Age at Diagnosis of Breast Cancer in Iran: A Systematic Review and Meta-Analysis
-
Mahasti Alizadeh
,
Morteza Ghojazadeh
,
Reza Piri
,
Mohammad Mirza-Aghazadeh-Attari
,
Sahar Mohammadi
,
Mohammad Naghavi-Behzad
Abstract
Background: Breast cancer is responsible for up to 25% of all cancers in Iran. The age at diagnosis of Iranian breast cancer patients starts a decade earlier than most of developed countries. This study aimed to evaluate the mean age at diagnosis of Iranian breast cancer patients.
Methods: In this systematic review and meta-analysis, the mean age at diagnosis of Iranian breast cancer patients and its pattern between 2008 and 2017, were evaluated. All papers with age at diagnosis of histopathological verified breast cancer patients were considered eligible to enter to the analysis. We used databases including Medline/PubMed, Scopus, Embase, Cochrane Library, Iranmedex and SID for the search process. The meta-analysis was performed only on studies with separate data for female patients, using random-effects model, Mantel and Haenszel method and the Comprehensive Meta-analysis software.
Results: Finally, 92 studies with 19,784 patients (both-genders) were included. The mean age at diagnosis had increased from 47.93 (2008) to 49.91 (2016) years. The meta-analysis was done on 78 studies containing of 15,071 female patients and the mean age at diagnosis was 46.76±1.19. There was a wide range of age at diagnosis within different provinces. The mean age at Hamadan and Khuzestan provinces were the lowest and highest, respectively (42.48±7.96 vs. 51.00±11.47). The heterogeneity of studies was statistically significant (I2=99.744).
Conclusion: Mean age at diagnosis of Iranian women with breast cancer was 46.76±1.19. There was an increasing pattern in mean age of diagnosis at breast cancer patients within the past 10 years.
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2. Wahba HA, El-Hadaad HA (2015). Current approaches in treatment of triple-negative breast cancer. Cancer Biol Med, 12(2):106-116.
3. Al Qadire M, Alkhalaileh M, Hedaya H (2018). Risk Factors for Breast Cancer among Jordanian Women: A Case-control Study. Iran J Public Health, 47(1):49-56.
4. Vostakolaei FA, Broeders MJ, Rostami N, et al (2012). Age at diagnosis and breast cancer survival in Iran. Int J Breast Cancer, 2012:517976.
5. Mousavi SM, Montazeri A, Mohagheghi MA, et al (2007). Breast cancer in Iran: an epidemiological review. Breast J, 13(4):383-91.
6. Abedi G, Janbabai G, Moosazadeh M, et al (2016). Survival rate of breast cancer in Iran: a meta-analysis. Asian Pac J Cancer Prev, 17(10):4615-4621.
7. DeSantis C, Ma J, Bryan L, Jemal A (2014). Breast cancer statistics, 2013. CA Cancer J Clin, 64(1):52-62.
8. Smink DS (2015). Schwartz's Principles of Surgery. Ann Surg, 261(5):1026.
9. Friedewald SM, Rafferty EA, Rose SL, et al (2014). Breast cancer screening using tomosynthesis in combination with digi-tal mammography. JAMA, 311(24):2499-507.
10. Oeffinger KC, Fontham ET, Etzioni R, et al (2015). Breast cancer screening for wom-en at average risk: 2015 guideline update from the American Cancer Society. JA-MA, 314(15):1599-614.
11. Harirchi I, Ebrahimi M, Zamani N, et al (2000). Breast cancer in Iran: a review of 903 case records. Public health, 114(2):143-5.
12. Najjar H, Easson A (2010). Age at diagnosis of breast cancer in Arab nations. Int J Surg, 8(6):448-52.
13. Sant M, Gatta G, Micheli A, et al (1991). Survival and age at diagnosis of breast cancer in a population-based cancer reg-istry. Eur J Cancer, 27(8):981-4.
