A Study of the Long-Term Trend of Epidemiological and Clinical Indices of Breast Cancer in Isfahan

Document Type : Original Article(s)

Authors

1 Department of Radiotherapy and Oncology, Seyed-Al-Shohada Hospital, Isfahan University of Medical Sciences, Isfahan, Iran

2 Associate Professor, Department of Immunology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

3 Radiotherapy and Oncology Specialist, Milad Hospital, Isfahan, Iran

4 Department of General Surgery, Seyed-Al-Shohada Hospital, Isfahan University of Medical Sciences, Isfahan, Iran

5 Assistant Professor, Department of Radiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

6 Associate Professor, Department of Radiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

7 Assistant Professor, Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran

8 Department of Hematology and Oncology, School of Internal Medicine, Tehran University of Medical Sciences, Tehran, Iran

9 Associate Professor, Department of Biostatistics, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background:  Breast cancer, as the most common cancer among women, is the main cause of death in women aged 45 to 55. Therefore, different novel screening methods and technologies to diagnose and treat the disease in its early stages are of high importance for health systems.  The present study aimed to investigate the epidemiological trend, and clinical and treatment indices of breast cancer by collecting available information from Seyed-Al-Shohada Hospital, in Isfahan during 1981-2006.Methods: All available data at Oncology Center of Isfahan Province, related to 1981-2006 were encoded and analyzed. Age groups of the patients, along with all cases of cancer recorded by Statistical Center of Iran, were calculated. After age specific rating (ASR), the resulted indices were evaluated. The frequency of clinical indices, such as tumor, metastasis, chemotherapy, and breast conserving surgery, as well as the frequency of age groups among patients, and the ASR pattern were calculated. Correlational tests and mean comparison were used to analyze the data.Results: Among 4652 breast cancer patients, 98.6% were female and 1.35% were male. Total ASR for breast cancer was calculated as 13 in 1996, 14.1 in 2001, and 18.21 in 2006 in the province of Isfahan. The values were then compared with the rate in the country (25.6) during 2006. The age of patients was 48.79 ± 11 years with 34.65% aging 40-50, and 26.7% aging less than 40 years. The ASR was estimated as approximately 57 in every 100,000 for age groups of 41-50, 51-60, and 61-70. Categorization of patients based on frequency among different age groups and frequency based on ASR did not result in an identical pattern.  The relative frequency of tumor sizes obtained from the patients were T1 = 7.6%, T2 = 61.2%, T3 = 27.2% and T4 = 3.8%.  In addition, an increasing trend of chemotherapy was observed during the studied period with 71.2% of the patients receiving the treatment. The tendency to perform breast conserving surgery is growing recently and 8.9% of the cases undergone the surgery during 2002-2006.Conclusion:  The increasing trend of ASR may indicate improved screening methods, staff training development, and modern disease detection equipments. The data proves that compared with most western countries, Iran is in a low risk region. However, changing people's lifestyle and increasing trend in breast cancer incidence would be a matter of caution for the health system.

