Journal of Preventive Medicine and Public Health

  • 제51권1호
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  • Pages.33-40
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  • 2018
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  • 1975-8375(pISSN)
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  • 2233-4521(eISSN)
대한예방의학회 (The Korean Society for Preventive Medicine)
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Spatial Inequalities in the Incidence of Colorectal Cancer and Associated Factors in the Neighborhoods of Tehran, Iran: Bayesian Spatial Models

  • Mansori, Kamyar (Department of Epidemiology, School of Public Health, Iran University of Medical Sciences) ;
  • Solaymani-Dodaran, Masoud (Department of Epidemiology, School of Public Health, Iran University of Medical Sciences) ;
  • Mosavi-Jarrahi, Alireza (Department of Health and Community Medicine, Shahid Beheshti University of Medical Sciences) ;
  • Motlagh, Ali Ganbary (Department of Radiotherapy, Shahid Baheshti University of Medical Sciences) ;
  • Salehi, Masoud (Department of Biostatistics, School of Public Health, Iran University of Medical Sciences) ;
  • Delavari, Alireza (Digestive Disease Research Institute, Tehran University of Medical Sciences) ;
  • Asadi-Lari, Mohsen (Department of Epidemiology, School of Public Health, Iran University of Medical Sciences)
  • 투고 : 2017.10.22
  • 심사 : 2017.12.11
  • 발행 : 2018.01.31
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초록

Objectives: The aim of this study was to determine the factors associated with the spatial distribution of the incidence of colorectal cancer (CRC) in the neighborhoods of Tehran, Iran using Bayesian spatial models. Methods: This ecological study was implemented in Tehran on the neighborhood level. Socioeconomic variables, risk factors, and health costs were extracted from the Equity Assessment Study conducted in Tehran. The data on CRC incidence were extracted from the Iranian population-based cancer registry. The $Besag-York-Molli{\acute{e}}$ (BYM) model was used to identify factors associated with the spatial distribution of CRC incidence. The software programs OpenBUGS version 3.2.3, ArcGIS 10.3, and GeoDa were used for the analysis. Results: The Moran index was statistically significant for all the variables studied (p<0.05). The BYM model showed that having a women head of household (median standardized incidence ratio [SIR], 1.63; 95% confidence interval [CI], 1.06 to 2.53), living in a rental house (median SIR, 0.82; 95% CI, 0.71 to 0.96), not consuming milk daily (median SIR, 0.71; 95% CI, 0.55 to 0.94) and having greater household health expenditures (median SIR, 1.34; 95% CI, 1.06 to 1.68) were associated with a statistically significant elevation in the SIR of CRC. The median (interquartile range) and mean (standard deviation) values of the SIR of CRC, with the inclusion of all the variables studied in the model, were 0.57 (1.01) and 1.05 (1.31), respectively. Conclusions: Inequality was found in the spatial distribution of CRC incidence in Tehran on the neighborhood level. Paying attention to this inequality and the factors associated with it may be useful for resource allocation and developing preventive strategies in at-risk areas.

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