14. Parvizpour S, Razmara J, Omidi Y (2018). Breast cancer vaccination comes to age: impacts of bioinformatics. BioImpacts, 8(3):223-235.
15. Harford JB (2011). Breast-cancer early detec-tion in low-income and middle-income countries: do what you can versus one size fits all. Lancet Oncol, 12(3):306-12.
16. Ziaei JE, Dastgiri S, Vaez J, et al (2011). Age Pattern of the Occurrence of Breast Can-cer in the Northwest of Iran. Indian J Can-cer, 48(4):406-9.
17. Fouladi N, Amani F, Harghi AS, et al (2011). Five year survival of women with breast cancer in Ardabil, north-west of Iran. Asian Pac J Cancer Prev, 12(7):1799-801.
18. Vostakolaei FA, Broeders MJ, Mousavi SM, et al (2013). The effect of demographic and lifestyle changes on the burden of breast cancer in Iranian women: A pro-jection to 2030. Breast, 22(3):277-81.
19. Zahmatkesh B, Keramat A, Alavi N, et al (2016). Breast Cancer Trend in Iran from 2000 to 2009 and Prediction till 2020 us-ing a Trend Analysis Method. Asian Pac J Cancer Prev, 17(3):1493-8.
20. Moher D, Liberati A, Tetzlaff J, et al (2009). Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med, 6(7):e1000097.
21. Shamseer L, Moher D, Clarke M, et al (2015). Preferred reporting items for sys-tematic review and meta-analysis proto-cols (PRISMA-P) 2015: elaboration and explanation. BMJ, 349:g7647.
22. Whiting PF, Sterne JA (2012). The Revised QUADAS-2 Tool. Ann Intern Med, 156(4):323-4.
23. Hozo SP, Djulbegovic B, Hozo I (2005). Es-timating the mean and variance from the median, range, and the size of a sample. BMC Med Res Methodol, 5:13.
24. Sterne J, Egger M, Smith G (2001). System-atic reviews in health care: Investigating and dealing with publication and other biases in meta-analysis. BMJ, 323 (7304): 101-5.
25. Sterne JA, Egger M (2001). Funnel plots for detecting bias in meta-analysis: guidelines on choice of axis. J Clin Epidemiol, 54(10):1046-55.
26. Higgins JP, Thompson SG, Deeks JJ, Alt-man DG (2003). Measuring inconsistency in meta-analyses. BMJ, 327(7414):557-60.
27. Moradzadeh R, Mansournia MA, Baghfalaki T, et al (2015). Misclassification adjust-ment of family history of breast cancer in a case-control study: a Bayesian ap-proach. Asian Pac J Cancer Prev, 16(18):8221-6.
28. Ghiasvand R, Maram ES, Tahmasebi S, et al (2011). Risk factors for breast cancer among young women in southern Iran. Int J Cancer, 129(6):1443-9.
29. Mohammadianpanah M, Ashouri Y, Ho-seini S, et al (2012). The efficacy and safe-ty of neoadjuvant chemotherapy+/− let-rozole in postmenopausal women with locally advanced breast cancer: a random-ized phase III clinical trial. Breast Cancer Res Treat, 132(3):853-61.
30. Sedghi M, Esfandiari E, Fazel-Najafabadi E, et al (2016). Genomic rearrangement screening of the BRCA1 from seventy Iranian high-risk breast cancer families. J Res Med Sci, 21:95.
31. Payandeh M, Sadeghi M, Sadeghi E, et al (2017). Is there any concordance between of IHC with FISH in HER2-positive breast cancer patients? Int J Hematol Oncol Stem Cell Res, 11(1):43-48.
32. Parkin DM (2008). The role of cancer regis-tries in cancer control. Int J Clin Oncol, 13(2):102-11.
33. Etemadi A, Sadjadi A, Semnani S, et al (2008). Cancer registry in Iran: a brief overview. Arch Iran Med, 11(5):577-80.
