Trends in Mortality Rates for Gastrointestinal Cancers in Fars Province, Iran (2005–2015)

  • Hossein-Ali Nikbakht
  • Sadaf Sahraian
  • Haleh Ghaem
  • Afshan Javadi
  • Maryam Janfada
  • Soheil Hassanipour
  • Ali-Reza MirahmadizadehEmail author
Original Research



In Iran, cancers are the third leading cause of death, and gastrointestinal cancers are the primary cause of mortality among all the cancers. This study aimed to determine the trend of crude and age-standardized mortality rates (ASMR) for different types of gastrointestinal cancers over an 11-year period in Fars province (Iran).


In this study, all the mortality data for gastrointestinal cancers were derived from the Electronic Death Registration System (EDRS) between 2005 and 2015. Subsequently, we calculated the crude and age-standardized mortality rates (ASMR) and their trends for different types of gastrointestinal cancers based on age groups and gender over the study period.


A total of 6547 deaths from gastrointestinal cancers were identified, with an average age of 66.0 ± 16.4 years. The crude and age-standardized mortality rates for gastrointestinal cancers were respectively 10.9 and 15.0 per 100,000 population in 2005 which significantly increased to 17.4 and 19.4 per 100,000 population in 2015 (P < 0.001). The ASMR for colon, pancreatic, and oral cancers showed an increasing trend; for small intestine cancers, a decreasing trend; and for esophageal, gastric, rectal, and hepatobiliary cancers displayed an almost constant trend.


Our study shows a higher ASMR and an increasing trend of gastrointestinal cancers in Fars province. Prevention and early diagnosis programs with screening techniques should be implemented to control the mortality rate of gastrointestinal cancers in the future.


Gastrointestinal cancer Age-standardized mortality rate Trend Iran 


Funding Information

This study was financially approved by Shiraz University of Medical Sciences, Shiraz, Iran (Grant number 96-01-109-14806).

Compliance with Ethical Standards

This study was conducted in compliance with the provisions of the Helsinki Declaration. The protocol was approved by the ethics committee of Shiraz University of Medical Sciences (No. IR.SUMS.REC. 1396.S619).

Conflict of Interest

The authors declare that they have no conflict of interest.


