Soleimani Mohsen, Chiti Hossein
Medical Informatics, Metabolic Diseases Research Center, Health and Metabolic Diseases Research Institute, Zanjan University of Medical Sciences, Zanjan, Iran.
Endocrinology and Metabolism, Metabolic Diseases Research Center, Health and Metabolic Diseases Research Institute, Zanjan University of Medical Sciences, Zanjan, Iran.
Sci Rep. 2025 Jul 16;15(1):25845. doi: 10.1038/s41598-025-11655-x.
Global thyroid cancer (TC) incidence has risen sharply, yet subnational spatial and temporal patterns, particularly in middle-income contexts like Iran, remain understudied. This study investigates TC's spatial heterogeneity and temporal trends across Iran (2014-2017) to delineate high-risk clusters and guide targeted interventions. Data from the Iranian National Cancer Registry (18,336 cases) were analyzed, with age-standardized rates (ASRs) computed via direct standardization and annual percent changes (APCs) estimated using Poisson regression. Global and Local Moran's I statistics evaluated spatial autocorrelation and clustering by sex, and province. The four-year ASR in Iran was 11.1 per 100,000 (95% CI: 0-28.2), with females at 35.1 (95% CI: 27.4-42.7) versus males at 9.64 (95% CI: 5.9-13.4), reflecting a 3.6-fold sex disparity. Annual ASRs increased from 2.1 to 3.6 per 100,000 (APC: 19.6%), with females (17.6%) exceeding males (11.2%). Grade 9 tumors prevailed (88.2%), most prevalent in females (69.9%) and Yazd (14.5%), rising from 16.8% in 2014 to 28.1% in 2017. Spatial analysis identified high-high clusters in central provinces (e.g., Yazd: 36.6, Esfahan: 17.5 per 100,000) versus low-low clusters in the northeast (e.g., Semnan: 4.8). Peak incidence occurred at 50-54 years (females) and 70-74 years (males). Thyroid Cancer in Iran displays marked sex, geographic, and temporal disparities, propelled by diagnostic enhancements and environmental influences. Standardized registries and selective screening in high-risk zones (e.g., Yazd, Esfahan) are imperative to address this growing burden, aligning with precision public health strategies.
全球甲状腺癌（TC）发病率急剧上升，但国家以下层面的时空模式，尤其是在伊朗这样的中等收入环境中，仍未得到充分研究。本研究调查了2014 - 2017年伊朗全国甲状腺癌的空间异质性和时间趋势，以确定高风险集群并指导针对性干预措施。分析了来自伊朗国家癌症登记处的数据（18336例病例），通过直接标准化计算年龄标准化率（ASR），并使用泊松回归估计年度百分比变化（APC）。全局和局部莫兰指数统计评估了按性别和省份划分的空间自相关性和聚类情况。伊朗四年的ASR为每10万人口11.1例（95%置信区间：0 - 28.2），女性为35.1例（95%置信区间：27.4 - 42.7），男性为9.64例（95%置信区间：5.9 - 13.4），反映出3.6倍的性别差异。年度ASR从每10万人口2.1例增加到3.6例（APC：19.6%），女性（17.6%）增速超过男性（11.2%）。9级肿瘤最为常见（88.2%），在女性（69.9%）和亚兹德省（14.5%）最为普遍，从2014年的16.8%上升至2017年的28.1%。空间分析确定中部省份存在高 - 高集群（例如，亚兹德：每10万人口36.6例，伊斯法罕：每10万人口17.5例），而东北部存在低 - 低集群（例如，塞姆南：每10万人口4.8例）。发病高峰出现在50 - 54岁（女性）和70 - 74岁（男性）。伊朗的甲状腺癌在性别、地理和时间上存在显著差异，这是由诊断技术进步和环境影响推动的。标准化登记和在高风险地区（如亚兹德、伊斯法罕）进行选择性筛查对于应对这一日益加重的负担至关重要，这与精准公共卫生策略相一致。