34. Gucalp A, Traina TA, Eisner JR, et al (2019). Male breast cancer: a disease distinct from female breast cancer. Breast Cancer Res Treat, 173(1):37-48.
35. Shahraki HR, Salehi A, Zare N (2015). Sur-vival prognostic factors of male breast cancer in Southern Iran: a LASSO-Cox regression approach. Asian Pac J Cancer Prev, 16(15):6773-7.
36. Salehi A, Zeraati H, Mohammad K, et al (2011). Survival of male breast cancer in Fars, South of Iran. Iran Red Crescent Med J, 13(2):99-105.
37. Jazayeri SB, Saadat S, Ramezani R, et al (2015). Incidence of primary breast can-cer in Iran: Ten-year national cancer reg-istry data report. Cancer Epidemiol, 39(4):519-27.
38. Yetkin G, Celayir MF, Tanik C, et al (2019). Male breast cancer: A 10 year retrospec-tive case series in a tertiary care hospital. J Pak Med Assoc, 69(8):1209-1212.
39. Özmen V, Özmen T, Doğru V (2019). Breast Cancer in Turkey; An Analysis of 20.000 Patients with Breast Cancer. Eur J Breast Health, 15(3):141-146.
40. Schlichting JA, Soliman AS, Schairer C, et al (2015). Breast cancer by age at diagnosis in the Gharbiah, Egypt, population-based registry compared to the United States surveillance, epidemiology, and end re-sults program, 2004–2008. BioMed Res Int, 2015:381574.
41. Karim SAM, Ghalib HHA, Mohammed SA, et al (2015). The incidence, age at diagno-sis of breast cancer in the Iraqi Kurdish population and comparison to some other countries of Middle-East and West. Int J Surg, 13:71-75.
42. Lee J, Oh M (2014). Effects of interval be-tween age at first pregnancy and age at diagnosis on breast cancer survival ac-cording to menopausal status: a register-based study in Korea. BMC Women's Health, 14(1):113.
43. Mehdi I, Monem EA, Al Bahrani BJ, et al (2014). Age at diagnosis of female breast cancer in Oman: Issues and implications. South Asian J Cancer, 3(2):101-6.
44. Missaoui N, Landolsi H, Jaidaine L, et al (2012). Breast cancer in Central Tunisia: An Earlier Age at Diagnosis and Inci-dence Increase over a 15 Year Period. Breast J, 18(3):289-91.
45. Franco-Marina F, López-Carrillo L, Keating NL, et al (2015). Breast cancer age at di-agnosis patterns in four Latin American Populations: A comparison with North American countries. Cancer Epidemiol, 39(6):831-7.
46. Salinas-Martinez AM, Juarez-Ruiz A, Mathiew-Quiros A, et al (2014). [Breast cancer in Mexico: a 10-year trend analysis on incidence and age at diagnosis]. Rev Invest Clin, 66(3):210-7.
47. Afsharfard A, Mozaffar M, Orang E, Tah-masbpour E (2013). Trends in epidemi-ology, clinical and histopathological char-acteristics of breast cancer in Iran: results of a 17 year study. Asian Pac J Cancer Prev, 14(11):6905-11.
48. Haghighat S, Akbari M, Ghaffari S, et al (2012). Standardized breast cancer mor-tality rate compared to the general female population of Iran. Asian Pac J Cancer Prev, 13(11):5525-8.
49. Baghestani AR, Shahmirzalou P, Zayeri F, et al (2015). Prognostic factors for survival in patients with breast cancer referred to omitted cancer research center in Iran. Asian Pac J Cancer Prev, 16(12):5081-4.
50. Kadivar M, Mafi N, Joulaee A, et al (2012). Breast cancer molecular subtypes and as-sociations with clinicopathological charac-teristics in Iranian women, 2002-2011. Asian Pac J Cancer Prev, 13(5):1881-6.
