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Ahadinezhad B, Maleki A, Amerzadeh M, Mohtashamzadeh B, Safdari M, Khosravizadeh O. Socioeconomic Inequalities in Cancer Incidence: A Comparative Investigation Based on Population of Iranian Provinces. CURRENT HEALTH SCIENCES JOURNAL 2023; 49:85-95. [PMID: 37780192 PMCID: PMC10541078 DOI: 10.12865/chsj.49.01.85] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 11/24/2022] [Indexed: 10/03/2023]
Abstract
Cancer is the second important cause of death worldwide. Cancer is one of the top health priorities in Iran. We aimed to study the socio-economic inequality of cancer incidence in Iran provinces. We conducted this cross-sectional study using provincial data. We obtained the required data from the statistical yearbook report, the Statistics Center Report and the National Cancer Registration Program Report of Iran's Ministry of Health and Medical Education (MoHME) for 2018. Socio-economic inequality of cancer incidence was analyzed by estimating the concentration index and extracting the concentration curve. Statistical analyzes were performed using STATA 14. Our findings revealed that cancer incidence was unequally distributed in terms of the socio-economic status in Iranian provinces. Cancer incidence is slightly concentrated in the provinces with higher than average literacy, per capita income and insurance coverage and household size below average. The concentration of cancer incidence has been to the detriment of the provinces that have a slightly better ranking in terms of the socio-economic index. The employment rate did not significantly affect cancer's distribution burden. We recommend policymakers facilitate early cancer detection by providing insurance coverage for screening services, payment exemptions, and public awareness.
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Affiliation(s)
- Bahman Ahadinezhad
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Aisa Maleki
- Student Research Committee, Qazvin University of Medical Sciences, Qazvin, Iran
- Health Products Safety Research Center, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Mohammad Amerzadeh
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
| | | | - Mahdi Safdari
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
- Department of Environmental Health Engineering, School of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Omid Khosravizadeh
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
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Chen JC, Pawlik T, Kelly EP, Obeng-Gyasi S. Intersectionality in patients with cancer: who should care and why? Future Oncol 2022; 18:4137-4140. [PMID: 36802840 PMCID: PMC10072129 DOI: 10.2217/fon-2022-0992] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 11/21/2022] [Indexed: 02/22/2023] Open
Affiliation(s)
- JC Chen
- Department of Surgery, Division of Surgical Oncology, The Ohio State University Wexner Medical Center & James Cancer Hospital, Columbus, OH 43210, USA
| | - Timothy Pawlik
- Department of Surgery, Division of Surgical Oncology, The Ohio State University Wexner Medical Center & James Cancer Hospital, Columbus, OH 43210, USA
| | - Elizabeth Palmer Kelly
- Department of Surgery, Division of Surgical Oncology, The Ohio State University Wexner Medical Center & James Cancer Hospital, Columbus, OH 43210, USA
| | - Samilia Obeng-Gyasi
- Department of Surgery, Division of Surgical Oncology, The Ohio State University Wexner Medical Center & James Cancer Hospital, Columbus, OH 43210, USA
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Rogers CR, Korous KM, Brooks E, De Vera MA, Tuuhetaufa F, Lucas T, Curtin K, Pesman C, Johnson W, Gallagher P, Moore JX. Early-Onset Colorectal Cancer Survival Differences and Potential Geographic Determinants Among Men and Women in Utah. Am Soc Clin Oncol Educ Book 2022; 42:1-16. [PMID: 35522914 DOI: 10.1200/edbk_350241] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
By 2030, early-onset colorectal cancer (EOCRC) is expected to become the leading cancer-related cause of death for people age 20 to 49. To improve understanding of this phenomenon, we analyzed the geographic determinants of EOCRC in Utah by examining county-level incidence and mortality. We linked data from the Utah Population Database to the Utah Cancer Registry to identify residents (age 18-49) diagnosed with EOCRC between 2000 and 2020, and we used spatial empirical Bayes smoothing to determine county-level hotspots. We identified 1,867 EOCRC diagnoses (52.7% in male patients, 69.2% in non-Hispanic White patients). Ten counties (34%) were classified as hotspots, with high EOCRC incidence or mortality. Hotspot status was unrelated to incidence rates, but non-Hispanic ethnic-minority men (incidence rate ratio, 1.49; 95% CI, 1.15-1.91), Hispanic White men and women (incidence rate ratio, 2.24; 95% CI, 2.00-2.51), and Hispanic ethnic-minority men and women (incidence rate ratio, 4.59; 95% CI, 3.50-5.91) were more likely to be diagnosed with EOCRC. After adjustment for income and obesity, adults living in hotspots had a 31% higher hazard for death (HR, 1.31; 95% CI, 1.02-1.69). Survival was poorest for adults with a late-stage diagnosis living in hotspots (chi square (1) = 4.0; p = .045). Adults who were married or who had a life partner had a lower hazard for death than single adults (HR, 0.73; 95% CI, 0.58-0.92). The risk for EOCRC is elevated in 34% of Utah counties, warranting future research and interventions aimed at increasing screening and survival in the population age 18 to 49.
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Affiliation(s)
- Charles R Rogers
- Department of Family & Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT
| | - Kevin M Korous
- Department of Family & Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT
| | - Ellen Brooks
- Department of Family & Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT
| | - Mary A De Vera
- University of British Columbia, Vancouver, British Columbia, Canada
| | - Fa Tuuhetaufa
- Department of Family & Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT
| | - Todd Lucas
- Division of Public Health, Michigan State University College of Human Medicine, Flint, MI
| | - Karen Curtin
- Department of Internal Medicine, Huntsman Cancer Institute, Utah Population Database Shared Resource, University of Utah School of Medicine, Salt Lake City, UT
| | | | - Wenora Johnson
- Patient-Centered Outcomes Research Institute, Chicago, IL
| | | | - Justin X Moore
- Medical College of Georgia, Georgia Cancer Center, Cancer Prevention, Control, & Population Health, Augusta University, Augusta, GA
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