Association between Socioeconomic Factors and the Risk of Gastric Cancer Incidence: Results from an Ecological Study
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Abstract
Background: Gastric cancer (GC), one of the most common cancer worldwide, remains the third leading cause of cancer-related mortality. The etiology of GC may arise from genetic and environmental factors. This study aimed to determine the association between GC incidence and socioeconomic status in Iran.
Methods: An ecological study was designed to investigate the relationship between socioeconomic factors and the risk of GC incidence. The data of socioeconomic variables such as income changes, unemployment rate, urbanization ratio, inflation rate, and air pollution changes in 31 provinces were collected from the Statistical Center of Iran, and the data of GC of 31 provinces were provided from the Iranian National Population-based Cancer Registry (INPCR). Data from 2014 to 2017 was analyzed using panel data analysis, the fixed effects model by EViews software.
Results: Panel data model was suitable for the present study. Results showed that there was a positive and significant relationship between GC incidence and socioeconomic factors including income changes (P≤ 0.001), unemployment rate (P≤0.01), inflation rate (P≤ 0.05), and air pollution changes (P≤ 0.001). The urbanization ratio showed a negative relationship and was not statistically associated with GC incidence (P> 0.05).
Conclusion: Our findings suggest a positive and significant association between socioeconomic status and GC incidence, proposing a GC risk factor. The key public health policies and welfare policies' priority should therefore be to schedule for the GC management.
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13. Malaty HM, Nyren O (2003). Epidemiology of Helicobacter pylori infection. Helicobacter, 8:8-12.
14. Merletti F, Galassi C, Spadea T (2011). The socioeconomic determinants of cancer. Environ Health, 10(Suppl 1):S7.
15. Babaie M (2020). The effect of health indicators and macroeconomic variables on the level of life expectancy: comparison of developing and developed countries with the panel data approach. J Res Med Sci, 31(7):568-75.
16. Babaie M, Tavakolian H, Shakeri A (2019). Determinants of Inflation Forecast: A Dynamic Model Averaging Approach. J Econ Res, 18 (71): 261-311.
17. Wong MD, Shapiro MF, Boscardin WJ, Ettner SL (2002). Contribution of major diseases to disparities in mortality. N Engl J Med, 347(20):1585-92.
18. Dalstra JA, Kunst AE, Borrell C,et al (2005). Socioeconomic differences in the prevalence of common chronic diseases: an overview of eight European countries. Int J Epidemiol, 34(2):316-326.
19. Nagel G, Linseisen J, Boshuizen HC,et al (2007). Socioeconomic position and the risk of gastric and oesophageal cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC-EURGAST). Int J Epidemiol, 36(1):66-76.
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25. Etemadi A, Safiri S, Sepanlou SG,et al (2020). The global, regional, and national burden of stomach cancer in 195 countries, 1990–2017: a systematic analysis for the Global Burden of Disease study 2017. Lancet Gastroenterol Hepatol, 5(1):42-54.
26. Jafari R, Rahbarghazi R, Ahmadi M, Hassanpour M, Rezaie J (2020). Hypoxic exosomes orchestrate tumorigenesis: molecular mechanisms and therapeutic implications. J Transl Med, 18(1):474.
27. Akbari ME, Hosseini SJ, Rezaee A, Hosseini MM, Rezaee I, Sheikhvatan M (2008). Incidence of genitourinary cancers in the Islamic Republic of Iran: a survey in 2005. Asian Pac J Cancer Prev, 9(4):549-52.
28. Farhood B, Geraily G, Alizadeh A (2018). Incidence and mortality of various cancers in Iran and compare to other countries: a review article. Iran J Public Health, 47(3):309-316.
29. Willis K, Hajizadeh M (2020). Socioeconomic inequalities in gastric cancer incidence in Canada: 1992–2010. Acta Oncol, 59(11):1333-1337.
30. Uthman OA, Jadidi E, Moradi T (2013). Socioeconomic position and incidence of gastric cancer: a systematic review and meta-analysis. J Epidemiol Community Health, 67(10):854-60.
31. Rottenberg Y, Jacobs JM, Ratzon NZ, et al (2017). Unemployment risk 2 years and 4 years following gastric cancer diagnosis: a population-based study. J Cancer Surviv, 11(1):119-125.
32. Eguchi H, Wada K, Prieto-Merino D, Smith DR (2017). Lung, gastric and colorectal cancer mortality by occupation and industry among working-aged men in Japan. Sci Rep, 7:43204.