51. Harirchi I, Kolahdoozan S, Karbakhsh M, et al (2010). Twenty years of breast cancer in Iran: downstaging without a formal screening program. Ann Oncol, 22(1):93-97.
52. Abdollahi M, Hajizadeh E, Baghestani AR, et al (2016). Determination of a change point in the age at diagnosis of breast cancer using a survival model. Asian Pac J Cancer Prev, 17(S3):5-10.
53. Mousavi SM, Mohagheghi MA, Mousavi-Jerrahi A, et al (2008). Outcome of breast cancer in Iran: a study of Tehran Cancer Registry data. Asian Pac J Cancer Prev, 9(2):275-8.
54. Najafi B, Anvari S, Roshan ZA (2013). Dis-ease free survival among molecular sub-types of early stage breast cancer between 2001 and 2010 in Iran. Asian Pac J Cancer Prev, 14(10):5811-6.
55. Taheri NS, Nosrat SB, Aarabi M, et al (2012). Epidemiological pattern of breast cancer in Iranian women: is there an eth-nic disparity? Asian Pac J Cancer Prev, 13(9):4517-20.
56. Fallahzadeh H, Momayyezi M, Akhundzar-deini R, et al (2014). Five year survival of women with breast cancer in Yazd. Asian Pac J Cancer Prev, 15(16):6597-601.
57. Heydari ST, Mehrabani D, Tabei S, et al (2009). Survival of breast cancer in south-ern Iran. Iranian Journal of Cancer Prevention, 2(1):51-54.
58. Ghavami V, Mahmoudi M, Foroushani AR, et al (2017). Long-Term Disease-Free Survival of Non-Metastatic Breast Cancer Patients in Iran: A Survival Model with Competing Risks Taking Cure Fraction and Frailty into Account. Asian Pac J Can-cer Prev, 18(10):2825-2532.
59. Lakzaei M, Salarilak S, Khalkhali HR, et al (2015). Association between age of mor-bidity and prognosis of breast breast cancer. Stud Med Sci, 26(7):625-33.
60. Sinaga ES, Ahmad RA, Shivalli S, et al (2018). Age at diagnosis predicted surviv-al outcome of female patients with breast cancer at a tertiary hospital in Yogyakarta, Indonesia. Pan Afr Med J, 31:163.
61. Bab S, Abdifard E, Elyasianfar S, et al (2019). Time trend analysis of breast can-cer in Iran and its six topographical re-gions: a population-based study. J Med Life, 12(2):140-149.
2. Wahba HA, El-Hadaad HA (2015). Current approaches in treatment of triple-negative breast cancer. Cancer Biol Med, 12(2):106-116.
3. Al Qadire M, Alkhalaileh M, Hedaya H (2018). Risk Factors for Breast Cancer among Jordanian Women: A Case-control Study. Iran J Public Health, 47(1):49-56.
4. Vostakolaei FA, Broeders MJ, Rostami N, et al (2012). Age at diagnosis and breast cancer survival in Iran. Int J Breast Cancer, 2012:517976.
5. Mousavi SM, Montazeri A, Mohagheghi MA, et al (2007). Breast cancer in Iran: an epidemiological review. Breast J, 13(4):383-91.
6. Abedi G, Janbabai G, Moosazadeh M, et al (2016). Survival rate of breast cancer in Iran: a meta-analysis. Asian Pac J Cancer Prev, 17(10):4615-4621.
7. DeSantis C, Ma J, Bryan L, Jemal A (2014). Breast cancer statistics, 2013. CA Cancer J Clin, 64(1):52-62.
8. Smink DS (2015). Schwartz's Principles of Surgery. Ann Surg, 261(5):1026.
9. Friedewald SM, Rafferty EA, Rose SL, et al (2014). Breast cancer screening using tomosynthesis in combination with digi-tal mammography. JAMA, 311(24):2499-507.
