SPATIAL STATISTICAL ANALYSIS OF FEMALE BREAST CANCER INCIDENCE IN IRAQ DURING 2000-2015

Abstract

The spatial statistical analysis of breast cancer incidences across Iraq has not been explored in Iraq. This paper aimed to explore the spatial pattern and risk clusters of female breast cancer incidence from 2000 to 2015 in Iraq (except the Kurdish region). To enhance statistical stability and to access the changes over time, we split the data according to the geographical district into three periods (2000-2004, 2005-2009, and 2010-2015). The age-standardized incidence rates (ASRs) were calculated using the world standard population. Having obtained estimates ASRs, the global index of spatial autocorrelation (Moran’s statistic) was used to assess spatial dependence across districts for ASRs. Anselin local Moran’s statistic was used to identify spatial outliers. Additionally, we used Getis-Ord statistic to detect hotspots and coldspots over entire Iraq that represent clusters of districts with significantly high or low ASRs. A total of 44,496 cases were reported in 2000-2015 in Iraq, with an ASR of incidence of (32.81/100,000). The ASR incidence of breast cancer showed a significant average percentage change of 5.40% from 2002 to 2015. The spatial autocorrelation analysis showed insignificant positive spatial autocorrelation in 2000-2004, and significant positive spatial autocorrelation in 2005-2009, and in 2010-2015. This study identified four districts as high-risk areas for breast cancer during the two periods 2005-2009 and 2010-2015, including Al-Karkh, Al-Adhamia, Al-Rissafa, and Al-Sadir. This information can assist the allocation of health care resources and expand cancer prevention efforts.