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      The Spatial Distribution of Cancer Incidence in Fars Province: A GIS-Based Analysis of Cancer Registry Data

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          Abstract

          Background:

          Cancer is a major health problem in the developing countries. Variations of its incidence rate among geographical areas are due to various contributing factors. This study was performed to assess the spatial patterns of cancer incidence in the Fars Province, based on cancer registry data and to determine geographical clusters.

          Methods:

          In this cross sectional study, the new cases of cancer were recorded from 2001 to 2009. Crude incidence rate was estimated based on age groups and sex in the counties of the Fars Province. Age-standardized incidence rates (ASR) per 100,000 was calculated in each year. Spatial autocorrelation analysis was performed in measuring the geographic patterns and clusters using geographic information system (GIS). Also, comparisons were made between ASRs in each county.

          Results:

          A total of 28,411 new cases were diagnosed with cancer during 2001-2009 in the Fars Province, 55.5% of which were men. The average age was 61.6 ± 0.5 years. The highest ASR was observed in Shiraz, which is the largest county in Fars. The Moran's Index of cancer was significantly clustered in 2004, 2005, and 2006 in total, men, and women. The type of spatial clustering was high-high cluster, that to indicate from north-west to south-east of Fars Province.

          Conclusions:

          Analysis of the spatial distribution of cancer shows significant differences from year to year and between different areas. However, a clear spatial autocorrelation is observed, which can be of great interest and importance to researchers for future epidemiological studies, and to policymakers for applying preventive measures.

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          Most cited references40

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          Cancer incidence and mortality in Iran.

          Cancer is the third main cause of death in Iran. This report was provided for explaining cancer incidence and mortality. The National Cancer Registry reports from 2003 to 2006, population-based cancer registry reports from five provinces in 2006 and National Death Registry reports from 1999 to 2004 have been applied in this report. The age-standardized incidence rate of cancers was 98 and 110 per 100,000 among females and males. The male to female standard ratio was 1.12. The most common cancer among women and men was breast cancer (24) and stomach cancer (15), respectively. The estimated mortality rate for cancer was 41.1 and 65 per 100,000 for females and males in 2004. The current low cancer incidence rates in Iran might be due to lack of national cancer screening programs for prostate, colorectal or breast cancer, a consequence of incomplete registration as well as incomplete diagnosis of cancer patients; it is expected that it will rise dramatically in the future because of anticipated increase in life expectancy and westernized lifestyle. The first priorities for health policy makers should be developing, establishing and implementing national cancer control; or else, the health system could not respond to the demands regarding to diagnosis, treatment and palliation for these patients in the future.
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            Cancer occurrence in Iran in 2002, an international perspective.

            For almost 30 years no population-based cancer statistics have been available with which to estimate the cancer burden in Iran. In 2002 and 2003 two separate reports of population based cancer registries were published from Iran and the cancer incidence rates from these sources have permitted informed estimates of cancer incidence and mortality to be prepared. They suggest that more than 51,000 cases of cancer are diagnosed and 35,000 deaths due to cancer occur each year. The 5 most common cancers in males (by ASR) are stomach (26.1 per 10(5)), esophagus (17.6 ), colon-rectum (8.3), bladder (8.0) and leukemia (4.8), and in females are breast (17.1), esophagus (14.4), stomach (11.1), colon-rectum (6.5) and cervix uteri (4.5). The incidence rates of esophageal and stomach cancer in Iran are high, well above the world average, while the incidence of lung cancer is very low. Breast cancer, although the most common cancer of females in Iran, has rates that are low by world standards, especially those observed in Europe and USA. Similarly, the incidence of cervix cancer in Iran is very low, even lower than such low risk countries as China, Kuwait and Spain. Comparing these rates with the data of 30 years ago, the incidence of esophageal cancer has decreased dramatically, but gastric cancer has increased about two fold.
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              Geographic information systems (GIS) for Health Promotion and Public Health: a review.

              The purpose of this literature review is to identify how geographic information system (GIS) applications have been used in health-related research and to critically examine the issues, strengths, and challenges inherent to those approaches from the lenses of health promotion and public health. Through the review process, conducted in 2007, it is evident that health promotion and public health applications of GIS can be generally categorized into four predominant themes: disease surveillance (n = 227), risk analysis (n = 189), health access and planning (n = 138), and community health profiling (n = 115). This review explores how GIS approaches have been used to inform decision making and discusses the extent to which GIS can be applied to address health promotion and public health questions. The contribution of this literature review will be to generate a broader understanding of how GIS-related methodological techniques and tools developed in other disciplines can be meaningfully applied to applications in public health policy, promotion, and practice.
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                Author and article information

                Journal
                Int J Prev Med
                Int J Prev Med
                IJPVM
                International Journal of Preventive Medicine
                Medknow Publications & Media Pvt Ltd (India )
                2008-7802
                2008-8213
                October 2013
                : 4
                : 10
                : 1122-1130
                Affiliations
                [1]Department of Social Science, College of Human Sciences, Shiraz University, Shiraz, Islamic Republic of Iran
                [1 ]Department of Community Medicine, Student Research Center, Shiraz University of Medical Sciences, Shiraz, Islamic Republic of Iran
                [2 ]Department of Civil Engineering, The Johns Hopkins University, Maryland, United States of America
                [3 ]Department of Non-communicable Diseases, Shiraz University of Medical Sciences, Shiraz, Islamic Republic of Iran
                [4 ]Department of Community Medicine, Shiraz Nephro-Urology Research Center, Shiraz University of Medical Sciences, Shiraz, Islamic Republic of Iran
                Author notes
                Correspondence to: Prof. Mehrdad Askarian, Department of Community Medicine, Shiraz University of Medical Sciences, P. O. Box: 71345-1737, Shiraz, Iran. E-mail: askariam@ 123456sums.ac.ir
                Article
                IJPVM-4-1122
                3843298
                24319551
                147cad7b-0699-4672-9388-2ec6c3e88ca3
                Copyright: © International Journal of Preventive Medicine

                This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 04 October 2012
                : 18 January 2013
                Categories
                Original Article

                Health & Social care
                cancer,iran,spatial analysis
                Health & Social care
                cancer, iran, spatial analysis

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