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Stomach, Esophageal, and Lung Cancer Mortality Risk and Their Shared Risk Factors in Iran: A County-Level Spatial

Shadi Ghasemi1, Emanuela Dreassi2, Ardeshir Khosravi3

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This study mapped stomach, esophageal, and lung cancer mortality in Iran, revealing shared risk factors and higher relative risks in the north. Smaller-scale mapping aids targeted health policies.

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Area of Science:

  • Epidemiology
  • Spatial Analysis
  • Public Health

Background:

  • Disease mapping is crucial in epidemiology for understanding spatial patterns of mortality.
  • Stomach, esophageal, and lung cancers are leading causes of death in Iran for both genders.
  • Investigating shared and specific risk factors for these cancers is vital for public health.

Purpose of the Study:

  • To analyze the geographical distribution of stomach, esophageal, and lung cancer mortality in Iran.
  • To identify spatial patterns of shared and specific risk factors for these three cancers.
  • To compare mortality data at province and county levels.

Main Methods:

  • Ecological study analyzing mortality data from March 2013 to March 2015.
  • Utilized Besag, York, and Mollie's (BYM) and shared component (SC) models.
  • Employed OpenBUGS version 3.2.3 and R version 3.6.3 for spatial risk analysis.

Main Results:

  • Stomach and esophageal cancer mortality patterns showed similarities due to shared risk factors.
  • Relative risks for esophageal and stomach cancers were higher in northern Iran.
  • Highest relative risks were observed in West and East Azerbaijan provinces; lowest in Hormozgan (esophageal/stomach) and Ilam (lung).

Conclusions:

  • Analyzing diseases at smaller scales (counties) improves identification of high-risk areas.
  • Smaller-scale mapping facilitates more accurate, cost-effective, and timely health policy development.
  • Targeted interventions can be implemented to reduce disease risk factors effectively.