Hamideh Salimzadeh
1, Farnaz Delavari
2, Catherine Sauvaget
3, Negar Rezaee
2,4, Alireza Delavari
1,5, Farzad Kompani
6, Nazila Rezaei
2, Ali Sheidaei
7,2, Mitra Modirian
2, Rosa Haghshenas
2, Maryam Chegini
2,8, Kimiya Gohari
2,7, Hossein Zokaiee
2, Farshad Farzadfar
2,9*, Reza Malekzadeh
1,51 Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
2 Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
3 Screening Group, Early Detection and Prevention, International Agency for Research on Cancer, 150 cours Albert Thomas 69008 Lyon, France
4 Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
5 Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
6 Division of Hematology and Oncology, Children’s Medical Center, Pediatrics Center of Excellence, Tehran University of Medical Sciences, Tehran, Iran
7 Department of Biostatistics, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
8 Department for Health, Arak University of Medical Sciences, Arak, Iran
9 Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
*Corresponding Author: Corresponding Author: Farshad Farzadfar, MD, MPH, DSc; Non-Communicable Diseases Research Center, Endocrinology and Metabolism Clinical Sciences Institute, No. 10, Al-e-Ahmad and Chamran Highway intersection, Shariati Hospital, Tehran 1411713136, Iran. Tel: +98-21-88631293, Fax: +98-21-82415400, Email:
farzadfar3@yahoo.com
Abstract
Background: 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.
Methods: 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.
Results: 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.
Conclusion: 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.