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Esophageal Cancer Declining in Iran’s Northern Regions
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Esophageal Cancer Declining in Iran’s Northern Regions

Six years ago esophageal cancer was most common in eight provinces in the country, namely North Khorasan, Khorasan Razavi, South Khorasan, Golestan, Mazandaran, West Azarbaijan and East Azarbaijan.
“Fortunately, dietary habits in the provinces have seen a change over the years and as a result the disease has reduced significantly,” Dr. Mohammadreza Ghavam Nasiri, head of Radiation Oncology Association, was quoted as saying by IRNA.
People in some of these provinces consumed a diet often comprising salt-cured, smoked and dried (preserved) meat and fish. Such processed meat is generally considered unhealthy as it contains plenty of salt, carcinogenic substances and harmful chemicals that are not naturally present in fresh meat. But, nowadays, people have stopped eating such foods as awareness of the disease risks has increased, he said.
In addition to excessive salt and processed food intake, high consumption of grilled or barbecued meat, poor dental hygiene, and low intake of fruits and vegetables are other causes for esophageal cancer, he added.  
Cancers that start in the esophagus are much more common in men than in women. Many of these cancers are linked to tobacco or alcohol use, or to excess body weight. The chance of getting esophageal cancer is low at younger ages and increases with age. Less than 15% of cases are found in people younger than age 55, according to cancer.org.
Ghavam Nasiri rejected reports that Iran will face a ‘cancer tsunami’ in the future and said, although the overall cancer rate is increasing across the country (and all over the world), thanks to the advanced diagnostic facilities, specialists can diagnose the disease in its early stages and offer life-saving treatment.

  Asian Cancer Belt
The so-called Asian esophageal cancer belt (the area that extends from northeastern China to the Caspian areas of northern Iran) and the Transkei region of South Africa have been identified as areas with the world’s highest incidence of esophageal cancer, with the rate as high as 246 per 100,000.
China is the most affected country in the world, where esophageal cancer is the fourth most common cause of death from cancer, accounting for 11.8 and 9.2% of all cancer deaths among men and women, respectively. The incidence rate of esophageal cancer is higher in rural (highest in Linxian in the Henan Province of northern China) in comparison to urban areas such as Beijing and Shanghai.
In Iran, the incidence of esophageal cancer is higher in areas such as Turkmen Sahra, a region in the northeast of the country near the Caspian Sea, with an estimated annual rate of 8.8 per 100,000, medscape .com reports.
The north and northeast regions are generally some of the known areas that have a higher incidence of this type of cancer.
In an earlier survey by the Iran Cancer Institute, 9% of all cancers and 27% of gastrointestinal cancers were esophageal carcinoma with a male to female ratio of 1.7:1.13. Golestan Province in the northeast is one of the higher risk areas, followed by Mazandaran and the three Khorasan provinces.
Earlier studies in Golestan had suggested that a low intake of fresh fruits and vegetables, and opium consumption are associated with a higher risk of esophageal cancer. In addition, studies have pointed towards the possible role of drinking very hot tea. In other words, recurrent thermal injury to the esophageal mucosa (lining) due to consumption of large amounts of hot drinks has long been suspected to be a risk factor for esophageal cancer.

  Screening Essential for Over 50s
Ghavam Nasiri also pointed to the increasing incidence of breast cancer in Iranian women and prostate cancer among men. “Breast cancer occurs a decade earlier among Iranian women than western women. Tehran, Isfahan, Gilan, Fars and Khorasan provinces have the highest incidence of breast cancer, respectively.”
He recommended prostate screening for men starting from 50 years of age. “According to the Iran Urological Association, prostate cancer is found in 33% of Iranian men in their fifties; however only advanced prostate cancers show symptoms.”
During the last decade, the number of identified cancer cases (of all types) has increased three-fold. Till a decade ago, annually there were 30,000 new cases of cancer in the country and the deaths per year due to cancer were between 10,000 and 12,000.
However, at present, annual cancer cases have increased to 90,000 and each year, 45,000 people lose their lives to the disease.

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