Epidemiologic features of upper gastrointestinal tract cancers in Northeastern Iran

• Published in: British journal of cancer Vol. 90; no. 7; pp. 1402 - 1406
• Main Authors: ISLAMI, F, KAMANGAR, F, NOURAIE, M, KHATIBIAN, M, ABEDI, B, BRAZANDEH, M. H, GHAZIANI, R, SOTOUDEH, M, DAWSEY, S. M, ABNET, C. C, TAYLOR, P. R, MALEKZADEH, R, AGHCHELI, K, FAHIMI, S, SEMNANI, S, TAGHAVI, N, MARJANI, H. A, MERAT, S, NASSERI-MOGHADDAM, S, POURSHAMS, A
• Format: Journal Article
• Language: English
• Published: Basingstoke Nature Publishing Group 05-04-2004
• Subjects: Adenocarcinoma - epidemiology; Alcohol Drinking; Biological and medical sciences; Carcinoma, Squamous Cell - epidemiology; Cardia; China - epidemiology; Epidemiology; Esophageal Neoplasms - epidemiology; Female; Gastroenterology. Liver. Pancreas. Abdomen; History, Early Modern 1451-1600; History, Modern 1601; Humans; Incidence; Iran - epidemiology; Male; Medical sciences; Risk Factors; Smoking; Stomach Neoplasms - epidemiology; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus; Tumors; Iran; Asia; China; Iran; gastric cancer; Digestive system; Turkmen; Digestive diseases; Malignant tumor; Gastrointestinal; Epidemiology; Stomach cancer; oesophageal cancer; Gastric disease; Esophagus
• ISSN: 0007-0920; 1532-1827
• DOI: 10.1038/sj.bjc.6601737

Previous studies have shown that oesophageal and gastric cancers are the most common causes of cancer death in the Golestan Province, Iran. In 2001, we established Atrak Clinic, a referral clinic for gastrointestinal (GI) diseases in Gonbad, the major city of eastern Golestan, which has permitted, for the first time in this region, endoscopic localisation and histologic examination of upper GI cancers. Among the initial 682 patients seen at Atrak Clinic, 370 were confirmed histologically to have cancer, including 223 (60%) oesophageal squamous cell cancers (ESCC), 22 (6%) oesophageal adenocarcinomas (EAC), 58 (16%) gastric cardia adenocarcinomas (GCA), and 58 (16%) gastric noncardia adenocarcinomas. The proportional occurrence of these four main site-cell type subdivisions of upper GI cancers in Golestan is similar to that seen in Linxian, China, another area of high ESCC incidence, and is markedly different from the current proportions in many Western countries. Questioning of patients about exposure to some known and suspected risk factors for squamous cell oesophageal cancer confirmed a negligible history of consumption of alcohol, little use of cigarettes or nass (tobacco, lime and ash), and a low intake of opium, suggesting that the high rates of ESCC seen in northeastern Iran must have other important risk factors that remain speculative or unknown. Further studies are needed to define more precisely the patterns of upper GI cancer incidence, to test other previously suspected risk factors, and to find new significant risk factors in this high-risk area.