Ovarian Cancer in Iran: National Based Study
Abstract
Background: Ovarian cancer (OC) is the 7th most common cancer, with 239,000 new cases per year. In Iran, it is the 8th most common cancer, with an ASIR of 3.9/100,000 women. The 5-year overall survival in Iran based on previous studies is about 61% which in comparison with eastern countries has better survival.
Methods: The study included patients from the Iran National Cancer Registry from 2009-2014. Several steps were taken to control data quality. This study used a Kaplan-Meier survival curve to compare OC survival rates across geographical, pathological, and other variables. All analyses were done in R (4.02) and SPSS (26), with a 0.05 P-value considered statistically significant.
Results: The study enrolled 7977 cases of OC. OC's ASIR was 4.10/100,000. In epithelial and non-specific OC, ASIR was >0.5. Five-year survival was 55% and 10-year survival was 45%.
Conclusion: OC is the 8th most common cancer in Iran, with lower age-specific incidence and better overall survival than East Asia and North America. In Iran, as in Eastern Europe, OC incidence correlated with reduced total fertility rate and population aging. Five and 10-year overall survival rates were 55% and 44%, respectively, higher than the West. This may be because late stage OC patients are excluded from pathology and classified as “undiagnosed” in death certificates or hospitalization files.
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13. Kjærbye-Thygesen A, Huusom LD, Frederiksen K, et al (2005). Trends in the incidence and mortality of ovarian cancer in Denmark 1978-2002. Comparison with other Nordic countries. Acta Obstet Gynecol Scand ,84(10):1006-12.
14. La Vecchia C, Levi F, Lucchini F, et al (1992). Descriptive epidemiology of ovarian cancer in Europe. Gynecol Oncol, 46(2):208-15.
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16. Doufekas, K., & Olaitan, A. (2014). Clinical epidemiology of epithelial ovarian cancer in the UK. Int J Womens Health, 537-545.
17. Mohammadi G, Akbari ME, Mehrabi Y, et al (2016). Estimating Completeness of Cancer Registration in Iran with Capture-Recapture Methods. Asian Pac J Cancer Prev,17(S3):93-9.
18. Ahmad OB, Boschi-Pinto C, Lopez AD, et al (2001). Age standardization of rates: a new WHO standard. Geneva: World Health Organization,9(10):1-4.
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22. Razi S, Ghoncheh M, Mohammadian-Hafshejani A, et al (2016). The incidence and mortality of ovarian cancer and their relationship with the Human Development Index in Asia. Ecancermedicalscience,10:628.
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25. Wang Y, Mang M, Wang Y, et al (2015). Tubal origin of ovarian endometriosis and clear cell and endometrioid carcinoma. Am J Cancer Res,5(3):869-279.
26. Aziz MF (2009). Gynecological cancer in Indonesia. J Gynecol Oncol, 20(1):8-10.
27. Matz M, Coleman MP, Sant M, et al (2017). The histology of ovarian cancer: worldwide distribution and implications for international survival comparisons (CONCORD-2). Gynecol Oncol,144(2):405-413.
28. Sung P-L, Chang Y-H, Chao K-C, et al (2014). Global distribution pattern of histological subtypes of epithelial ovarian cancer: a database analysis and systematic review. Gynecol Oncol,133(2):147-54.
29. Torre LA, Trabert B, DeSantis CE, et al (2018). Ovarian cancer statistics, 2018. CA Cancer J Clin,68(4):284-296.
30. Jacoby VL, Fujimoto VY, Giudice LC, et al (2010). Racial and ethnic disparities in benign gynecologic conditions and associated surgeries. Am J Obstet Gynecol,202(6):514-21.
31. Harrison M, Jameson C, Gore M (2008). Mucinous ovarian cancer. Int J Gynecol Cancer, 18(2):209-14.
32. Rahman R, Asombang AW, Ibdah JA (2014). Characteristics of gastric cancer in Asia. World J Gastroenterol,20(16):4483-4490.
33. Zhang Y, Luo G, Li M, et al (2019). Global patterns and trends in ovarian cancer incidence: age, period and birth cohort analysis. BMC Cancer,19(1):984.
34. UN Population Division. (2015). World Population Prospects: The 2015 Revision, Key Findings and Advance Tables. Working Paper No. ESA/P/WP. 241.
35. Oberaigner W, Minicozzi P, Bielska-Lasota M, et al (2012). Survival for ovarian cancer in Europe: the across-country variation did not shrink in the past decade. Acta Oncol,51(4):441-53.
36. Statistical Center of Iran(2019). Available from: www.amar.org.ir
37. Murray CJ, Callender CS, Kulikoff XR, et al (2018). Population and fertility by age and sex for 195 countries and territories, 1950–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet,392(10159):1995-2051.
38. Fathalla M (1971). Incessant ovulation—a factor in ovarian neoplasia. Lancet, 2(7716):163.
39. Yamagami W, Nagase S, Takahashi F, et al (2016). Clinical statistics of gynecologic cancers in Japan. J Gynecol Oncol, 28(2):e32.