Keywords

References

  1. Jemal A, Siegel R, Xu J, Ward E. Cancer statistics, 2010. CA Cancer J Clin 2010; 60(5): 277-300.
  2. Jemal A, Siegel R, Ward E, Hao Y, Xu J, Thun MJ. Cancer statistics, 2009. CA Cancer J Clin 2009; 59(4): 225-49.
  3. Deputy Cancer Office. Iranian Annual of National Cancer Registration Report (2005-2006). Tehran, Iran: Islamic Republic of Iran, Ministry of Health and Medical Education, Health Deputy; 2006.
  4. Parkin DM, Fernandez LM. Use of statistics to assess the global burden of breast cancer. Breast J 2006; 12(Suppl 1): S70-S80.
  5. Nasseri K. Secular trends in the incidence of female breast cancer in the United States, 1973-1998. Breast J 2004; 10(2): 129-35.
  6. Shin HR, Boniol M, Joubert C, Hery C, Haukka J, Autier P, et al. Secular trends in breast cancer mortality in five East Asian populations: Hong Kong, Japan, Korea, Singapore and Taiwan. Cancer Sci 2010; 101(5): 1241-6.
  7. Shen YC, Chang CJ, Hsu C, Cheng CC, Chiu CF, Cheng AL. Significant difference in the trends of female breast cancer incidence between Taiwanese and Caucasian Americans: implications from age-period-cohort analysis. Cancer Epidemiol Biomarkers Prev 2005; 14(8): 1986-90.
  8. Salim EI, Moore MA, Al-Lawati JA, Al-Sayyad J, Bazawir A, Bener A, et al. Cancer epidemiology and control in the arab world - past, present and future. Asian Pac J Cancer Prev 2009; 10(1): 3-16.
  9. Majid RA, Mohammed HA, Saeed HM, Safar BM, Rashid RM, Hughson MD. Breast cancer in Kurdish women of northern Iraq: incidence, clinical stage, and case control analysis of parity and family risk. BMC Womens Health 2009; 9: 33.
  10. Miller BA, Chu KC, Hankey BF, Ries LA. Cancer incidence and mortality patterns among specific Asian and Pacific Islander populations in the U.S. Cancer Causes Control 2008; 19(3): 227-56.
  11. Rennet G. Breast Cancer: National Cancer Institute MECC Monograph. Middle East Cancer Consortium; 2006.
  12. Freedman LS, Edwards BK, Ries LAG, Young J. Cancer incidence in four member countries of the MECC compared with US SEER. In: Rennet G, editor. Breast Cancer. National Cancer Institute ed. Middle East Cancer Consortium; 2006. p. 73-81.
  13. Tsang T, Cheung KF. Incidence and mortality trends of female breast cancer. Public Health & Epidemiology Bulletin 2002; 11(5): 57-62.
  14. Marjani A, Kabir MJ. Breast cancer incidence among females in the Golestan province, Iran. Indian J Cancer 2009; 46(4): 351-2.
  15. Bray F, McCarron P, Parkin DM. The changing global patterns of female breast cancer incidence and mortality. Breast Cancer Res 2004; 6(6): 229-39.
  16. Althuis MD, Dozier JM, Anderson WF, Devesa SS, Brinton LA. Global trends in breast cancer incidence and mortality 1973-1997. Int J Epidemiol 2005; 34(2): 405-12.
  17. Parkin DM, Muir CS, Whelan SL, Gao YT, Ferlay J, Powell J. Cancer Incidence in Five Continents. Oxford, UK: Oxford University Press; 1993.
  18. Al-Lawati T, Al JM, Mateen M, Nahar H, Al-Saadi A, Thomas S, et al. Sentinel lymph node biopsy in the Sultanate of Oman. Gulf J Oncolog 2007; 1(1): 11-6.
  19. Smigal C, Jemal A, Ward E, Cokkinides V, Smith R, Howe HL, et al. Trends in breast cancer by race and ethnicity: update 2006. CA Cancer J Clin 2006; 56(3): 168-83.
  20. Jemal A, Ward E, Thun MJ. Recent trends in breast cancer incidence rates by age and tumor characteristics among U.S. women. Breast Cancer Res 2007; 9(3): R28.
  21. Plevritis SK, Sigal BM, Salzman P, Rosenberg J, Glynn P. A stochastic simulation model of U.S. breast cancer mortality trends from 1975 to 2000. J Natl Cancer Inst Monogr 2006; (36): 86-95.
  22. Matsuno RK, Anderson WF, Yamamoto S, Tsukuma H, Pfeiffer RM, Kobayashi K, et al. Early- and late-onset breast cancer types among women in the United States and Japan. Cancer Epidemiol Biomarkers Prev 2007; 16(7): 1437-42.
  23. Pisani P. Breast cancer: geographic variation and risk factors. J Environ Pathol Toxicol Oncol 1992; 11(5-6): 313-6.
  24. Mousavi SM, Montazeri A, Mohagheghi MA, Jarrahi AM, Harirchi I, Najafi M, et al. Breast cancer in Iran: an epidemiological review. Breast J 2007; 13(4): 383-91.
