The spatial distribution of colorectal cancer relative risk in Iran: a nationwide spatial study

AIM: The aim of this study was to estimate the standardized incidence rate (SIR) and also the relative risk (RR) of colorectal cancer (CRC) in Iran and to determine the distribution of CRC risk in a map after adjusting socioeconomic risk factors. BACKGROUND: The growth of CRC incidence rate in Iran is a major public health problem and identifying high-risk regions is essential for further intervention. METHODS: For this cross-sectional study, all CRC cases that occurred in 30 Iranian provinces between 2005 and 2008 were collected according to the International Classification of Diseases (ICD-10). In addition, socioeconomic information was extracted from statistical center of Iran. Bayesian and Poison regression models were fitted to identify significant covariates. For RR estimating, the spatial analysis using GIS technique was carried out. RESULTS: The Bayesian method with increasing precision of the parameter estimates had a better fit. According to spatial model, East Azerbaijan province had a high (11.14) and South Khorasan province had a low (0.22) risk of CRC in the period of study. SIR for the male population was 1.92 ± 3.25, and for the female population it was 1.85 ± 3.37. CONCLUSION: There is a non-uniform spatial pattern of CRC risk in Iran. According to the results, North, Northwest and some parts of West and Central provinces of Iran are identified as high-risk areas; thus, it is recommended that health policymakers, especially in these areas, have more intervention measures. Further studies are needed to map the RR adjusted for nutrition factors.