Introduction
After cardiovascular diseases, cancer is the main cause of death in the world and the third leading cause of death in Iran after road accidents and cardiovascular diseases [
1]. According to GLOBOCAN 2020 report, it is predicted that there will be 28.4 million cases of cancer in the world by 2040 [
2]. The number of cancer cases in 2015 in Iran was 124,128 according to the report of the National Program of Cancer Registration [
3]. According to this report, the lowest incidence of cancer was in Sistan and Baluchestan province. The number of cancer cases in Guilan province was 4555 people. Therefore, geographical differences can be effective in the incidence of cancer. According to this report, the most common cancers in Iran were breast cancer, prostate cancer, colorectal cancer, skin cancer (non-melanoma), and gastric cancer. in Guilan province, the most common cancers were breast cancer, gastric cancer, colorectal cancer, prostate cancer, and skin cancer (non-melanoma) [
3].
Finding information about the characteristics of patients (such as age and gender) and cancer (common types and the location of tumor) can be useful in the early prevention and control of cancer. Considering that there is no information available regarding the epidemiology of cancer in Guilan province, we aim to determine the prevalence of different types of cancers in Guilan province and compare the results with other provinces of Iran and other countries.
Methods
In this analytical cross-sectional study, the data from the PERSIAN Guilan Cohort study were used. The participants were 10,520 men and women from urban and rural areas of Sowme’e Sara county in Guilan province, whose information was collected from October 8, 2014 to January 20, 2017. The presence or absence of cancer was determined based on their self-reports. In this study, the prevalence rate was calculated per 100 thousand people. Descriptive statistics (mean, standard deviation, frequency, and percentage) were used for describing collected data. Statistical analyses were performed in STATA version 13 software.
Results
In this study, 94 cancer patients and 98 types of cancer were recorded. Their mean age was 53.23±9.05 years in overall, 56.55±8.84 years in men, and 51.09±8.76 in women. Of 94 participants, 65 (68.4%) were women. The mean age at diagnosis was 45.58±10.09 years in overall (ranged 19-64 years), 47.61±11.23 years in men (ranged 23-64 years), and 44.30±7.87 years in women (ranged 19-61 years). In overall, the most common cancers were breast cancer, brain and central nervous system (CNS) cancer, and prostate cancer. The prevalence of breast cancer was higher than other types of cancer (
Table 1).
![](./files/site1/images/T1(14).jpg)
In men, the most common cancers were prostate cancer, colorectal cancer, and brain and CNS cancer. In women, the most common cancers were breast cancer, brain and CNS cancer, and ovarian cancer (
Figure 1).
![](./files/site1/images/F1(6).jpg)
The men in urban areas had 10% more cancer (
Figure 1) and the women in urban areas had 42% less cancer compared rural men and women (
Figure 2).
![](./files/site1/images/F2(1).jpg)
Discussion
According to report of the National Program of Cancer Registration, the most common cancers in the female population of Iran are breast cancer, colorectal cancer, skin cancer (non-melanoma) and gastric cancer, while in Guilan province the most common types are breast cancer, colorectal cancer, gastric cancer, and skin cancer (non-melanoma). In our study, the most common cancers in women were breast cancer, brain and CNS cancer, and, and ovarian cancer. Our results regarding breast cancer in women are consistent with the national report for all provinces except for Chaharmahal and Bakhtiari, Kohgiluyeh and Boyer-Ahmad, and Yazd [
3]. The high prevalence of breast cancer in our study showed the importance of the early detection of breast cancer in women living in Sowme’e Sara County. With the increase in the incidence of breast cancer in the world and in Iran, it seems necessary to pay attention to screening of patients and finding risk factors and prevention methods for it. In a study in Iran, it was found that 23% of breast cancer occur in women under the age of 40 and, due to the lack of early diagnosis, 70% of them die in a short period [
4]. Overall, screening for breast cancer in women and prostate cancer in men living in Sowme’e Sara County should be considered which is under operation by the PERSIAN cohort study team using mammography and prostate specific antigen tests.
One of the limitations of this study was the lack of assessment of cancer prevalence in the entire population of Sowme’e Sara County and in all age groups; it was investigated only in 10,520 adults aged 35-70 years, and some of them were excluded from this study based on the inclusion criteria of cohort studies.
Ethical Considerations
Compliance with ethical guidelines
This study was approved by the ethics committee of Guilan University of Medical Sciences (Code: IR.GUMS.REC.1399.386).
Funding
The present study was funded by the Deputy for Research and Technology of Guilan University of Medical Sciences.
Authors' contributions
Conceptualization and design of the study: Fariborz Mansour-Ghanaei, Farahnaz Joukar and Heydar Ali Balou; Acquisition, analysis and interpretation of data: Fariborz Mansour-Ghanaei, Mohammadreza Naghipour, Farahnaz Joukar, Sara Yeganeh, Heydar Ali Balou, Soheil Hassanipour and Gholamreza Sadeghi; Drafting of the manuscript: Farahnaz Joukar, Sara Yeganeh, Massood Baghaee, Soheil Hassanipour and Golsa Hayadokht; Critical review of the manuscript for important intellectual content: Mansour-Ghanaei and Farahnaz Joukar; Statistical analysis: Farahnaz Joukar, Soheil Hassanipourand Hossein Ali Nikbakht; Attracting financial resources: Vice President of Research and Technology of Guilan University of Medical Sciences; Administrative, technical or material support: Vice President of Research and Technology of Guilan University of Medical Sciences; Supervision of the study: Fariborz Mansour-Ghanaei, Farahnaz Joukar, Heydar Ali Balou and Mohammadreza Naghipour.
Conflicts of interest
There is no conflict of interest.
Acknowledgements
The authors would like to thank the staff of the Gastrointestinal and Liver Diseases Research Center of Guilan University of Medical Sciences as well as the staff of the endoscopy department of Razi hospital in Rasht for their cooperation.
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