ﺑﺮوز و ﺗﻮزﯾﻊ ﺟﻐﺮاﻓﯿﺎﯾﯽ ﺳﺮﻃﺎن ﭘﺴﺘﺎن در اﺳﺘﺎن ﻫﻤﺪان ﺑﺎ اﺳﺘﻔﺎده از روش ﺑﯿﺰ

Geographical Distribution of Breast Cancer in Hamadan Province during 2008-2015 Using Bayesian Method

ﻣﻘﺪﻣﻪ و اﻫﺪاف: ﺳﺮﻃﺎن ﭘﺴﺘﺎن رﺗﺒﻪ اول ﺑﺮوز را ﻣﯿﺎن زﻧﺎن اﯾﺮاﻧﯽ ﻣﺒﺘﻼ ﺑﻪ ﺳﺮﻃﺎن دارد. روش ﮐﺎر: ﭘﮋوﻫﺶ ﺣﺎﺿﺮ ﻣﻄﺎﻟﻌﻪ ﺗﻮﺻﯿﻔﯽ از ﻧﻮع ﻣﻘﻄﻌﯽ و ﺟﻤﻌﯿﺖ ﻣﻮردﻣﻄﺎﻟﻌﻪ زﻧﺎن ﻣﺒﺘﻼ ﺑﻪ ﺳﺮﻃﺎن ﭘﺴﺘﺎن در 9 ﺷﻬﺮﺳﺘﺎن اﺳﺘﺎن ﻫﻤﺪان ﺑﻮد. ﺗﻤﺎم زﻧﺎن ﻣﺒﺘﻼ ﺑﻪ ﺳﺮﻃﺎن ﭘﺴﺘﺎن ﻃﯽ ﺳﺎل 1387-1394 وارد ﻣﻄﺎﻟﻌﻪ ﺷﺪﻧﺪ. ﺛﺒﺖ ﺳﺮﻃﺎن ﭘﺴﺘﺎن ﺑﺮ ﻣﺒﻨﺎي روش ﭘﺎﺗﻮﻟﻮژي اﺳﺖ ﮐﻪ اﻃﻼﻋﺎت ﻣﺮﺑﻮﻃﻪ از ﻣﺮﮐﺰ ﺑﻬﺪاﺷﺖ اﺳﺘﺎن ﻫﻤﺪان ﺟﻤﻊآوري ﺷﺪ. ﻧﻤﻮﻧﻪﻫﺎي ﻣﻮردﺑﺮرﺳﯽ ﺑﻪ ﭼﻬﺎر ﮔﺮوه ﺑﻪ ﺗﻔﮑﯿﮏ ﺳﻦ )50>و50<( و ﻣﻮﻗﻌﯿﺖ ﻣﮑﺎﻧﯽ )ﺷﻬﺮ،روﺳﺘﺎ( ﺗﻘﺴﯿﻢ ﺷﺪﻧﺪ. رﺳﻢ ﻧﻘﺸﻪ ﻣﻨﺎﻃﻖ ﭘﺮﺧﻄﺮ در اﺳﺘﺎن ﻫﻤﺪان از GeoBUGS و ﺑﺮ اﺳﺎس ﺑﺮآورد ﺧﻄﺮ ﻧﺴﺒﯽ ﺗﻌﺪﯾﻞﺷﺪه)RR*( در ﻧﺮماﻓﺰار 3.2.3 OpenBUGS v اﺳﺘﻔﺎده ﺷﺪ. ﻫﻤﮕﺮاﯾﯽ زﻧﺠﯿﺮهﻫﺎي ﺗﻮﻟﯿﺪﺷﺪه ﺑﺮاي ﺗﻮزﯾﻊ-ﻫﺎي ﭘﺴﯿﻦ از ﺑﺮﻧﺎﻣﻪ Coda ﺗﺤﺖ ﻧﺮماﻓﺰارR 4.0.2 v از آزﻣﻮن دورﺑﯿﻦ-راﻓﺴﻮن اﻧﺠﺎم ﺷﺪ. ﯾﺎﻓﺘﻪﻫﺎ: در ﻣﻄﺎﻟﻌﻪ ﺣﺎﺿﺮ 1316 زن ﻣﺒﺘﻼ ﺑﻪ ﺳﺮﻃﺎن ﭘﺴﺘﺎن ﻣﻮردﺑﺮرﺳﯽ ﻗﺮار ﮔﺮﻓﺖ. ﻣﯿﺎﻧﮕﯿﻦ ﺳﻦ زﻧﺎن 50/38±12/98 ﺳﺎل ﺑﻮد. ﻧﺘﺎﯾﺞ ﻣﻄﺎﻟﻌﻪ ﻧﺸﺎن داد ﮐﻪ ﺑﯿﺸﺘﺮﯾﻦ ﺑﺮوز ﺳﺮﻃﺎن ﭘﺴﺘﺎن ﺑﺮاي زﻧﺎن ﺷﻬﺮي ﺑﯿﺸﺘﺮ از 50 ﺳﺎل ﻣﺮﺑﻮط ﺑﻪ ﺷﻬﺮﺳﺘﺎن اﺳﺪآﺑﺎد 1,32, CI%95=(0.99,1.79))=RR*(، و ﮐﻤﺘﺮ از 50 ﺳﺎل ﻣﺮﺑﻮط ﺑﻪ ﺷﻬﺮﺳﺘﺎنﻫﺎي ﺗﻮﯾﺴﺮﮐﺎن )1,09, CI%95=(1.08,1.38)=RR*( و ﺷﻬﺮﺳﺘﺎن رزن)1,09, CI%95=(0.85,1.40)=RR*( ﺑﻮد. ﻫﻢﭼﻨﯿﻦ زﻧﺎن روﺳﺘﺎﯾﯽ ﺑﯿﺸﺘﺮ از 50 ﺳﺎل ﺷﻬﺮﺳﺘﺎن رزن 1,18, CI%95=(0.82,1.73)=RR*( و ﮐﻤﺘﺮ از 50 ﺳﺎل ﺷﻬﺮﺳﺘﺎن ﻣﻼﯾﺮ )1,08, CI%95=(0.81,1.45)=RR*( ﺑﯿﺸﺘﺮﯾﻦ ﺑﺮوز ﺳﺮﻃﺎن ﭘﺴﺘﺎن داﺷﺘﻨﺪ. ﻧﺘﯿﺠﻪﮔﯿﺮي: ﺗﻮزﯾﻊ ﺳﺮﻃﺎن ﭘﺴﺘﺎن در ﺳﻨﯿﻦ ﻣﺨﺘﻠﻒ و در ﺳﻄﺢ ﺷﻬﺮﺳﺘﺎنﻫﺎي اﺳﺘﺎن ﻫﻤﺪان ﻣﺘﻔﺎوت اﺳﺖ. ﺷﻬﺮﺳﺘﺎن اﺳﺪآﺑﺎد ﺗﻮﯾﺴﺮﮐﺎن، رزن و ﻣﻼﯾﺮ ﺟﺰء ﻣﻨﺎﻃﻖ ﭘﺮﺧﻄﺮ ﺳﺮﻃﺎن ﭘﺴﺘﺎن در اﺳﺘﺎن ﻫﻤﺪان اﺳﺖ.

