Geographical and socioeconomic inequalities in female breast cancer incidence and mortality in Iran: A Bayesian spatial analysis of registry data
In Iran, trends in breast cancer incidence and mortality have generally been monitored at national level. The purpose of this study is to examine province-level disparities in age-standardised breast cancer incidence versus mortality from 2000 to 2010 and their association with socioeconomic status....
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| creator | Rahimzadeh, Shadi Burczynska, Beata Ahmadvand, Alireza Sheidaei, Ali Khademioureh, Sara Pazhuheian, Forough Saeedi Moghaddam, Sahar Bentham, James Farzadfar, Farshad Di Cesare, Mariachiara |
| description | In Iran, trends in breast cancer incidence and mortality have generally been monitored at national level. The purpose of this study is to examine province-level disparities in age-standardised breast cancer incidence versus mortality from 2000 to 2010 and their association with socioeconomic status.
In this study, data from Iran's national cancer and death registry systems, and covariates from census and household expenditure surveys were used. We estimated the age-standardised incidence and mortality rates in women aged more than 30 years for all 31 provinces in the consecutive time intervals 2000-2003, 2004-2007 and 2008-2010 using a Bayesian spatial model.
Mean age-standardised breast cancer incidence across provinces increased over time from 15.0 per 100,000 people (95% credible interval 12.0,18.3) in 2000-2003 to 39.6 (34.5,45.1) in 2008-2010. The mean breast cancer mortality rate declined from 10.9 (8.3,13.8) to 9.9 (7.5,12.5) deaths per 100,000 people in the same period. When grouped by wealth index quintiles, provinces in the highest quintile had higher levels of incidence and mortality. In the wealthiest quintile, reductions in mortality over time were larger than those observed among provinces in the poorest quintile. Relative breast cancer mortality decreased by 16.7% in the highest quintile compared to 10.8% in the lowest quintile.
Breast cancer incidence has increased over time, with lower incidence in the poorest provinces likely driven by underdiagnoses or late-stage diagnosis. Although the reported mortality rate is still higher in wealthier provinces, the larger decline over time in these provinces indicates a possible future reversal, with the most deprived provinces having higher mortality rates. Ongoing analysis of incidence and mortality at sub-national level is crucial in addressing inequalities in healthcare systems and public health both in Iran and elsewhere. |
| doi_str_mv | 10.1371/journal.pone.0248723 |
| format | Article |
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In this study, data from Iran's national cancer and death registry systems, and covariates from census and household expenditure surveys were used. We estimated the age-standardised incidence and mortality rates in women aged more than 30 years for all 31 provinces in the consecutive time intervals 2000-2003, 2004-2007 and 2008-2010 using a Bayesian spatial model.
Mean age-standardised breast cancer incidence across provinces increased over time from 15.0 per 100,000 people (95% credible interval 12.0,18.3) in 2000-2003 to 39.6 (34.5,45.1) in 2008-2010. The mean breast cancer mortality rate declined from 10.9 (8.3,13.8) to 9.9 (7.5,12.5) deaths per 100,000 people in the same period. When grouped by wealth index quintiles, provinces in the highest quintile had higher levels of incidence and mortality. In the wealthiest quintile, reductions in mortality over time were larger than those observed among provinces in the poorest quintile. Relative breast cancer mortality decreased by 16.7% in the highest quintile compared to 10.8% in the lowest quintile.