  1. 1.
    Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68(6):394–424. Scholar
  2. 2.
    Ferlay J, Soerjomataram I, Dikshit R, Eser S, Mathers C, Rebelo M, et al. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer. 2015;136(5):E359–86. Scholar
  3. 3.
    Hassanipour S, Fathalipour M, Salehiniya H. The incidence of prostate cancer in Iran: a systematic review and meta-analysis. Prostate Int. 2018;6(2):41–5. Scholar
  4. 4.
    Hassanipour S, Namvar G, Fathalipour M, Salehiniya H. The incidence of kidney cancer in Iran: a systematic review and meta-analysis. BioMedicine (France). 2018;8(2):22–7. Scholar
  5. 5.
    Hassanipour S, Mohammadian-Hafshejani A, Ghoncheh M, Salehiniya H. The incidence and mortality of esophageal cancer and its relationship with development in the world. Biomed Res Ther J. 2017;4:1607.CrossRefGoogle Scholar
  6. 6.
    Salehiniya H, Hassanipour S, Mansour-Ghanaei F, Mohseni S, Joukar F, Abdzadeh E, et al. The incidence of esophageal cancer in Iran: a systematic review and meta-analysis. Biomed Res Ther. 2018;5(7):2493–503.CrossRefGoogle Scholar
  7. 7.
    Moradzadeh R, Golmohammadi P, Ghaitasi B, Nadrian H, Najafi A. Incidence of esophageal Cancer in Iran, a population-based study: 2001-2015. J Gastrointest Cancer. 2018.
  8. 8.
    Reshadat S, Saeidi S, Zangeneh A, Ziapour A, Saeidi F, Choobtashani M. A comparative study of spatial distribution of gastrointestinal cancers in poverty and affluent strata (Kermanshah Metropolis, Iran). J Gastrointest Cancer. 2018.
  9. 9.
    Salimzadeh H, Delavari F, Sauvaget C, Rezaee N, Delavari A, Kompani F, et al. Annual trends of gastrointestinal cancers mortality in Iran during 1990-2015; NASBOD study. Arch Iran Med. 2018;21(2):46–55.Google Scholar
  10. 10.
    Bray F, Soerjomataram I (2015) The changing global burden of cancer: transitions in human development and implications for cancer prevention and control. In: Gelband H, Jha P, Sankaranarayanan R, Horton S (eds) Cancer: disease control priorities, third edition (volume 3). The International Bank for Reconstruction and Development / the World Bank (c) 2015 International Bank for Reconstruction and Development / the World Bank., Washington (DC).
  11. 11.
    Li D-J, Liang D, Song G-H, Li Y-W, Wen D-G, Jin J, et al. Upper gastrointestinal cancer burden in Hebei Province, China: a population-based study. World J Gastroenterol. 2017;23(14):2625–34. Scholar
  12. 12.
    Van Malderen C, Van Oyen H, Speybroeck N. Contributing determinants of overall and wealth-related inequality in under-5 mortality in 13 African countries. J Epidemiol Community Health. 2013;67(8):667–76. Scholar
  13. 13.
    O'Hare B, Makuta I, Chiwaula L, Bar-Zeev N. Income and child mortality in developing countries: a systematic review and meta-analysis. J R Soc Med. 2013;106(10):408–14. Scholar
  14. 14.
    Khosravi A, Taylor R, Naghavi M, Lopez AD. Mortality in the Islamic Republic of Iran, 1964-2004. Bull World Health Organ. 2007;85(8):607–14.CrossRefGoogle Scholar
  15. 15.
    Abolverdi J, Ferdosifar G, Khalili D, Kamgar-Haghighi AA. Spatial and temporal changes of precipitation concentration in Fars province, southwestern Iran. Meteorog Atmos Phys. 2016;128(2):181–96.CrossRefGoogle Scholar
  16. 16.
    Noroozian M. The elderly population in Iran: an ever growing concern in the health system. Iran J Psychiatry Behav Sci. 2012;6(2):1–6.Google Scholar
  17. 17.
    Pourhoseingholi MA, Fazeli Z, Ashtari S, Bavand-Pour FSF. Mortality trends of gastrointestinal cancers in Iranian population. Gastroenterol Hepatol Bed Bench. 2013;6(Suppl 1):S52–7.Google Scholar
  18. 18.
    Farkas K, Szucs M, Nyari TA. Trends in gastrointestinal cancer mortality rate in Hungary. Pathol Oncol Res. 2016;22(4):681–8. Scholar
  19. 19.
    Saadat S, Yousefifard M, Asady H, Moghadas Jafari A, Fayaz M, Hosseini M. The most important causes of death in Iranian population; a retrospective cohort study. Emergency (Tehran, Iran). 2015;3(1):16–21.Google Scholar
  20. 20.
    Levi F, Lucchini F, Negri E, Boyle P, La Vecchia C. Cancer mortality in Europe, 1995-1999, and an overview of trends since 1960. Int J Cancer. 2004;110(2):155–69. Scholar
  21. 21.
    Malvezzi M, Carioli G, Bertuccio P, Boffetta P, Levi F, La Vecchia C, et al. European cancer mortality predictions for the year 2018 with focus on colorectal cancer. Annals of oncology: official journal of the European society for. Med Oncol. 2018;29(4):1016–22. Scholar
  22. 22.
    Pourhoseingholi MA, Moghimi-Dehkordi B, Safaee A, Hajizadeh E, Solhpour A, Zali MR. Prognostic factors in gastric cancer using log-normal censored regression model. Indian J Med Res. 2009;129(3):262–7.Google Scholar
  23. 23.
    Pourhoseingholi MA, Baghestani A, Abadi A, Hajizadeh N. Iranian regional cancer incidence is misclassified in neighborhood's provinces. Gastroenterol Hepatol Bed Bench. 2016;9(2):75–7.Google Scholar
  24. 24.
    Sunkara V, Hebert JR. The colorectal cancer mortality-to-incidence ratio as an indicator of global cancer screening and care. Cancer. 2015;121(10):1563–9. Scholar
  25. 25.
    Bosetti C, Bertuccio P, Malvezzi M, Levi F, Chatenoud L, Negri E, et al. Cancer mortality in Europe, 2005-2009, and an overview of trends since 1980. Ann Oncol. 2013;24(10):2657–71. Scholar
  26. 26.
    González-Santiago O, Yeverino-Gutiérrez ML, Del Rosario González-González M, Corral-Symes R, Morales-San-Claudio PC. Mortality assessment of patients with pancreatic cancer in Mexico, 2000-2014. Ecancermedicalscience. 2017;11:788–8.
  27. 27.
    Kroep S, Lansdorp-Vogelaar I, Rubenstein JH, Lemmens VEPP, van Heijningen EB, Aragonés N, et al. Comparing trends in esophageal adenocarcinoma incidence and lifestyle factors between the United States, Spain, and the Netherlands. Am J Gastroenterol. 2014;109(3):336–44. Scholar
  28. 28.
    Center MM, Jemal A (2011) International trends in liver cancer incidence rates. Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology 20 (11):2362–2368. doi:
  29. 29.
    Hajiani E, Masjedizadeh R, Hashemi J, Azmi M, Rajabi T. Hepatis C virus transmission and its risk factors within families of patients infected with hepatitis C virus in southern Iran: Khuzestan. World J Gastroenterol. 2006;12(43):7025–8. Scholar
  30. 30.
    Joukar F, Mansour-Ghanaei F, Naghipour MR, Hassanipour S. Knowledge, distribution and risk factors of hepatitis B and C infection in high-risk groups in Guilan province, Iran. Hepat Mon. 2018;18(8).
  31. 31.
    Moradi-Lakeh M, Esteghamati A. National Immunization Program in Iran: whys and why nots. Hum Vaccin Immunother. 2013;9(1):112–4. Scholar
  32. 32.
    Rezaee R, Aghcheli B, Poortahmasebi V, Qorbani M, Alavian SM, Jazayeri SM. Prevalence of National Responsiveness to HBV vaccine after 22 years of Iranian expanded program on immunization (EPI): a systematic review and meta-analysis study. Hepat Mon. 2015;15(5):e23618–8.