A cross-sectional study was conducted. All female with breast cancer during 2008-2015 were enrolled. Breast cancer registration is based on the pathology method in Iran. The information about female with breast cancer was collected from their files in the cancer registry department of Hamadan Health Center. The samples were divided into four groups according to age (<50 and> 50) and location (city, village). GeoBUGS was used to generate a map of high-risk areas in Hamedan Province based on the adjusted relative risk estimate (RR*) in OpenBUGS v 3.2.3 software. Results: This study included 1316 females with breast cancer. The mean age of the patients was 50.38±12.98 years. The results of the study showed that high-risk areas of breast cancer for were Assadabad urban females aged over 50 years (RR*(i)=1.32, CI= 0.99,1.79) and Tuyserkan (RR*(i)=1.09, CI= 1.08,1.38) and Razan (RR*(i)=1.09, CI= 0.85,1.40) for females below 50 years. In addition, Razan for rural females over 50 years old (RR*(i)=1.18, CI=0.82,1.73) and Malayer for females below 50 years old (RR*(i)=1.08, CI= 0.81,1.45) were high risk areas for breast cancer in Hamadan Province. Conclusion: The distribution of breast cancer is different at different ages and in the cities of Hamadan Province. Asadabad, Tuyserkan, Razan and Malayer were high risk areas for breast cancer in Hamadan Province.