Breast cancer incidence has increased over time, with lower incidence in the poorest provinces likely driven by underdiagnoses or late-stage diagnosis. Although the reported mortality rate is still higher in wealthier provinces, the larger decline over time in these provinces indicates a possible future reversal, with the most deprived provinces having higher mortality rates. Ongoing analysis of incidence and mortality at sub-national level is crucial in addressing inequalities in healthcare systems and public health both in Iran and elsewhere.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0248723</identifier><identifier>PMID: 33730079</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Age ; Bayesian analysis ; Biology and Life Sciences ; Breast cancer ; Completeness ; Computer programs ; Data analysis ; Demographic aspects ; Diseases ; Drafting software ; Economic aspects ; Editing ; Endocrinology ; Epidemiology ; Estimates ; Ethics ; Fatalities ; Females ; Income ; Insurance ; Insurance coverage ; Medical research ; Medicine and Health Sciences ; Metabolism ; Methodology ; Mortality ; Pathology ; Patients ; People and Places ; Population ; Provinces ; Public health ; Research facilities ; Science and technology ; Social aspects ; Socioeconomic factors ; Software ; Spatial analysis ; Statistical analysis ; Technology ; Womens health</subject><ispartof>PloS one, 2021-03, Vol.16 (3), p.e0248723-e0248723</ispartof><rights>COPYRIGHT 2021 Public Library of Science</rights><rights>2021 Rahimzadeh et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2021 Rahimzadeh et al 2021 Rahimzadeh et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-326dc2a4dd647e71aab53c38c830000097cc90fdc687c072a4f5427556b02a4f3</citedby><cites>FETCH-LOGICAL-c692t-326dc2a4dd647e71aab53c38c830000097cc90fdc687c072a4f5427556b02a4f3</cites><orcidid>0000-0002-3934-3364 ; 0000-0001-5568-8787</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7968648/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7968648/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2096,2915,23847,27903,27904,53769,53771,79346,79347</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33730079$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Radfar, Amir</contributor><creatorcontrib>Rahimzadeh, Shadi</creatorcontrib><creatorcontrib>Burczynska, Beata</creatorcontrib><creatorcontrib>Ahmadvand, Alireza</creatorcontrib><creatorcontrib>Sheidaei, Ali</creatorcontrib><creatorcontrib>Khademioureh, Sara</creatorcontrib><creatorcontrib>Pazhuheian, Forough</creatorcontrib><creatorcontrib>Saeedi Moghaddam, Sahar</creatorcontrib><creatorcontrib>Bentham, James</creatorcontrib><creatorcontrib>Farzadfar, Farshad</creatorcontrib><creatorcontrib>Di Cesare, Mariachiara</creatorcontrib><title>Geographical and socioeconomic inequalities in female breast cancer incidence and mortality in Iran: A Bayesian spatial analysis of registry data</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>In Iran, trends in breast cancer incidence and mortality have generally been monitored at national level. The purpose of this study is to examine province-level disparities in age-standardised breast cancer incidence versus mortality from 2000 to 2010 and their association with socioeconomic status.
In this study, data from Iran's national cancer and death registry systems, and covariates from census and household expenditure surveys were used. We estimated the age-standardised incidence and mortality rates in women aged more than 30 years for all 31 provinces in the consecutive time intervals 2000-2003, 2004-2007 and 2008-2010 using a Bayesian spatial model.
Mean age-standardised breast cancer incidence across provinces increased over time from 15.0 per 100,000 people (95% credible interval 12.0,18.3) in 2000-2003 to 39.6 (34.5,45.1) in 2008-2010. The mean breast cancer mortality rate declined from 10.9 (8.3,13.8) to 9.9 (7.5,12.5) deaths per 100,000 people in the same period. When grouped by wealth index quintiles, provinces in the highest quintile had higher levels of incidence and mortality. In the wealthiest quintile, reductions in mortality over time were larger than those observed among provinces in the poorest quintile. Relative breast cancer mortality decreased by 16.7% in the highest quintile compared to 10.8% in the lowest quintile.
Breast cancer incidence has increased over time, with lower incidence in the poorest provinces likely driven by underdiagnoses or late-stage diagnosis. Although the reported mortality rate is still higher in wealthier provinces, the larger decline over time in these provinces indicates a possible future reversal, with the most deprived provinces having higher mortality rates. Ongoing analysis of incidence and mortality at sub-national level is crucial in addressing inequalities in healthcare systems and public health both in Iran and elsewhere.</description><subject>Age</subject><subject>Bayesian analysis</subject><subject>Biology and Life Sciences</subject><subject>Breast cancer</subject><subject>Completeness</subject><subject>Computer programs</subject><subject>Data analysis</subject><subject>Demographic aspects</subject><subject>Diseases</subject><subject>Drafting software</subject><subject>Economic aspects</subject><subject>Editing</subject><subject>Endocrinology</subject><subject>Epidemiology</subject><subject>Estimates</subject><subject>Ethics</subject><subject>Fatalities</subject><subject>Females</subject><subject>Income</subject><subject>Insurance</subject><subject>Insurance coverage</subject><subject>Medical research</subject><subject>Medicine and Health 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and socioeconomic inequalities in female breast cancer incidence and mortality in Iran: A Bayesian spatial analysis of registry data</title><author>Rahimzadeh, Shadi ; Burczynska, Beata ; Ahmadvand, Alireza ; Sheidaei, Ali ; Khademioureh, Sara ; Pazhuheian, Forough ; Saeedi Moghaddam, Sahar ; Bentham, James ; Farzadfar, Farshad ; Di Cesare, Mariachiara</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c692t-326dc2a4dd647e71aab53c38c830000097cc90fdc687c072a4f5427556b02a4f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Age</topic><topic>Bayesian analysis</topic><topic>Biology and Life Sciences</topic><topic>Breast cancer</topic><topic>Completeness</topic><topic>Computer programs</topic><topic>Data analysis</topic><topic>Demographic aspects</topic><topic>Diseases</topic><topic>Drafting software</topic><topic>Economic 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Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Rahimzadeh, Shadi</au><au>Burczynska, Beata</au><au>Ahmadvand, Alireza</au><au>Sheidaei, Ali</au><au>Khademioureh, Sara</au><au>Pazhuheian, Forough</au><au>Saeedi Moghaddam, Sahar</au><au>Bentham, James</au><au>Farzadfar, Farshad</au><au>Di Cesare, Mariachiara</au><au>Radfar, Amir</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Geographical and socioeconomic inequalities in female breast cancer incidence and mortality in Iran: A Bayesian spatial analysis of registry data</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2021-03-17</date><risdate>2021</risdate><volume>16</volume><issue>3</issue><spage>e0248723</spage><epage>e0248723</epage><pages>e0248723-e0248723</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>In Iran, trends in breast cancer incidence and mortality have generally been monitored at national level. The purpose of this study is to examine province-level disparities in age-standardised breast cancer incidence versus mortality from 2000 to 2010 and their association with socioeconomic status.
