Upper Gastrointestinal Cancer in Ardabil, North-west of Iran: a Review

Introduction ancer is a serious health problem worldwide, imposing a large economical and psychological burden as well as loss of life and productivity. Lots of effort and money have been put in the fields of clinical, epidemiological, pharmacological, and biological research on cancer in the recent decades. Although we have witnessed dramatic progress in the field, but still there is a long way to go. Cancer is the third most common cause of death in Iran, accounting for 14% of the total death toll. It stands just after cardiovascular events and accidents (46% and 17% of the total death toll respectively, Table 1) according to the latest census of the Iranian Ministry of Health and Medical Education (IMHME). Overall, gastrointestinal (GI) cancers cause about half of all cancer deaths in Iran. Of the 17,450 GI cancers recorded in the IMHME report, 7,560 (43.3%) were gastric cancers. In other words, of every 100 people dying of cancer in Iran, 22 die of gastric cancer, and six from esophageal cancer. Unfortunately, both of these cancers come to medical attention when they are rather advanced and limited or no effective therapies are available for them. Theoretically, these cancers may be treatable in their early stage; therefore, finding them at the earliest possible stage may subject them to effective therapy. Other nations, such as the Japanese, have managed to decrease the toll of gastric cancer by effective screening programs and timely intervention. Therefore, if we are to plan meaningfully to combat this still deadly disease we should have accurate information about the epidemiology and clinical characteristics of various cancers, especially the upper GI cancers in Iran. Earlier reports indicated that Ardabil, in NorthWest of Iran, had a rather high incidence of upper GI cancers. 4 – 8 In their 1973 report, Mahboubi et al reported that about 64% of all cancer deaths in Ardabil are due to esophageal and gastric cancers (56% esophagus and 8% stomach). This background and the availability of facilities of a collaborating local medical university and easy means of air travel to the area made Ardabil an appropriate place for epidemiological and clinical cancer studies in the past few years. This review focuses on the background and recent studies done in the region as a model of cancer research in Iran.