10. Oeffinger KC, Fontham ET, Etzioni R, et al (2015). Breast cancer screening for wom-en at average risk: 2015 guideline update from the American Cancer Society. JA-MA, 314(15):1599-614.
11. Harirchi I, Ebrahimi M, Zamani N, et al (2000). Breast cancer in Iran: a review of 903 case records. Public health, 114(2):143-5.
12. Najjar H, Easson A (2010). Age at diagnosis of breast cancer in Arab nations. Int J Surg, 8(6):448-52.
13. Sant M, Gatta G, Micheli A, et al (1991). Survival and age at diagnosis of breast cancer in a population-based cancer reg-istry. Eur J Cancer, 27(8):981-4.
14. Parvizpour S, Razmara J, Omidi Y (2018). Breast cancer vaccination comes to age: impacts of bioinformatics. BioImpacts, 8(3):223-235.
15. Harford JB (2011). Breast-cancer early detec-tion in low-income and middle-income countries: do what you can versus one size fits all. Lancet Oncol, 12(3):306-12.
16. Ziaei JE, Dastgiri S, Vaez J, et al (2011). Age Pattern of the Occurrence of Breast Can-cer in the Northwest of Iran. Indian J Can-cer, 48(4):406-9.
17. Fouladi N, Amani F, Harghi AS, et al (2011). Five year survival of women with breast cancer in Ardabil, north-west of Iran. Asian Pac J Cancer Prev, 12(7):1799-801.
18. Vostakolaei FA, Broeders MJ, Mousavi SM, et al (2013). The effect of demographic and lifestyle changes on the burden of breast cancer in Iranian women: A pro-jection to 2030. Breast, 22(3):277-81.
19. Zahmatkesh B, Keramat A, Alavi N, et al (2016). Breast Cancer Trend in Iran from 2000 to 2009 and Prediction till 2020 us-ing a Trend Analysis Method. Asian Pac J Cancer Prev, 17(3):1493-8.
20. Moher D, Liberati A, Tetzlaff J, et al (2009). Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med, 6(7):e1000097.
21. Shamseer L, Moher D, Clarke M, et al (2015). Preferred reporting items for sys-tematic review and meta-analysis proto-cols (PRISMA-P) 2015: elaboration and explanation. BMJ, 349:g7647.
22. Whiting PF, Sterne JA (2012). The Revised QUADAS-2 Tool. Ann Intern Med, 156(4):323-4.
23. Hozo SP, Djulbegovic B, Hozo I (2005). Es-timating the mean and variance from the median, range, and the size of a sample. BMC Med Res Methodol, 5:13.
24. Sterne J, Egger M, Smith G (2001). System-atic reviews in health care: Investigating and dealing with publication and other biases in meta-analysis. BMJ, 323 (7304): 101-5.
25. Sterne JA, Egger M (2001). Funnel plots for detecting bias in meta-analysis: guidelines on choice of axis. J Clin Epidemiol, 54(10):1046-55.
26. Higgins JP, Thompson SG, Deeks JJ, Alt-man DG (2003). Measuring inconsistency in meta-analyses. BMJ, 327(7414):557-60.
27. Moradzadeh R, Mansournia MA, Baghfalaki T, et al (2015). Misclassification adjust-ment of family history of breast cancer in a case-control study: a Bayesian ap-proach. Asian Pac J Cancer Prev, 16(18):8221-6.
28. Ghiasvand R, Maram ES, Tahmasebi S, et al (2011). Risk factors for breast cancer among young women in southern Iran. Int J Cancer, 129(6):1443-9.
29. Mohammadianpanah M, Ashouri Y, Ho-seini S, et al (2012). The efficacy and safe-ty of neoadjuvant chemotherapy+/− let-rozole in postmenopausal women with locally advanced breast cancer: a random-ized phase III clinical trial. Breast Cancer Res Treat, 132(3):853-61.
