The spatial distribution of esophageal and gastric cancer in Caspian region of Iran: An ecological analysis of diet and socio-economic influences
The spatial distribution of esophageal and gastric cancer in Caspian region of Iran: An ecological analysis of diet and socio-economic influences
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DOI：
10.1186/1476-072x-10-13
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发表时间：
2011-02-15
影响因子：
4.9
通讯作者：
Burton, Robert C.
中科院分区：
文献类型：
--
作者：
Mohebbi, Mohammadreza;Wolfe, Rory;Burton, Robert C.
最近的研究表明，伊朗里海地区食管癌（EC）和胃癌（GC）发病率具有系统的地理格局。本研究的目的是调查这些癌症与该地区的饮食和社会经济风险因素之间的关系，并在调整风险因素和从地区特定年龄标准化发病率（SIRs）中去除随机和地理差异后绘制EC和GC。我们从2001年至2005年的Babol癌症登记处获得了癌症数据，从伊朗统计中心获得了社会经济指数，并在研究区域进行的病例对照研究中获得了对照组的饮食模式。拟合回归模型以确定显著的协变量，并确定了升高的群集。我们发现了EC和GC在男性和女性以及两性合并中系统聚类的证据。城市地区的EC和GC SIRs较低，高收入地区的SIRs也较低。在食物选择不受限制的人群比例较高的地区，EC SIRs较低，而在食物选择受限制的人群比例较高的地区，SIRs较高。EC和GC与综合危险因素相关，包括收入、城市化和饮食模式。这些变量代表了改善的生活方式的影响，这与近几十年来上消化道癌症发病率的下降相吻合，但在整个地区并不一定是一致的。
Recent studies have suggested a systematic geographic pattern of esophageal cancer (EC) and gastric cancer (GC) incidence in the Caspian region of Iran. The aims of this study were to investigate the association between these cancers and the region's dietary and socioeconomic risk factors and to map EC and GC after adjustment for the risk factors and the removal of random and geographic variations from area specific age standardised incidence ratios (SIRs).We obtained cancer data from the Babol cancer registry from 2001 to 2005, socioeconomic indices from the Statistical Centre of Iran, and dietary patterns from the control group in a case control study conducted in the study region. Regression models were fitted to identify significant covariates, and clusters of elevated rates were identified.We found evidence of systematic clustering for EC and GC in men and women and both sexes combined. EC and GC SIRs were lower in urban areas, and were also lower in areas of high income. EC SIRs were lower in areas with higher proportions of people having unrestricted food choice and higher in areas with higher proportions of people with restricted food choice.EC and GC were associated with aggregated risk factors, including income, urbanisation, and dietary patterns.These variables represent the influence of improved lifestyle which has coincided with a decrease in upper gastrointestinal cancer frequency over recent decades but which has not necessarily been uniform throughout the region.