Volume 22, Issue 2 (7-2026)
J Health Syst Res 2026, 22(2): 364-371 |
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Research code: IR.MUI.RESEARCH.REC.1401.265
Ethics code: 3401479
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Moghimi M, Ravankhah Z, Teimouri F, Maracy M. Relative Survival of Patients with Gastric Cancer in Isfahan City, Iran, from 2014 to 2021: A Retrospective Cohort Study. J Health Syst Res 2026; 22 (2) :364-371
URL: http://hsr.mui.ac.ir/article-1-1972-en.html
URL: http://hsr.mui.ac.ir/article-1-1972-en.html
1- Department of Statistics and Epidemiology, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
2- Cancer Registration Unit, Isfahan Provincial Health Office, Isfahan University of Medical Sciences, Isfahan, Iran
3- Professor, Department of Statistics and Epidemiology, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
2- Cancer Registration Unit, Isfahan Provincial Health Office, Isfahan University of Medical Sciences, Isfahan, Iran
3- Professor, Department of Statistics and Epidemiology, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
Abstract: (28 Views)
Background: Relative survival, as an estimate of net survival, is a more suitable measure compared to observed survival and cause-specific survival for analyzing the survival of cancer patients based on population-based cancer registry data.
Methods: To calculate relative survival in this study, information on 1773 patients with gastric cancer who were registered in the National Cancer Registry Program from the study years 2014-2021 was received from the Ministry of Health. Annual death data in Finland was used as a standard population to estimate expected survival. In this study, the second Eder method was used to calculate relative survival, and the data were assessed and analyzed using R software. Joint point regression was also used to determine the trend of survival changes.
Findings: Based on the results, the observed survival in all patients with gastric cancer decreased with increasing years of follow-up and age. In patients with gastric cancer, relative survival in three age groups (14-44, 45-59, and 60-74) decreased with increasing years of follow-up. In the age group over 75, relative survival decreased through the third year of follow-up, then increased slightly. Based on the results of trend analysis with the Join point regression model, a change point (join point) was identified for all age groups in 2016. In the period 2014 to 2016 (first period), the slope of annual changes in relative survival had a decreasing trend, and the largest decrease was observed in the age group 14 to 44 (with an average annual change of -17.81%). In contrast, in the second period (2016 to 2019), annual changes in the same age group were very small and equal to 0.26 percent, which indicates relative stability in the survival trend in recent years.
Conclusion: Given the slight increase in relative survival in the over-75 age group, it may be due to competing risks and under-reporting of cancer in this group compared to younger age groups. There are always caveats about the accuracy of death certificate reporting, and with our mobile population, some patient deaths may be unrecorded. However, low survival in young and middle-aged age groups remains a concern. It highlights the need to implement targeted screening programs, public education about early symptoms of gastric cancer, and strengthen the cancer care chain.
Methods: To calculate relative survival in this study, information on 1773 patients with gastric cancer who were registered in the National Cancer Registry Program from the study years 2014-2021 was received from the Ministry of Health. Annual death data in Finland was used as a standard population to estimate expected survival. In this study, the second Eder method was used to calculate relative survival, and the data were assessed and analyzed using R software. Joint point regression was also used to determine the trend of survival changes.
Findings: Based on the results, the observed survival in all patients with gastric cancer decreased with increasing years of follow-up and age. In patients with gastric cancer, relative survival in three age groups (14-44, 45-59, and 60-74) decreased with increasing years of follow-up. In the age group over 75, relative survival decreased through the third year of follow-up, then increased slightly. Based on the results of trend analysis with the Join point regression model, a change point (join point) was identified for all age groups in 2016. In the period 2014 to 2016 (first period), the slope of annual changes in relative survival had a decreasing trend, and the largest decrease was observed in the age group 14 to 44 (with an average annual change of -17.81%). In contrast, in the second period (2016 to 2019), annual changes in the same age group were very small and equal to 0.26 percent, which indicates relative stability in the survival trend in recent years.
Conclusion: Given the slight increase in relative survival in the over-75 age group, it may be due to competing risks and under-reporting of cancer in this group compared to younger age groups. There are always caveats about the accuracy of death certificate reporting, and with our mobile population, some patient deaths may be unrecorded. However, low survival in young and middle-aged age groups remains a concern. It highlights the need to implement targeted screening programs, public education about early symptoms of gastric cancer, and strengthen the cancer care chain.
Type of Study: Research |
Subject:
Biostatistics and Epidemiology
Received: 2025/01/7 | Accepted: 2025/11/11 | Published: 2026/07/6
Received: 2025/01/7 | Accepted: 2025/11/11 | Published: 2026/07/6
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