Abstract
BackgroundThe most common gender-specific malignancies are cancers of the breast and the prostate. In developing countries, cancer screening of all at risk is impractical because of healthcare resource limitations. Thus, determining high-risk areas might be an important first screening step. This study explores incidence patterns of potential high-risk clusters of breast and prostate cancers in southern Iran.MethodsThis cross-sectional study was conducted in the province of Kerman, South Iran. Patient data were aggregated at the county and district levels calculating the incidence rate per 100,000 people both for cancers of the breast and the prostate. We used the natural-break classification with five classes to produce descriptive maps. A spatial clustering analysis (Anselin Local Moran’s I) was used to identify potential clusters and outliers in the pattern of these cancers from 2014 to 2017.ResultsThere were 1350 breast cancer patients (including, 42 male cases) and 478 prostate cancer patients in the province of Kerman, Iran during the study period. After 45 years of age, the number of men with diagnosed prostate cancer increased similarly to that of breast cancer for women after 25 years of age. The age-standardised incidence rate of breast cancer for women showed an increase from 29.93 to 32.27 cases per 100,000 people and that of prostate cancer from 13.93 to 15.47 cases per 100,000 during 2014–2017. Cluster analysis at the county level identified high-high clusters of breast cancer in the north-western part of the province for all years studied, but the analysis at the district level showed high-high clusters for only two of the years. With regard to prostate cancer, cluster analysis at the county and district levels identified high-high clusters in this area of the province for two of the study years.ConclusionsNorth-western Kerman had a significantly higher incidence rate of both breast and prostate cancer than the average, which should help in designing tailored screening and surveillance systems. Furthermore, this study generates new hypotheses regarding the potential relationship between increased incidence of cancers in certain geographical areas and environmental risk factors.
Highlights
The most common gender-specific malignancies are cancers of the breast and the prostate
This study aimed to identify the spatial patterns of cancer of the breast and the prostate and to investigate the potential clustering in genderspecific patterns of these cancers in southern Iran between 2014 and 2017
We found high-risk areas for the whole study period of breast and prostate cancers in the north-western part of Kerman, an area extending southeast of the Iranian volcano-plutonic copper belt [37] where arsenic contamination is one of the most significant environmental concerns [38]
Summary
The most common gender-specific malignancies are cancers of the breast and the prostate. Cancer screening of all at risk is impractical because of healthcare resource limitations. This study explores incidence patterns of potential high-risk clusters of breast and prostate cancers in southern Iran. Human exposure to multiple risk factors has increased the cancer burden worldwide [3]. If cancer is diagnosed promptly, cures can sometimes be found and life prolonged leading to considerably lower disease burdens [5, 6]. Health systems, in developing countries, are not capable of screening all people to identify patients in the early stages of the disease. Identifying high-risk geographical areas could help decreasing the cost of screening, finding the people at risk and implementing more efficient diagnostic strategies [7]. Investigating high-risk areas should provide valuable knowledge to scientists about the aetiology of some malignancies [3]
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