33. Rana N, Gosain R, Lemini R, et al (2020). Socio-demographic disparities in gastric adenocarcinoma: a population-based study. Cancers(Basel), 12(1):157.
34. Chang Y, Cho B, Son KY, et al (2015). Determinants of gastric cancer screening attendance in Korea: a multi-level analysis. BMC Cancer, 15(1):336.
35. Momenyan S, Sadeghifar M, Sarvi F, et al (2016). Relationship between urbanization and cancer incidence in Iran using quantile regression. Asian Pac J Cancer Prev, 17(S3):113-7.
36. Nagel G, Stafoggia M, Pedersen M,et al (2018). Air pollution and incidence of cancers of the stomach and the upper aerodigestive tract in the European Study of Cohorts for Air Pollution Effects (ESCAPE). Int J Cancer, 143(7):1632-1643.
37. Weinmayr G, Pedersen M, Stafoggia M, et al (2018). Particulate matter air pollution components and incidence of cancers of the stomach and the upper aerodigestive tract in the European Study of Cohorts of Air Pollution Effects (ESCAPE). Environ Int, 120:163-171.
2. Sitarz R, Skierucha M, Mielko J, Offerhaus G, Maciejewski R, Polkowski W (2018). Gastric cancer: epidemiology, prevention, classification, and treatment. Cancer Manag Res, 10:239–248.
3. Machlowska J, Baj J, Sitarz M, Maciejewski R, Sitarz R (2020). Gastric cancer: epidemiology, risk factors, classification, genomic characteristics and treatment strategies. Int J Mol Sci, 21(11):4012.
4. Rahman R, Asombang AW, Ibdah JA (2014). Characteristics of gastric cancer in Asia. World J Gastroenterol, 20(16):4483-90.
5. Zhang X-y, Zhang P-y (2017). Gastric cancer: somatic genetics as a guide to therapy. J Med Genet, 54(5):305-312.
6. Roshandel G, Ferlay J, Ghanbari‐Motlagh A, et al (2021). Cancer in Iran 2008 to 2025: Recent incidence trends and short‐term predictions of the future burden. Int J Cancer, 149(3):594-605.
7. Roshandel G, Ghanbari-Motlagh A, Partovipour E, et al (2019). Cancer incidence in Iran in 2014: results of the Iranian National Population-based Cancer Registry. Cancer Epidemiol, 61:50-58.
8. Yusefi AR, Lankarani KB, Bastani P, Radinmanesh M, Kavosi Z (2018). Risk factors for gastric cancer: a systematic review. Asian Pac J Cancer Prev, 19(3):591-603.
9. Tukmechi A, Rezaee J, Nejati V, Sheikhzadeh N (2014). Effect of acute and chronic toxicity of paraquat on immune system and growth performance in rainbow trout, O ncorhynchus mykiss. Aquac Res, 45(11):1737-43.
10. Gammon MD, Ahsan H, Schoenberg JB, et al (1997). Tobacco, alcohol, and socioeconomic status and adenocarcinomas of the esophagus and gastric cardia. J Natl Cancer Inst, 89(17):1277-84.
11. Engel LS, Chow WH, Vaughan TL,et al (2003). Population attributable risks of esophageal and gastric cancers. J Natl Cancer Inst, 95(18):1404-13.
12. Van Loon A, Goldbohm RA, Van den Brandt PA (1998). Socioeconomic status and stomach cancer incidence in men: results from The Netherlands Cohort Study. J Epidemiol Community Health, 52(3):166-71.
13. Malaty HM, Nyren O (2003). Epidemiology of Helicobacter pylori infection. Helicobacter, 8:8-12.
14. Merletti F, Galassi C, Spadea T (2011). The socioeconomic determinants of cancer. Environ Health, 10(Suppl 1):S7.
15. Babaie M (2020). The effect of health indicators and macroeconomic variables on the level of life expectancy: comparison of developing and developed countries with the panel data approach. J Res Med Sci, 31(7):568-75.
16. Babaie M, Tavakolian H, Shakeri A (2019). Determinants of Inflation Forecast: A Dynamic Model Averaging Approach. J Econ Res, 18 (71): 261-311.
17. Wong MD, Shapiro MF, Boscardin WJ, Ettner SL (2002). Contribution of major diseases to disparities in mortality. N Engl J Med, 347(20):1585-92.
18. Dalstra JA, Kunst AE, Borrell C,et al (2005). Socioeconomic differences in the prevalence of common chronic diseases: an overview of eight European countries. Int J Epidemiol, 34(2):316-326.