30. Sedghi M, Esfandiari E, Fazel-Najafabadi E, et al (2016). Genomic rearrangement screening of the BRCA1 from seventy Iranian high-risk breast cancer families. J Res Med Sci, 21:95.
31. Payandeh M, Sadeghi M, Sadeghi E, et al (2017). Is there any concordance between of IHC with FISH in HER2-positive breast cancer patients? Int J Hematol Oncol Stem Cell Res, 11(1):43-48.
32. Parkin DM (2008). The role of cancer regis-tries in cancer control. Int J Clin Oncol, 13(2):102-11.
33. Etemadi A, Sadjadi A, Semnani S, et al (2008). Cancer registry in Iran: a brief overview. Arch Iran Med, 11(5):577-80.
34. Gucalp A, Traina TA, Eisner JR, et al (2019). Male breast cancer: a disease distinct from female breast cancer. Breast Cancer Res Treat, 173(1):37-48.
35. Shahraki HR, Salehi A, Zare N (2015). Sur-vival prognostic factors of male breast cancer in Southern Iran: a LASSO-Cox regression approach. Asian Pac J Cancer Prev, 16(15):6773-7.
36. Salehi A, Zeraati H, Mohammad K, et al (2011). Survival of male breast cancer in Fars, South of Iran. Iran Red Crescent Med J, 13(2):99-105.
37. Jazayeri SB, Saadat S, Ramezani R, et al (2015). Incidence of primary breast can-cer in Iran: Ten-year national cancer reg-istry data report. Cancer Epidemiol, 39(4):519-27.
38. Yetkin G, Celayir MF, Tanik C, et al (2019). Male breast cancer: A 10 year retrospec-tive case series in a tertiary care hospital. J Pak Med Assoc, 69(8):1209-1212.
39. Özmen V, Özmen T, Doğru V (2019). Breast Cancer in Turkey; An Analysis of 20.000 Patients with Breast Cancer. Eur J Breast Health, 15(3):141-146.
40. Schlichting JA, Soliman AS, Schairer C, et al (2015). Breast cancer by age at diagnosis in the Gharbiah, Egypt, population-based registry compared to the United States surveillance, epidemiology, and end re-sults program, 2004–2008. BioMed Res Int, 2015:381574.
41. Karim SAM, Ghalib HHA, Mohammed SA, et al (2015). The incidence, age at diagno-sis of breast cancer in the Iraqi Kurdish population and comparison to some other countries of Middle-East and West. Int J Surg, 13:71-75.
42. Lee J, Oh M (2014). Effects of interval be-tween age at first pregnancy and age at diagnosis on breast cancer survival ac-cording to menopausal status: a register-based study in Korea. BMC Women's Health, 14(1):113.
43. Mehdi I, Monem EA, Al Bahrani BJ, et al (2014). Age at diagnosis of female breast cancer in Oman: Issues and implications. South Asian J Cancer, 3(2):101-6.
44. Missaoui N, Landolsi H, Jaidaine L, et al (2012). Breast cancer in Central Tunisia: An Earlier Age at Diagnosis and Inci-dence Increase over a 15 Year Period. Breast J, 18(3):289-91.
45. Franco-Marina F, López-Carrillo L, Keating NL, et al (2015). Breast cancer age at di-agnosis patterns in four Latin American Populations: A comparison with North American countries. Cancer Epidemiol, 39(6):831-7.
46. Salinas-Martinez AM, Juarez-Ruiz A, Mathiew-Quiros A, et al (2014). [Breast cancer in Mexico: a 10-year trend analysis on incidence and age at diagnosis]. Rev Invest Clin, 66(3):210-7.
47. Afsharfard A, Mozaffar M, Orang E, Tah-masbpour E (2013). Trends in epidemi-ology, clinical and histopathological char-acteristics of breast cancer in Iran: results of a 17 year study. Asian Pac J Cancer Prev, 14(11):6905-11.