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Hossein-Ali Nikbakht
    • 1
    • 2
  • Sadaf Sahraian
    • 3
  • Haleh Ghaem
    • 4
  • Afshan Javadi
    • 5
  • Maryam Janfada
    • 6
  • Soheil Hassanipour
    • 7
  • Ali-Reza Mirahmadizadeh
    • 8
    • 9
    Email author
  1. 1.Student Research CommitteeShiraz University of Medical SciencesShirazIran
  2. 2.Social Determinants of Health Research Center, Health Research InstituteBabol University of Medical SciencesBabolIran
  3. 3.Division of Neuroradiology, The Russell H. Morgan Department of Radiology and Radiological ScienceJohns Hopkins Medical InstitutionsBaltimoreUSA
  4. 4.Research Center for Health Sciences, Institute of Health, Department of Epidemiology, School of HealthShiraz University of Medical SciencesShirazIran
  5. 5.Statistics Department, Health Vice-chancellorShiraz University of Medical SciencesShirazIran
  6. 6.Medical Records, Health Vice-chancellorShiraz University of medical sciencesShirazIran
  7. 7.Gastrointestinal & Liver Diseases Research CenterGuilan University of Medical SciencesRashtIran
  8. 8.Non-communicable Diseases Research CenterShiraz University of Medical SciencesShirazIran
  9. 9.Department of Epidemiology, School of HealthShiraz University of Medical SciencesShirazIran

Personalised recommendations