 0.87% to 2.72%) for males and 3.31% (95% CI: 2.49% to 4.14%) for females. Local drifts remained consistently above zero for all age groups from 2005 to 2017, except for the under-5 age group in both males and females, and the 45-49 and 50-54 age groups in females. After accounting for period deviations, the risk of cancer incidence exhibited an exponential increase with age for both sexes. Based on the Bayesian age-period-cohort analysis, it is estimated that there will be around 210,701 new cancer cases in 2027. Moreover, the Age-Standardized Rate (ASR) for cancer is anticipated to reach 240.32 per 100,000 by 2027. The forecasts indicate a rise in cancer incidence rates across all age groups for both males and females.
This study underscores the urgency of implementing targeted preventive strategies aligned with demographic shifts and lifestyle factors. Emphasizing the role of robust cancer registries, it advocates for continuous monitoring to inform evidence-based interventions.
癌症是伊朗一个重大的公共卫生问题，近年来其发病率一直在上升。本研究的目的是使用贝叶斯年龄-时期-队列（APC）模型预测伊朗总体癌症的发病率。
本研究利用年龄-时期-队列模型，评估了2005年至2017年期间年龄、时期和队列对癌症发病率的多方面影响。计算了关键指标，包括净漂移（代表总体年度百分比变化）、局部漂移（表示特定年龄组内的年度百分比变化）和纵向年龄曲线（描绘随时间变化的预期年龄别发病率）。此外，评估还包括对时期和队列相对风险的分析。为了预测2018年至2027年癌症的未来年龄标准化发病率，贝叶斯年龄-时期-队列分析采用了嵌套拉普拉斯近似法。
伊朗的年龄标准化发病率和癌症病例绝对数呈上升趋势。男性的净漂移为1.79%（95%置信区间，CI：0.87%至2.72%），女性为3.31%（95%CI：2.49%至4.14%）。2005年至2017年，除男性和女性的5岁以下年龄组以及女性的45-49岁和50-54岁年龄组外，所有年龄组的局部漂移一直高于零。在考虑时期偏差后，男女癌症发病率风险均随年龄呈指数增长。根据贝叶斯年龄-时期-队列分析，预计2027年将有大约210,701例新癌症病例。此外，预计到2027年癌症的年龄标准化率（ASR）将达到每10万人240.32例。预测表明，男性和女性所有年龄组的癌症发病率都将上升。
本研究强调了实施与人口结构变化和生活方式因素相适应的针对性预防策略的紧迫性。强调了强大的癌症登记系统的作用，主张持续监测以为循证干预提供信息。