In this study, data from Iran's national cancer and death registry systems, and covariates from census and household expenditure surveys were used. We estimated the age-standardised incidence and mortality rates in women aged more than 30 years for all 31 provinces in the consecutive time intervals 2000-2003, 2004-2007 and 2008-2010 using a Bayesian spatial model.
Mean age-standardised breast cancer incidence across provinces increased over time from 15.0 per 100,000 people (95% credible interval 12.0,18.3) in 2000-2003 to 39.6 (34.5,45.1) in 2008-2010. The mean breast cancer mortality rate declined from 10.9 (8.3,13.8) to 9.9 (7.5,12.5) deaths per 100,000 people in the same period. When grouped by wealth index quintiles, provinces in the highest quintile had higher levels of incidence and mortality. In the wealthiest quintile, reductions in mortality over time were larger than those observed among provinces in the poorest quintile. Relative breast cancer mortality decreased by 16.7% in the highest quintile compared to 10.8% in the lowest quintile.
Breast cancer incidence has increased over time, with lower incidence in the poorest provinces likely driven by underdiagnoses or late-stage diagnosis. Although the reported mortality rate is still higher in wealthier provinces, the larger decline over time in these provinces indicates a possible future reversal, with the most deprived provinces having higher mortality rates. Ongoing analysis of incidence and mortality at sub-national level is crucial in addressing inequalities in healthcare systems and public health both in Iran and elsewhere.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>33730079</pmid><doi>10.1371/journal.pone.0248723</doi><tpages>e0248723</tpages><orcidid>https://orcid.org/0000-0002-3934-3364</orcidid><orcidid>https://orcid.org/0000-0001-5568-8787</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | PloS one, 2021-03, Vol.16 (3), p.e0248723-e0248723 |
| issn | 1932-6203 1932-6203 |
| language | eng |
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| source | Public Library of Science (PLoS) Journals Open Access; DOAJ Directory of Open Access Journals; PubMed Central; Free Full-Text Journals in Chemistry; EZB Electronic Journals Library |
| subjects | Age Bayesian analysis Biology and Life Sciences Breast cancer Completeness Computer programs Data analysis Demographic aspects Diseases Drafting software Economic aspects Editing Endocrinology Epidemiology Estimates Ethics Fatalities Females Income Insurance Insurance coverage Medical research Medicine and Health Sciences Metabolism Methodology Mortality Pathology Patients People and Places Population Provinces Public health Research facilities Science and technology Social aspects Socioeconomic factors Software Spatial analysis Statistical analysis Technology Womens health |
| title | Geographical and socioeconomic inequalities in female breast cancer incidence and mortality in Iran: A Bayesian spatial analysis of registry data |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-27T20%3A11%3A55IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Geographical%20and%20socioeconomic%20inequalities%20in%20female%20breast%20cancer%20incidence%20and%20mortality%20in%20Iran:%20A%20Bayesian%20spatial%20analysis%20of%20registry%20data&rft.jtitle=PloS%20one&rft.au=Rahimzadeh,%20Shadi&rft.date=2021-03-17&rft.volume=16&rft.issue=3&rft.spage=e0248723&rft.epage=e0248723&rft.pages=e0248723-e0248723&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0248723&rft_dat=%3Cgale_plos_%3EA655343488%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2502193862&rft_id=info:pmid/33730079&rft_galeid=A655343488&rft_doaj_id=oai_doaj_org_article_2e55421b214b4cd288de0c6fed4da8b1&rfr_iscdi=true |