48. Haghighat S, Akbari M, Ghaffari S, et al (2012). Standardized breast cancer mor-tality rate compared to the general female population of Iran. Asian Pac J Cancer Prev, 13(11):5525-8.
49. Baghestani AR, Shahmirzalou P, Zayeri F, et al (2015). Prognostic factors for survival in patients with breast cancer referred to omitted cancer research center in Iran. Asian Pac J Cancer Prev, 16(12):5081-4.
50. Kadivar M, Mafi N, Joulaee A, et al (2012). Breast cancer molecular subtypes and as-sociations with clinicopathological charac-teristics in Iranian women, 2002-2011. Asian Pac J Cancer Prev, 13(5):1881-6.
51. Harirchi I, Kolahdoozan S, Karbakhsh M, et al (2010). Twenty years of breast cancer in Iran: downstaging without a formal screening program. Ann Oncol, 22(1):93-97.
52. Abdollahi M, Hajizadeh E, Baghestani AR, et al (2016). Determination of a change point in the age at diagnosis of breast cancer using a survival model. Asian Pac J Cancer Prev, 17(S3):5-10.
53. Mousavi SM, Mohagheghi MA, Mousavi-Jerrahi A, et al (2008). Outcome of breast cancer in Iran: a study of Tehran Cancer Registry data. Asian Pac J Cancer Prev, 9(2):275-8.
54. Najafi B, Anvari S, Roshan ZA (2013). Dis-ease free survival among molecular sub-types of early stage breast cancer between 2001 and 2010 in Iran. Asian Pac J Cancer Prev, 14(10):5811-6.
55. Taheri NS, Nosrat SB, Aarabi M, et al (2012). Epidemiological pattern of breast cancer in Iranian women: is there an eth-nic disparity? Asian Pac J Cancer Prev, 13(9):4517-20.
56. Fallahzadeh H, Momayyezi M, Akhundzar-deini R, et al (2014). Five year survival of women with breast cancer in Yazd. Asian Pac J Cancer Prev, 15(16):6597-601.
57. Heydari ST, Mehrabani D, Tabei S, et al (2009). Survival of breast cancer in south-ern Iran. Iranian Journal of Cancer Prevention, 2(1):51-54.
58. Ghavami V, Mahmoudi M, Foroushani AR, et al (2017). Long-Term Disease-Free Survival of Non-Metastatic Breast Cancer Patients in Iran: A Survival Model with Competing Risks Taking Cure Fraction and Frailty into Account. Asian Pac J Can-cer Prev, 18(10):2825-2532.
59. Lakzaei M, Salarilak S, Khalkhali HR, et al (2015). Association between age of mor-bidity and prognosis of breast breast cancer. Stud Med Sci, 26(7):625-33.
60. Sinaga ES, Ahmad RA, Shivalli S, et al (2018). Age at diagnosis predicted surviv-al outcome of female patients with breast cancer at a tertiary hospital in Yogyakarta, Indonesia. Pan Afr Med J, 31:163.
61. Bab S, Abdifard E, Elyasianfar S, et al (2019). Time trend analysis of breast can-cer in Iran and its six topographical re-gions: a population-based study. J Med Life, 12(2):140-149.
| Files | ||
| Issue | Vol 50 No 8 (2021) | |
| Section | Review Article(s) | |
| DOI | https://doi.org/10.18502/ijph.v50i8.6802 | |
| Keywords | ||
| Age at diagnosis Breast cancer Iran Meta-analysis | ||
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How to Cite
1.
Alizadeh M, Ghojazadeh M, Piri R, Mirza-Aghazadeh-Attari M, Mohammadi S, Naghavi-Behzad M. Age at Diagnosis of Breast Cancer in Iran: A Systematic Review and Meta-Analysis. Iran J Public Health. 2021;50(8):1564-1576.
