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Spatial Variation in Lung Cancer Mortality and Related Men–Women Disparities in Iran from 2011 to 2014

Authors Ghasemi S, Mahaki B, Dreassi E, Aghamohammadi S

Received 24 January 2020

Accepted for publication 3 June 2020

Published 17 June 2020 Volume 2020:12 Pages 4615—4624

DOI https://doi.org/10.2147/CMAR.S247178

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Dr Eileen O'Reilly


Shadi Ghasemi,1 Behzad Mahaki,2 Emanuela Dreassi,3 Saeedeh Aghamohammadi4

1Student Research Committee, Department of Biostatistics and Epidemiology, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran; 2Department of Biostatistics, Kermanshah University of Medical Sciences, Kermanshah, Iran; 3Department of Statistics, Computer Science, Applications (DiSIA), University of Florence, Florence, Italy; 4Iranian Ministry of Health and Medical Education, Tehran, Iran

Correspondence: Behzad Mahaki Tel +98 09128077960
Email behzad.mahaki@gmail.com

Purpose: Lung cancer is considered as a common cause of cancer mortality. The disease represents the second and third causes of deaths from cancer among Iranian women and men, respectively. The present study aimed to evaluate the spatial variations in relative risk of lung cancer mortality in Iran and its relation to common risk factors between men and women and specific risk factors among women.
Methods: In this ecological study, the lung cancer mortality data were analyzed in Iran during 2011– 2014. Besag, York, and Mollie’s (BYM) model and shared component model (SCM) were used to compare the spatial variations of the relative risk of lung cancer mortality by applying OpenBUGS version 3.2.3 and R version 3.6.1.
Results: The median age for death due to lung cancer in Iran is 74 years. During 2011– 2014, the age-standardized lung cancer mortality rates among men and women were 12 and 5 per 100,000 individuals, respectively. In addition, almost similar spatial patterns were observed for both men and women. Further, risk factors, which are shared between men and women, were considered as the main cause of variation of lung cancer mortality relative risk in the regions under study for both men and women. The highest impact of the women-specific risk factors was estimated in northeastern and southwestern of the country while the lowest was related to Gilan province in northern part of Iran.
Conclusion: Based on the spatial pattern, lung cancer risk factors are at relatively high levels in most parts of Iran, especially in the northwest of the country. Regarding the women, the high-risk regions were considerably extended. Further, the highest concentration of the specific risk factors among women was observed in the eastern, central, and southwestern parts. The smoking effect, and the second-smoking effect and environmental pollutions could play more significant roles for men and women, respectively.

Keywords: ecological study, age-standardized mortality rate, BYM model, shared component model

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