J Breast Cancer.  2013 Dec;16(4):372-377. 10.4048/jbc.2013.16.4.372.

Social Disparity in Breast and Ovarian Cancer Incidence in Iran, 2003-2009: A Time Trend Province-Level Study

• Kiadaliri

• KMID: 1976374
• DOI: http://doi.org/10.4048/jbc.2013.16.4.372

Abstract

PURPOSE
This pioneering study aimed to investigate social disparities in breast cancer (BC) and ovarian cancer (OC) incidence rates among women across Iran's provinces from 2003 to 2009.
METHODS
Provincial level population distribution data pertaining to women were obtained from the Statistical Centre of Iran. Age-standardized incidence rates of BC and OC were gathered from the National Cancer Registry. Human Development Index was used as the provinces' social rank (SR), and rate ratio and Kunst and Mackenbach relative index of inequality were used to assess social disparities. Annual percentage change (APC) was calculated using joinpoint regression, and Spearman rank correlation was used to examine the association between APC and SR.
RESULTS
It was found that over the study period, annual incidence rates rose by 11.6% and 9.7% for BC and OC, respectively. Social disparities were substantial and stable in favor of provinces with lower SR in Iran, and were more profound for BC than OC. Correlations between APC and SR were small and nonsignificant for both BC and OC.
CONCLUSION
The results showed that both BC and OC incidence increased in Iran during 2003 to 2009. There were positive associations between BC and OC incidence rates and the provinces' SR. This study's recommendations provide valuable information for health resource allocation pertaining to BC and OC control programs across provinces in Iran.

Keyword

Breast neoplasms; Health status disparities; Iran; Longitudinal studies; Ovarian neoplasms

MeSH Terms

Breast Neoplasms
Breast*
Demography
Female
Health Resources
Health Status Disparities
Human Development
Humans
Incidence*
Iran*
Longitudinal Studies
Ovarian Neoplasms*
Socioeconomic Factors

Figure

• 

  Figure 1 Average age-standardized incidence rates of breast cancer (A) and ovarian cancer (B) across Iran's provinces over 2003 to 2009. As Northern Khorasan, Razavi Khorasan and Southern Khorasan formed a single province before 2005, the estimates for these provinces are based on data year 2005 to 2009.

• 

  Figure 2 Age-standardized incidence rates of breast cancer (A) and ovarian cancer (B) through 2003 to 2009 in Iran. X and Y axes show data year and age-standardized incidence rates per 100,000 population, respectively.

• 

  Figure 3 Age-standardized incidence rates of breast cancer (A) and ovarian cancer (B) across five quintiles of Human Development Index over 2003 to 2009 in Iran.

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