40. Momenimovahed Z, Tiznobaik A, Taheri S, et al (2019). Ovarian cancer in the world: epidemiology and risk factors. Int J Womens Health, 11:287-299.
41. Tsukuma H, Ajiki W, Ioka A, Oshima A (2006). Survival of cancer patients diagnosed between 1993 and 1996: a collaborative study of population-based cancer registries in Japan. Jpn J Clin Oncol,36(9):602-7.
42. Ries LA, Eisner MP, Kosary CL, et al (2003). SEER cancer statistics review, 1975–2000. Bethesda, MD: National Cancer Institute,2.
43. D O'Malley C, Cress RD, Campleman SL, et al (2003). Survival of Californian women with epithelial ovarian cancer, 1994–1996: a population-based study. Gynecol Oncol, 91(3):608-15.
44. Schiff M, Becker TM, Smith HO, et al (1996). Ovarian cancer incidence and mortality in American Indian, Hispanic, and non-Hispanic white women in New Mexico. Cancer Epidemiol Biomarkers Prev,5(5):323-7.
45. Loka A, Tsukuma H, Ajiki W, et al (2003). Ovarian cancer incidence and survival by histologic type in Osaka, Japan. Cancer Sci,94(3):292-6.
46. Modirian M, Rahimzadeh S, Cheraghi Z, et al (2014). Quality evaluation of national cancer registry system in Iran: study protocol. Arch Iran Med ,17(3):193-7.
2. Hannaford PC, Selvaraj S, Elliott AM, et al (2007). Cancer risk among users of oral contraceptives: cohort data from the Royal College of General Practitioner's oral contraception study. BMJ ,335(7621):651.
3. Akbari ME, Abachizadeh K, Khaiamzadeh M. (2008). Cancer in Iran. 1st ed. Cancer Research Center, Shahid Beheshti University of Medical Sciences.pp.:97-114
4. Arab M, Khayamzadeh M, Tehranian A, et al (2010). Incidence rate of ovarian cancer in Iran in comparison with developed countries. Indian J Cancer,47(3):322-7.
5. Takiar R (2019). Status of ovarian cancer in India (2012–14). EC Gynaecology,8:358-64.
6. Rahmani K M-LM, Mansori K, Bidokhti F , et al (2018). Global Inequalities in Incidence and Mortality of Ovarian Cancer and Associated Factors: An Ecological Study. SM J Neurol Disord Stroke,4(1):1016s3.
7. Arab M, Khayamzadeh M, Mohit M, et al (2009). Survival of ovarian cancer in Iran: 2000-2004. Asian Pac J Cancer Prev,10(4):555-8.
8. Berek JS. Berek MA (2017). Novak's gynecology. Gynecologic Oncology.16th ed. Lippincott Williams & Wilkins, USA.
9. Howlader N (2011). SEER Cancer Statistics Review, 1975-2008, National Cancer Institute, Bethesda, MD. Available from: https://seer.cancer.gov/archive/csr/1975_2008/. based on November 2010 SEER data submission.
10. Ries L, Eisner M, Kosary C, Hankey B, Miller B, Clegg L, et al(2001). SEER cancer statistics review, 1973-1998, National Cancer Institute.Available from: https://seer.cancer.gov/archive/csr/1973_1996/overview.pdf
11. Laurvick CL, Semmens JB, Holman CDAJ, et al (2003). Ovarian cancer in Western Australia (1982–98): incidence, mortality and survival. Aust N Z J Public Health,27(6):588-95.
12. Myers T, Moore K, Cofer A, et al (2007). Advanced ovarian cancer: Is cure a reasonable expectation? Gynecologic Oncology,107(2):371.
13. Kjærbye-Thygesen A, Huusom LD, Frederiksen K, et al (2005). Trends in the incidence and mortality of ovarian cancer in Denmark 1978-2002. Comparison with other Nordic countries. Acta Obstet Gynecol Scand ,84(10):1006-12.
14. La Vecchia C, Levi F, Lucchini F, et al (1992). Descriptive epidemiology of ovarian cancer in Europe. Gynecol Oncol, 46(2):208-15.
15. Fritz A, Percy C, Jack A, Shanmugaratnam K, Sobin LH, Parkin DM, et al (2000). International classification of diseases for oncology / editors, April Fritz. 3rd ed. Geneva: World Health Organization.Available from: https://apps.who.int/iris/handle/10665/42344
16. Doufekas, K., & Olaitan, A. (2014). Clinical epidemiology of epithelial ovarian cancer in the UK. Int J Womens Health, 537-545.
17. Mohammadi G, Akbari ME, Mehrabi Y, et al (2016). Estimating Completeness of Cancer Registration in Iran with Capture-Recapture Methods. Asian Pac J Cancer Prev,17(S3):93-9.
18. Ahmad OB, Boschi-Pinto C, Lopez AD, et al (2001). Age standardization of rates: a new WHO standard. Geneva: World Health Organization,9(10):1-4.
19. Jensen, OM (1991). Cancer registration: principles and methods. (Vol. 95). IARC.
20. Smith PG(1992). Comparison between registries: age-standardized rates. Cancer incidence in five continents. 865-70.
21. Collaboration GBoDC (2019). Global, regional, and national cancer incidence, mortality, years of life lost, years lived with disability, and disability-adjusted life-years for 29 cancer groups, 1990 to 2017: a systematic analysis for the global burden of disease study. JAMA oncol, 5(12):1749-1768.