  25. Ibrahim EM, Zeeneldin AA, Sadiq BB, Ezzat AA. The present and the future of breast cancer burden in the Kingdom of Saudi Arabia. Med Oncol 2008; 25(4): 387-93.
  26. Maalej M, Hentati D, Messai T, Kochbati L, El MA, Mrad K, et al. Breast cancer in Tunisia in 2004: a comparative clinical and epidemiological study. Bull Cancer 2008; 95(2): E5-E9.
  27. Non Communicable Disease Deputy, Cancer Department. Annual Report of Iranian National Cancer Registration (2006-2007). Tehran, Iran: Health Deputy, Ministry of Health and Medical Education, Islamic Republic of Iran; 2008.
  28. .General Population and Housing Gensus Register Information System (2006). [Online]. Available from: URL: Amar.org.ir.
  29. Jemal A, Siegel R, Ward E, Murray T, Xu J, Smigal C, et al. Cancer statistics, 2006. CA Cancer J Clin 2006; 56(2): 106-30.
  30. Hayat MJ, Howlader N, Reichman ME, Edwards BK. Cancer statistics, trends, and multiple primary cancer analyses from the Surveillance, Epidemiology, and End Results (SEER) Program. Oncologist 2007; 12(1): 20-37.
  31. General Population and Housing Gensus Register Information System (1996). [Online]. Available from: URL: amar.org.ir.
  32. Agarwal G, Pradeep PV, Aggarwal V, Yip CH, Cheung PS. Spectrum of breast cancer in Asian women. World J Surg 2007; 31(5): 1031-40.
  33. El Saghir NS, Khalil MK, Eid T, El Kinge AR, Charafeddine M, Geara F, et al. Trends in epidemiology and management of breast cancer in developing Arab countries: a literature and registry analysis. Int J Surg 2007; 5(4): 225-33.
  34. Harirchi I, Ebrahimi M, Zamani N, Jarvandi S, Montazeri A. Breast cancer in Iran: a review of 903 case records. Public Health 2000; 114(2): 143-5.
  35. Ebrahimi M, Vahdaninia M, Montazeri A. Risk factors for breast cancer in Iran: a case-control study. Breast Cancer Res 2002; 4(5): R10.
  36. Yavari P, Mosavizadeh M, Sadrol-Hefazi B, Mehrabi Y. Reproductive characteristics and the risk of breast cancer--a case-control study in Iran. Asian Pac J Cancer Prev 2005; 6(3): 370-5.
  37. Joslyn SA, Foote ML, Nasseri K, Coughlin SS, Howe HL. Racial and ethnic disparities in breast cancer rates by age: NAACCR Breast Cancer Project. Breast Cancer Res Treat 2005; 92(2): 97-105.
  38. Hebert JR, Ghumare SS, Gupta PC. Stage at diagnosis and relative differences in breast and prostate cancer incidence in India: comparison with the United States. Asian Pac J Cancer Prev 2006; 7(4): 547-55.
  39. Sim X, Ali RA, Wedren S, Goh DL, Tan CS, Reilly M, et al. Ethnic differences in the time trend of female breast cancer incidence: Singapore, 1968-2002. BMC Cancer 2006; 6: 261.
  40. Son BH, Kwak BS, Kim JK, Kim HJ, Hong SJ, Lee JS, et al. Changing patterns in the clinical characteristics of Korean patients with breast cancer during the last 15 years. Arch Surg 2006; 141(2): 155-60.
  41. Harirchi I, Karbakhsh M, Kashefi A, Momtahen AJ. Breast cancer in Iran: results of a multi-center study. Asian Pac J Cancer Prev 2004; 5(1): 24-7.
  42. El Saghir NS, Shamseddine AI, Geara F, Bikhazi K, Rahal B, Salem ZM, et al. Age distribution of breast cancer in Lebanon: increased percentages and age adjusted incidence rates of younger-aged groups at presentation. J Med Liban 2002; 50 (1-2): 3-9.
  43. Wong IO, Cowling BJ, Schooling CM, Leung GM. Age-period-cohort projections of breast cancer incidence in a rapidly transitioning Chinese population. Int J Cancer 2007; 121(7): 1556-63.
  44. Chia KS, Reilly M, Tan CS, Lee J, Pawitan Y, Adami HO, et al. Profound changes in breast cancer incidence may reflect changes into a Westernized lifestyle: a comparative population-based study in Singapore and Sweden. Int J Cancer 2005; 113(2): 302-6.
  45. Tarone RE. Breast cancer trends among young women in the United States. Epidemiology 2006; 17(5): 588-90.
Journal of Isfahan Medical School
Volume 29, Issue 161 - Serial Number 161
September and October 2011
Pages 1831-1843

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History

  • Receive Date: 22 November 2010
  • Revise Date: 01 November 2024
  • Accept Date: 06 April 2022

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