A 10-year Study of Esophageal Cancer in Guilan Province, Iran: The Guilan Cancer Registry Study (GCRS)

Abstract

Background: Northern Iran counts as one of the highest prevalence regions for esophageal cancer (EC) worldwide. This study was designed to assess the epidemiologic aspects of EC in north central and northwest Iran over a 10 year period. Materials and Methods: The Guilan cancer registry study (GCRS) is a populationbased cancer registry study featuring retrospective (1996-2003) and prospective (2004-2005) phases. A detailed questionnaire based on WHO standards for cancer registratration was applied to gather the required information. Two trained physicians coded information using ICD-O-3 in close coordination with an expert pathologist. Results: A total of 19,936 cases of malignancy (mean age 55.4±18.0 years, range: 1-98 years) were registered, including 1,147 cases (670 males, 447 female; mean age: 64.0±11.5 years) of EC. In 1996 the male/female ratio among patients with EC was 1.25 which increased to 1.53 in 2005. The lower third of the esophagus still remained the most common site of tumors. The average age-standardized rate (ASR) was 6.9 and 4.1 per 10 5 men and women, respectively. In 1996, the ASRs were 7.2 and 5.2 per 10 5 men and women which decreased to 6.9 and 4.1 per 10 5 in 2004-2005. Squamous cell carcinoma (SCC) was the most prevalent histological subtype of EC accounting over 80% of cases. Conclusions: However the prevalence of adenocarcinoma (ADC) showed an increase to 18.4%. Guilan province may be considered a relatively low incidence region for EC.

Prevalence of Esophageal Cancer in the Northern Part of Afghanistan

“…However, the incidence of esophageal cancer is low in western countries compared to Asian countries (Bloomfled et al, 2006). The high rates of esophageal cancer in the northern part of Afghanistan reflected that this area lies in Central Asian Esophageal Cancer Belt (Mir et al, 2009;Mansour-Ghanaei et al, 2012). This shows the variable geographic distribution of esophageal cancer which might due to many known and unknown environmental and ethnic reasons.…”

The Incidence of Esophageal Cancer in Iran: A Systematic Review and Meta-analysis

“…The included studies were published from 1968 to 2017. Based on geographical locations, four studies were conducted in all states of Iran [24][25][26][27], three in Fars province [28][29][30], three in East Azerbaijan [15,31,32], two in Ardabil province [33,34], two in Guilan province [35,36], two in Golestan province [37,38], one in Kerman province [39], one in Semnan province [40], one in Tehran metropolis [41], one in Mazandaran province [42], one in Caspian littoral [43] and one in Shahroud city [44]. All the studies have reported ASRs.…”

“…Some parts of Iran, which have common borders with Turkmenistan and Afghanistan countries, experience much higher incidence rates of this cancer. These regions include Mazandaran, Golestan, and Khorasan provinces [14,35].…”

Lymph Node Dissection along the Recurrent Laryngeal Nerve in Video-Assisted Thoracoscopic Surgery (VATSE) for Esophageal Squamous Cell Carcinoma

“…In 50-60% of cases, ESCC is located in the middle third thoracic esophagus in Thailand, Iran, and Japan [3,12,13,14]. About 60% of SCCs is also located in the middle third of the esophagus in Iran.…”