Author/Authors :
Rezaei, Nazila Non-Communicable Diseases Research Center - Endocrinology and Metabolism Population Sciences Institute - Tehran University of Medical Sciences, Tehran , Pishgar, Farhad Non-Communicable Diseases Research Center - Endocrinology and Metabolism Population Sciences Institute - Tehran University of Medical Sciences, Tehran , Yoosefi, Moein Non-Communicable Diseases Research Center - Endocrinology and Metabolism Population Sciences Institute - Tehran University of Medical Sciences, Tehran , Sheidaei, Ali Department of Epidemiology and Biostatistics - School of Public Health - Tehran University of Medical Sciences, Tehran , Saeedi Moghaddam, Sahar Non-Communicable Diseases Research Center - Endocrinology and Metabolism Population Sciences Institute - Tehran University of Medical Sciences, Tehran , Mansouri, Anita Non-Communicable Diseases Research Center - Endocrinology and Metabolism Population Sciences Institute - Tehran University of Medical Sciences, Tehran , Tahernia, Leila Division of Hematology and Oncology - Children’s Medical Center - Pediatrics Center of Excellence - Tehran University of Medical Sciences, Tehran , Naderimagham, Shohreh Non-Communicable Diseases Research Center - Endocrinology and Metabolism Population Sciences Institute - Tehran University of Medical Sciences, Tehran , Modirian, Mitra Non-Communicable Diseases Research Center - Endocrinology and Metabolism Population Sciences Institute - Tehran University of Medical Sciences, Tehran , Pazhuheian, Forough Non-Communicable Diseases Research Center - Endocrinology and Metabolism Population Sciences Institute - Tehran University of Medical Sciences, Tehran , Rezaei, Negar Non-Communicable Diseases Research Center - Endocrinology and Metabolism Population Sciences Institute - Tehran University of Medical Sciences, Tehran , Namazi Shabestari, Alireza Department of Geriatric Medicine - School of Medicine - Tehran University of Medical Sciences, Tehran , Kompani, Farzad Division of Hematology and Oncology - Children’s Medical Center - Pediatrics Center of Excellence - Tehran University of Medical Sciences, Tehran , Farzadfar, Farshad Non-Communicable Diseases Research Center - Endocrinology and Metabolism Population Sciences Institute - Tehran University of Medical Sciences, Tehran
Abstract :
Background: Cancer, a common disease in adulthood, is a rare albeit slowly increasing condition among children. Currently, limited data are available on the incidence, prevalence, and mortality of these diseases in many regions, including developing countries. Herein, we are reporting national and sub-national estimates on deaths due to childhood cancers between 2000 and 2015 in Iran.
Methods: Cancer mortality rates were estimated using the national death registration system’s data after addressing its incompleteness and misclassification, using demographic (complete birth history and summary birth history) and statistical analysis (spatiotemporal, Gaussian process regression, and generalized linear mixed models). We included data from cemeteries of two cities (Tehran and Isfahan) that were not included in the death registration system. We used census data and household expenditure and income surveys for data on population and other covariates used in the modeling.
Results: The overall age-standardized death rate (ASDR) of childhood cancers have decreased by 69.52% (80.67–49.71) in Iran (equal to an annual percent change of -3.63 [-4.53– -2.24]), declining from 12.24 (95% UI: 10.52–14.49) in 2000 to 3.73 (2.8–5.29) deaths per 100 000 in 2015. This decrement was equal to an annual percent change of 4.35% over these years. Leukemia, brain, and nervous system malignancies accounted for about 66% of all cancer-related mortalities among children and adolescents in 2015, which had a 10% increase compared to 2000. Moreover, trends at the sub-national level showed that the highest and lowest ASDR of childhood cancers ranged from 2.12 to 4.99 across provinces of Iran in 2015.
Conclusion: Although the overall mortalities have decreased, there is still inequality in the distribution of the recorded deaths. This inequality should be addressed with the improvement of the quality of care and better access to pediatric hospitals and oncologists in these areas.
Keywords :
Cancer , Child , Epidemiology , Iran , Mortality
