Clinical Cancer Investigation Journal

ORIGINAL ARTICLE
Year
: 2018  |  Volume : 7  |  Issue : 3  |  Page : 87--89

Epidemiology of female reproductive cancers in Mazandaran Province (Northern Iran): Results of the Mazandaran population-based cancer registry


Akbar Hedayatizadeh-Omran, Reza Alizadeh-Navaei, Majid Yaghoubi Ashrafi, Zainab Ghazizadeh, Rasieh Sadat Mousavi, Ramin Shekarriz, Mohammad Eslami Jouybari, Ehsan Zaboli, Ghasem Janbabaei, Siavash Moradi, Mohsen Aarabi, Mahmood Moosazadeh, Parisa Eslami 
 Gastrointestinal Cancer Research Center, Mazandaran University of Medical Sciences, Sari, Iran

Correspondence Address:
Dr. Reza Alizadeh-Navaei
Gastrointestinal Cancer Research Center, Mazandaran University of Medical Sciences, Sari
Iran

Abstract

Purpose: Cancer is a most important disease, and female reproductive system cancers are the most common cause of women mortality rate. Materials and Methods: This cross-sectional study analyzed medical record data for 4460 patients in Mazandaran population-based cancer registry. Results: The mean (standard deviation) age of these patients was 53.45 years, and the incidence rate of female reproductive cancers (age-standardized incidence rate) was 8.51 per 100,000 persons-year. These cancers incidences were more in urban than rural, but this difference was not significant. Differences between frequency of uterus and ovary cancers with tumor behavior are significant (P = 0.046). Conclusion: This certainly calls for further attention to preventive and treatment planning on female reproductive system cancers.



How to cite this article:
Hedayatizadeh-Omran A, Alizadeh-Navaei R, Ashrafi MY, Ghazizadeh Z, Mousavi RS, Shekarriz R, Jouybari ME, Zaboli E, Janbabaei G, Moradi S, Aarabi M, Moosazadeh M, Eslami P. Epidemiology of female reproductive cancers in Mazandaran Province (Northern Iran): Results of the Mazandaran population-based cancer registry.Clin Cancer Investig J 2018;7:87-89


How to cite this URL:
Hedayatizadeh-Omran A, Alizadeh-Navaei R, Ashrafi MY, Ghazizadeh Z, Mousavi RS, Shekarriz R, Jouybari ME, Zaboli E, Janbabaei G, Moradi S, Aarabi M, Moosazadeh M, Eslami P. Epidemiology of female reproductive cancers in Mazandaran Province (Northern Iran): Results of the Mazandaran population-based cancer registry. Clin Cancer Investig J [serial online] 2018 [cited 2019 Jul 23 ];7:87-89
Available from: http://www.ccij-online.org/text.asp?2018/7/3/87/247008


Full Text



 Introduction



Cancer is a most important disease in Iran and worldwide.[1] Nowadays, cancer is considered to be the second leading cause of death after cardiovascular disorders.[2] About one-thirds of total cancers in women are female reproductive system cancers.[3] These cancers in female include cervical cancer, cancer of the corpus uteri, ovarian, vulvar, vaginal, fallopian tube cancers, choriocarcinoma, and placental cancers.[4] Female reproductive cancers are estimated to be the third most common group of cancers in women.[3] Malignancies of the female reproductive tract are a significant source of mortality in the world.[4] Considering the different distribution of cancers in the world and the importance of cancer in any country and given the high geographical variations in the field of cancer, it is essential to identify and determine the pattern and type of cancers to do planning at national contribution for cancer control.[5] Statistical data play an important role in decision-making, prevention, and treatment of cancer patients.[6] As yet, there has been no comprehensive study of the epidemiological status of female reproductive cancers in northern Iran. Therefore, in this study, we provide a statistically analyze the data for female reproductive cancers based on the data available from a population-based cancer registry in Mazandaran province in North of Iran.

 Materials and Methods



It is a cross-sectional study and population-based survey on 4460 individuals in Mazandaran population-based cancer registry (MazPCR) office which was known as the main center of cancer registry office in Mazandaran province which was located in North of Iran. The data for this project on primary female reproductive cancers diagnosed between 2014 and 2015 (one solar year) were collected based on related checklists MazPCR office of Mazandaran University of medical sciences. Data were obtained from all hospitals, pathology laboratories, diagnostic radiology clinics, and main insurer organizations in Mazandaran Province. The data about cancer-related deaths were collected from the death registry at the health department of Mazandaran University of medical sciences. Age-standardized incidence rates (ASRs) (per 100,000 person-years) were calculated by the direct standardization method. Cancer cases were classified according to of International Classification of Diseases for Oncology the third edition. Then, the data were entered into the excel software and were analyzed with SPSS version 16 statistical software (SPSS Inc company, Chicago, USA). Descriptive statistics and Chi-square tests were used. P < 0.05 was considered to be statistically significant. Duplicate data were deleted by excel 2013 software. This study was approved by Ethical Committee of Mazandaran University of Medical Sciences.

