Spatial Inequalities in the Incidence of Colorectal Cancer and Associated Factors in the Neighborhoods of Tehran, Iran: Bayesian Spatial Models

Abstract

ObjectivesThe aim of this study was to determine the factors associated with the spatial distribution of the incidence of colorectal cancer (CRC) in the neighborhoods of Tehran, Iran using Bayesian spatial models.MethodsThis ecological study was implemented in Tehran on the neighborhood level. Socioeconomic variables, risk factors, and health costs were extracted from the Equity Assessment Study conducted in Tehran. The data on CRC incidence were extracted from the Iranian population-based cancer registry. The Besag-York-Mollié (BYM) model was used to identify factors associated with the spatial distribution of CRC incidence. The software programs OpenBUGS version 3.2.3, ArcGIS 10.3, and GeoDa were used for the analysis.ResultsThe Moran index was statistically significant for all the variables studied (p<0.05). The BYM model showed that having a women head of household (median standardized incidence ratio [SIR], 1.63; 95% confidence interval [CI], 1.06 to 2.53), living in a rental house (median SIR, 0.82; 95% CI, 0.71 to 0.96), not consuming milk daily (median SIR, 0.71; 95% CI, 0.55 to 0.94) and having greater household health expenditures (median SIR, 1.34; 95% CI, 1.06 to 1.68) were associated with a statistically significant elevation in the SIR of CRC. The median (interquartile range) and mean (standard deviation) values of the SIR of CRC, with the inclusion of all the variables studied in the model, were 0.57 (1.01) and 1.05 (1.31), respectively.ConclusionsInequality was found in the spatial distribution of CRC incidence in Tehran on the neighborhood level. Paying attention to this inequality and the factors associated with it may be useful for resource allocation and developing preventive strategies in atrisk areas.

Clinicodemographical assessment of colorectal cancer with emphasis on B3GALNT2, MUC1, P53 and Ki67-related risk of metastasis

“…We also found adenocarcinoma (91.53%) appeared to be the most common pathology followed by mucinosis (7.31%), which occurred in the second place. This finding is in line with surgery reference books [31]; indeed, 94% of tumors in the colon are predominantly adenocarcinoma [32,33]. The results of the present study suggest that most hospitalized stages III/IV CRC patients' post-surgery's 5-year survival rate typically ranged from a 90%, 70% and 10% for those encountered with localized, mild regional and sever distant metastasis, respectively.…”

Urban and Rural Disparities in Hospital Utilization among Indonesian Adults

“…There was a relationship between the regional disparity of obstetrics and gynecologic services with children and infants mortality rates in Iran (34), while regional disparities were proven to exist in the distribution of health care facilities in Iran (35). Spatially Rostami et al (36) also proved the existence of geographic disparity in fatal drug overdose cases, while Mansori et al (37) and Momenyan et al (38) found a spatial disparity. Mansori et al (37) detected disparity in the incidence of colorectal cancer case, and Momenyan et al (38) in HIV/AIDS cases mortality risk.…”

Clinicodemographical assessment of colorectal cancer with emphasis on B3GALNT2, MUC1, P53 and Ki67-related risk of metastasis

“…indeed, 94% of tumors in the colon are predominantly adenocarcinoma [32,33]. The results of the present study suggest that most patients referred to the hospital were in the stages III and IV CRC post-surgery survival is highly dependent upon the diagnosis stage, and typically ranges from a 90% of 5-year survival rate for CRCs detected at the localized stage; 70% for regional to 10% for people diagnosed for distant metastatic CRC.…”