22. Razi S, Ghoncheh M, Mohammadian-Hafshejani A, et al (2016). The incidence and mortality of ovarian cancer and their relationship with the Human Development Index in Asia. Ecancermedicalscience,10:628.
23. Sung H, Ferlay J, Siegel RL, et al (2021). Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin,71(3):209-249.
24. Bhatla N, Jones A(2018). The world ovarian cancer coalition atlas. Available from: https://worldovariancancercoalition.org/wp-content/uploads/2018/10/THE-WORLD-OVARIAN-CANCER-COALITION-ATLAS-2018
25. Wang Y, Mang M, Wang Y, et al (2015). Tubal origin of ovarian endometriosis and clear cell and endometrioid carcinoma. Am J Cancer Res,5(3):869-279.
26. Aziz MF (2009). Gynecological cancer in Indonesia. J Gynecol Oncol, 20(1):8-10.
27. Matz M, Coleman MP, Sant M, et al (2017). The histology of ovarian cancer: worldwide distribution and implications for international survival comparisons (CONCORD-2). Gynecol Oncol,144(2):405-413.
28. Sung P-L, Chang Y-H, Chao K-C, et al (2014). Global distribution pattern of histological subtypes of epithelial ovarian cancer: a database analysis and systematic review. Gynecol Oncol,133(2):147-54.
29. Torre LA, Trabert B, DeSantis CE, et al (2018). Ovarian cancer statistics, 2018. CA Cancer J Clin,68(4):284-296.
30. Jacoby VL, Fujimoto VY, Giudice LC, et al (2010). Racial and ethnic disparities in benign gynecologic conditions and associated surgeries. Am J Obstet Gynecol,202(6):514-21.
31. Harrison M, Jameson C, Gore M (2008). Mucinous ovarian cancer. Int J Gynecol Cancer, 18(2):209-14.
32. Rahman R, Asombang AW, Ibdah JA (2014). Characteristics of gastric cancer in Asia. World J Gastroenterol,20(16):4483-4490.
33. Zhang Y, Luo G, Li M, et al (2019). Global patterns and trends in ovarian cancer incidence: age, period and birth cohort analysis. BMC Cancer,19(1):984.
34. UN Population Division. (2015). World Population Prospects: The 2015 Revision, Key Findings and Advance Tables. Working Paper No. ESA/P/WP. 241.
35. Oberaigner W, Minicozzi P, Bielska-Lasota M, et al (2012). Survival for ovarian cancer in Europe: the across-country variation did not shrink in the past decade. Acta Oncol,51(4):441-53.
36. Statistical Center of Iran(2019). Available from: www.amar.org.ir
37. Murray CJ, Callender CS, Kulikoff XR, et al (2018). Population and fertility by age and sex for 195 countries and territories, 1950–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet,392(10159):1995-2051.
38. Fathalla M (1971). Incessant ovulation—a factor in ovarian neoplasia. Lancet, 2(7716):163.
39. Yamagami W, Nagase S, Takahashi F, et al (2016). Clinical statistics of gynecologic cancers in Japan. J Gynecol Oncol, 28(2):e32.
40. Momenimovahed Z, Tiznobaik A, Taheri S, et al (2019). Ovarian cancer in the world: epidemiology and risk factors. Int J Womens Health, 11:287-299.
41. Tsukuma H, Ajiki W, Ioka A, Oshima A (2006). Survival of cancer patients diagnosed between 1993 and 1996: a collaborative study of population-based cancer registries in Japan. Jpn J Clin Oncol,36(9):602-7.
42. Ries LA, Eisner MP, Kosary CL, et al (2003). SEER cancer statistics review, 1975–2000. Bethesda, MD: National Cancer Institute,2.
43. D O'Malley C, Cress RD, Campleman SL, et al (2003). Survival of Californian women with epithelial ovarian cancer, 1994–1996: a population-based study. Gynecol Oncol, 91(3):608-15.
44. Schiff M, Becker TM, Smith HO, et al (1996). Ovarian cancer incidence and mortality in American Indian, Hispanic, and non-Hispanic white women in New Mexico. Cancer Epidemiol Biomarkers Prev,5(5):323-7.
45. Loka A, Tsukuma H, Ajiki W, et al (2003). Ovarian cancer incidence and survival by histologic type in Osaka, Japan. Cancer Sci,94(3):292-6.
46. Modirian M, Rahimzadeh S, Cheraghi Z, et al (2014). Quality evaluation of national cancer registry system in Iran: study protocol. Arch Iran Med ,17(3):193-7.
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| Issue | Vol 52 No 4 (2023) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/ijph.v52i4.12453 | |
| Keywords | ||
| Ovarian cancer Epidemiology Iran | ||
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How to Cite
1.
Akbari A, Azizmohammad Looha M, Moradi A, Akbari ME. Ovarian Cancer in Iran: National Based Study. Iran J Public Health. 2023;52(4):797-808.
