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Epidemiologic features of upper gastrointestinal tract cancers in Northeastern Iran

Authors
Journal
British Journal of Cancer
0007-0920
Publisher
Nature Publishing Group
Publication Date
Identifiers
DOI: 10.1038/sj.bjc.6601737
Keywords
  • Epidemiology
Disciplines
  • Biology
  • Medicine

Abstract

Epidemiologic features of upper gastrointestinal tract cancers in Northeastern Iran F Islami1, F Kamangar2, K Aghcheli1, S Fahimi1, S Semnani3, N Taghavi1, HA Marjani1, S Merat1, S Nasseri-Moghaddam1, A Pourshams1, M Nouraie1, M Khatibian1, B Abedi1, MH Brazandeh3, R Ghaziani3, M Sotoudeh1, SM Dawsey2, CC Abnet2, PR Taylor2 and R Malekzadeh*,1 1Digestive Disease Research Center, Tehran University of Medical Sciences, Shariati Hospital, North Kargar Avenue, Tehran, Iran; 2Cancer Prevention Studies Branch, National Cancer Institute, Bethesda, MD, USA; 3Golestan University of Medical Sciences, Gorgan, Iran 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 defi

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