Ahmad Haddad Khoshkar , Tohid Jafari-Koshki, Behzad Mahaki,
Volume 11, Issue 3 (10-2015)
Abstract
Background: Breast cancer is the leading cancer among women in Iran with standardized incidence rate of 28.25. With regard to the aging, increasing cancer trends in Iranian population, the importance, and geographical variations of this cancer, it is necessary to identify regions with high breast cancer incidence. This information on geographical patterns can determine the breat cancer risk factors using advanced statistical methods.Methods: In the present ecological study, the breast cancer registry data in Iran from 2005 to 2008 was used. We assessed the effect of cigarette smoking, fruit and vegetable consumption, physical activity, overweightness, and socioeconomic status on breast cancer incidence using gamma-poisson, log-normal and Besag, York, and Mollie (BYM) models.Findings: Total number of registered new breast cancer cases was 25152. Among the fitted models, unadjusted BYM had the best performance. In this model, Isfahan, Yazd, and Tehran had the highest and Sistan-Baluchestan and Chaharmahal- Bakhtiyari had the lowest incidence rate. After confounder’s adjustment, the incidence was the highest in Khorasan-Razavi, Lorestan, and Hamadan and the lowest in Ardebil and Kohgiluyeh-Boyerahmad. More results showed that there was positive significant association between the human development index (HDI) and the breast cancer incidence.Conclusion: The BYM model as the best fitted model in this paper, can use as more applicable model in future. The incidence is generally high in central provinces of Iran. Due to significant relationsip between the human development index (HDI) and breast cancer, it is recommended to take it into account as a risk factor in advanced researches. Key Words: Disease Mapping, Breast Cancer, Human Development Index, BYM Model
Sedigheh Rastaghi, Tohid Jafari-Koshki, Behzad Mahaki, Yousef Bashiri,
Volume 11, Issue 4 (1-2016)
Abstract
Background: The age standardized incidence rates of esophageal cancer in women and men in Iran have the fifth and eighth ranks, respectively. Due to the high incidence rate of esophageal cancer and the necessity of knowledge of its geographical distribution, the incidence of this cancer was mapped at province and county levels in the present study.Methods: The study population of this empirical and ecological study included all cases of esophageal cancer from 2005 to 2008 in Iran. The Bayesian Multilevel Space-Time Model was used to measure the relative risk of esophageal cancer. The data consisted of three geographically nested levels in which the countries were nested in the provinces and provinces in time (year). Data analysis was conducted using the Integrated Nested Laplace Approximations (INLA) Bayesian approach in R software.Findings: The total number of registered esophageal cancer cases in Iran was 7160 from 2005 to 2008. Based on the results of the three-level model, with the adjustment of all risk factors, the annual variation trend was significant and cumulative.Conclusion: Considering the better fit of the three-level model with the adjustment of all risk factors (physical activity, smoking, fruit and vegetable intake, and overweight), the use of multi-level models with the adjustment of more effective risk factors is recommended in future studies. This investigation showed that Northeast, Northwest, and some areas in Central Iran had the highest risk of esophageal cancer incidence.