19. Nagel G, Linseisen J, Boshuizen HC,et al (2007). Socioeconomic position and the risk of gastric and oesophageal cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC-EURGAST). Int J Epidemiol, 36(1):66-76.
20. Greene WH (2008). The econometric approach to efficiency analysis. The measurement of productive efficiency and productivity growth. online edn. Oxford Academic. New York.
21. Karapetyan L, Wang L, Gardiner J, Laird-Fick H (2019) Association of socioeconomic status with incidence and outcomes of gastric cancer in a Michigan cohort. J Clin Oncol, 37(4):25-25.
22. MacKinnon JA, Duncan RC, Huang Y, et al (2007). Detecting an association between socioeconomic status and late stage breast cancer using spatial analysis and area-based measures. Cancer Epidemiol Biomarkers Prev, 16(4):756-62.
23. Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, Bray F (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. Fitzmaurice C, Dicker D, Pain A, et al (2015). The global burden of cancer 2013. JAMA Oncol, 1(4):505-527.
25. Etemadi A, Safiri S, Sepanlou SG,et al (2020). The global, regional, and national burden of stomach cancer in 195 countries, 1990–2017: a systematic analysis for the Global Burden of Disease study 2017. Lancet Gastroenterol Hepatol, 5(1):42-54.
26. Jafari R, Rahbarghazi R, Ahmadi M, Hassanpour M, Rezaie J (2020). Hypoxic exosomes orchestrate tumorigenesis: molecular mechanisms and therapeutic implications. J Transl Med, 18(1):474.
27. Akbari ME, Hosseini SJ, Rezaee A, Hosseini MM, Rezaee I, Sheikhvatan M (2008). Incidence of genitourinary cancers in the Islamic Republic of Iran: a survey in 2005. Asian Pac J Cancer Prev, 9(4):549-52.
28. Farhood B, Geraily G, Alizadeh A (2018). Incidence and mortality of various cancers in Iran and compare to other countries: a review article. Iran J Public Health, 47(3):309-316.
29. Willis K, Hajizadeh M (2020). Socioeconomic inequalities in gastric cancer incidence in Canada: 1992–2010. Acta Oncol, 59(11):1333-1337.
30. Uthman OA, Jadidi E, Moradi T (2013). Socioeconomic position and incidence of gastric cancer: a systematic review and meta-analysis. J Epidemiol Community Health, 67(10):854-60.
31. Rottenberg Y, Jacobs JM, Ratzon NZ, et al (2017). Unemployment risk 2 years and 4 years following gastric cancer diagnosis: a population-based study. J Cancer Surviv, 11(1):119-125.
32. Eguchi H, Wada K, Prieto-Merino D, Smith DR (2017). Lung, gastric and colorectal cancer mortality by occupation and industry among working-aged men in Japan. Sci Rep, 7:43204.
33. Rana N, Gosain R, Lemini R, et al (2020). Socio-demographic disparities in gastric adenocarcinoma: a population-based study. Cancers(Basel), 12(1):157.
34. Chang Y, Cho B, Son KY, et al (2015). Determinants of gastric cancer screening attendance in Korea: a multi-level analysis. BMC Cancer, 15(1):336.
35. Momenyan S, Sadeghifar M, Sarvi F, et al (2016). Relationship between urbanization and cancer incidence in Iran using quantile regression. Asian Pac J Cancer Prev, 17(S3):113-7.
36. Nagel G, Stafoggia M, Pedersen M,et al (2018). Air pollution and incidence of cancers of the stomach and the upper aerodigestive tract in the European Study of Cohorts for Air Pollution Effects (ESCAPE). Int J Cancer, 143(7):1632-1643.
37. Weinmayr G, Pedersen M, Stafoggia M, et al (2018). Particulate matter air pollution components and incidence of cancers of the stomach and the upper aerodigestive tract in the European Study of Cohorts of Air Pollution Effects (ESCAPE). Environ Int, 120:163-171.
| Files | ||
| Issue | Vol 52 No 8 (2023) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/ijph.v52i8.13413 | |
| Keywords | ||
| Gastric cancer Socioeconomic factors Panel data Income Urbanization ratio | ||
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How to Cite
1.
Babaie M, Pirnejad H, Rezaie J, Roshandel G, Hoseini R. Association between Socioeconomic Factors and the Risk of Gastric Cancer Incidence: Results from an Ecological Study. Iran J Public Health. 2023;52(8):1739-1748.
