Objectives
Recent studies have suggested the occurrence patterns and related diet factor of esophagus cancer (EC) and gastric cancer (GC). Incidence of these cancers was mapped either in general and stratified by sex. The aim of this study was to model the geographical variation in incidence of these two related cancers jointly to explore the relative importance of an intended risk factor, diet low in fruit and vegetable intake, in Golestan, Iran. Methods
Data on the incidence of EC and GC between 2004 and 2008 were extracted from Golestan Research Center of Gastroenterology and Hepatology, Hamadan, Iran. These data were registered as new observations in 11 counties of the province yearly. The Bayesian shared component model was used to analyze the spatial variation of incidence rates jointly and in this study we analyzed the data using this model. Joint modeling improved the precision of estimations of underlying diseases pattern, and thus strengthened the relevant results. Results
From 2004 to 2008, the joint incidence rates of the two cancers studied were relatively high (0.8–1.2) in the Golestan area. The general map showed that the northern part of the province was at higher risk than the other parts. Thus the component representing diet low in fruit and vegetable intake had larger effect of EC and GC incidence rates in this part. This incidence risk pattern was retained for female but for male was a little different. Conclusion
Using a shared component model for joint modeling of incidence rates leads to more precise estimates, so the common risk factor, a diet low in fruit and vegetables, is important in this area and needs more attention in the allocation and delivery of public health policies.
Citations
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Objectives
Recent studies of esophageal cancer (EC) and gastric cancer (GC) have been reported to have high incidence rates of these cancers in Golestan Province of Iran. The present study describes the geographical patterns of EC and GC incidence based on cancer registry data and display statistically significant regions within this province. Methods
In order to map the distribution of upper gastrointestinal cancer, relative risk (RR) were calculated. Therefore, to estimate a more reliable RR, Poisson regression models were used. The adjusted models (adjusted to urban–rural area, sex, and grouped age proportion) were utilized. We considered two-component random effects for each observation, an unstructured (noncorrelated) and a group of “neighbor” (correlated) heterogeneities. We estimated the model parameters using Gibbs sampling and empirical Bayes method. We used EC and GC data that were registered with Golestan Research Center of Gastroenterology and Hepatology in the years 2004–2008. Results
The EC and GC maps were drawn for 2004–2008 in the province. Kalaleh and Minoodasht counties have a high RR of EC and GC in the years of study. In almost all years, the areas with a high RR were steady. Conclusion
The EC and GC maps showed significant spatial patterns of risk in Golestan province of Iran. Further study is needed to multivariate clustering and mapping of cancers RRs with considering diet and socioeconomic factors.
Citations
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