Abstract
Introduction: Gastric cancer (GC) remains a major cause of cancer mortality worldwide, with particularly high incidence and poor survival in northeastern Iran. This study aimed to estimate the 1-, 3-, and 5-year survival rates of GC patients diagnosed in the Golestan Province in 2015–2016 and to identify demographic and clinical factors associated with survival.
Methods: In this cohort study, newly diagnosed GC cases were retrieved from the Golestan Population-based Cancer Registry. Vital status was determined through registry records and telephone follow-ups. Survival rates were calculated using life table and Kaplan–Meier methods, with group comparisons made using the log-rank test. Cox proportional hazards regression assessed the association between potential risk factors and mortality.
Results: Among 476 reviewed cases, 298 were included in the survival analysis. The mean age at diagnosis was 64.6±13.7 years, and 67.9% of patients were male. At follow-up, 87.6% had died. The 1-, 3-, and 5-year survival rates were 59%, 21%, and 13%, respectively. Older age (P<0.001), metastatic disease (P<0.001), rural residence (P=0.001), and lack of surgical treatment (P<0.001) were significantly associated with poorer survival. Gender, smoking status, tumor location, and chemotherapy/radiotherapy showed no significant association.
Conclusion: GC survival in the Golestan Province remains low. Age at diagnosis, metastasis, residence, and surgical treatment were key prognostic factors. Enhancing early detection, increasing access to cancer care, and implementing structured screening programs may improve outcomes in this high-risk region.