 Results



Of 4460 cancer cases registered in MazPCR during 2014–2015, 183 were female reproductive cancers. [Figure 1] shows the frequency of female reproductive cancers with age groups.{Figure 1}

[Figure 2] shows the distribution of patients in cities of Mazandaran province. According to pathological reports, the frequency of carcinoma in situ and malignant primary site was 4.9% and 95.1%, respectively. These reports show frequency of malignancies are well differentiated and moderate differentiated 43.8%, 37.5%, respectively.{Figure 2}

[Table 1] shows the frequency of involved organs and ASR.{Table 1}

[Table 2] presents the mean age (standard deviation [SD]) of these patients according to involved organs.{Table 2}

[Table 3] shows the frequency of uterus and ovary cancers according to residents of cities and villages, tumor behavior (in situ and malignant primary site), and grade of tumors. The differences between residents of cities and villages and grade of tumors were not significant (P = 1.000 and 0.228, respectively).{Table 3}

 Discussion



The female reproductive cancers are estimated to be the third most common group of cancers in women.[4],[7] Thus, this study was performed to inspect the epidemiological characteristics of female reproductive cancers in northern Iran in comparison with relevant studies. In this study, the mean (SD) age of patients was 53.45 (14.32) years and 18% of individuals were 50–54 years. According to this study, the incidence rate of female reproductive cancers was 8.51 per 100,000 persons-year while in Golestan province (near the Mazandaran province), the incidence rate of female reproductive cancers was 14.39 per 100,000 persons-year.[3] According to Globocan 2012, the ASR of female reproductive cancers in the world and WHO East Mediterranean region are 24.8 and 15.2/100,000 person-years, respectively.[7] This low incidence rate may be elucidated by appropriate medical education and protected sexual behaviors or implementation of effective controlling programs such as screening programs in Mazandaran province. Our study showed that the incidence rate of the cancer of the uterus was 2.58/100000 person-year, which was in line with a population-based study in the Golestan province in North of Iran (city = 2.98 and village = 2.24),[3] but in America, the overall incidence of this cancer increased.[8] This difference may be related to genetic high geographical variations in the field of cancer.[5] However, future studies are needed to discover the true etiology of this difference. Besides, the low incidence rate of cervical cancer in Mazandaran province may be related to the low prevalence of HPV as a main etiologic factor in Iran, for example, the global and national meta-analysis study about the prevalence of human papillomavirus shows that this ratio in Iran is less than world prevalence.[9],[10] Our results showed that the ASR of ovarian cancer was 2.65 per 100,000 persons-year. It was not similar to the rates reported for Golestan province in the north of Iran.[3] Our findings showed that female reproductive cancer incidence is more in urban than rural (according to residents of cities and villages in Mazandaran province is 54.7% and 45.3%, respectively). This result was in line with the findings of NegarSadat Taheri et al.[3] This may be elucidated by differences in lifestyle, genetic factors,[6] and socioeconomic status.[3] Our results showed that the mean age (SD) of these patients according to involved organs was 53.45 years. The most frequent in corpus uterus and ovary groups was 56.70 and 52.04 years, respectively. Furthermore, the differences between these cancers groups were not significant (P = 0.179). The ASR of cervical cancer in Mazandaran female was 1.48 per 100,000 person-year, which was in line with the findings of developed countries.[3] According to our study, differences between frequency of uterus and ovary cancers with tumor behavior (in situ and malignant primary site) were significant (P = 0.046).

 Conclusion



We found higher rates of reproductive cancer incidence in urban than rural. The incidence rate of cervical cancer in Mazandaran province is low, and the ASR of cervical cancer in Mazandaran female was in line with the findings of developed countries. We found significant differences between frequency of uterus and ovary cancers with tumor behavior.

Acknowledgment

We would like to thank Department of Health Service of Mazandaran University of Medical Sciences, Sari, Iran.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

References

1Salehiniya H, Ghobadi Dashdebi S, Rafiemanesh H, Mohammadian-Hafshejani A, Enayatrad M. Time trend analysis of cancer-incidence in caspian sea, 2004-2009: A Population-based cancer registries study (Northern Iran). Caspian J Intern Med 2016;7:25-30.
2Ghasem J, Hedayatizadeh-Omran A, Alizadeh-Navaei R, Moradi S, Omrani-Nava V, Rashidi Alashti M, et al. An epidemiological study of patients with breast cancer in Northern Iran, between 2006 and 2015. World Cancer Res J 2016;3:e803.
3Taheri N, Fazel A, Mahmoodzadeh H, Omranpour R, Roshandel G, Gharahjeh S, et al. Epidemiology of female reproductive cancers in iran: Results of the gholestan population-based cancer registry. Asian Pac J Cancer Prev 2014;15:8779-82.
4Weiderpass E, Labrèche F. Malignant tumors of the female reproductive system. Saf Health Work 2012;3:166-80.
5Karami K, Cheraghi M, Amori N, Pedram M, Sobhani A. Common cancers in khuzestan province, south west of iran, during 2005-2011. Asian Pac J Cancer Prev 2014;15:9475-8.
6Janbabaei G, Hedayatizadeh-Omran A, Alizadeh-Navaei R, Moradi S, Ahmadi A, Rashidi Alashti M, et al. An epidemiological study on patients with colorectal cancer admitted to one referral center in North of Iran from 2006 to 2015. World Cancer Res J 2017;4:e841.
7Ferlay J, Soerjomataram I, Ervik M, Dikshit R, Eser S, Mathers C, et al. Cancer Incidence and Mortality Worldwide: IARC CancerBase International Agency for Research on Cancer. Vol. 1. GLOBOCAN 2012. 2012. p. 11.
8Forman D, BF, Brewster DH. Cancer incidence in five continents Vol. X - IARC. International Agency for research on cancer. IARC Scientific Publications 2014;10:22.
9Bruni L, Diaz M, Castellsagué X, Ferrer E, Bosch FX, de Sanjosé S, et al. Cervical human papillomavirus prevalence in 5 continents: Meta-analysis of 1 million women with normal cytological findings. J Infect Dis 2010;202:1789-99.
10Malary M, Moosazadeh M, Hamzehgardeshi Z, Afshari M, Moghaddasifar I, Afsharimoghaddam A, et al. The prevalence of cervical human papillomavirus infection and the most at-risk genotypes among iranian healthy women: A Systematic review and meta-analysis. Int J Prev Med 2016;7:70.