Incidence Trend of Lung Cancer in Iran: A Systematic Review and Meta-analysis

authors:

avatar Elham Bastani 1 , avatar Fariba Shokri 1 , *

Department of Internal Medicine, Shahid Mostafa Khomaeini Hospital, School of Medicine, Ilam University of Medical Sciences, Ilam, Iran
International Journal of Cancer Management: Vol.16, issue 1; e135020
published online: April 30, 2023
article type: Systematic Review
received: January 17, 2023
revised: February 25, 2023
accepted: February 28, 2023
DOI: https://doi.org/10.5812/ijcm-135020

how to cite: Bastani E, Shokri F. Incidence Trend of Lung Cancer in Iran: A Systematic Review and Meta-analysis. Int J Cancer Manag. 2023;16(1):e135020. https://doi.org/10.5812/ijcm-135020.

Abstract

Context:

Lung cancer (LC) is one of the common diseases in the pulmonary system, which is defined as the uncontrolled growth of cells in the lung tissue.

Objectives:

The present investigation was conducted with the aim of the prevalence of LC in Iran by meta-analysis method.

Methods:

In this meta-analysis study, the articles that were conducted to determine age-standardized incidence rates (ASRs) in the field of LC were included in the study. The inclusion criteria included determining the number of ASRs in Iranian LC patients, reporting the sample size in men and women groups, and publishing articles between 2000 and January 2023. Data were analyzed, using CMA software.

Results:

In this meta-analysis study, 889 articles were found in the initial search, and after the final search, 23 articles were included in the meta-analysis stage. Out of the 22 final articles, the prevalence of LC was 3.7% (95% CI, 2.6 - 5.3) in women and 7.1% (95% CI, 5.7 - 9) in males.

Conclusions:

Considering that the incidence rate of LC in this study was high, it is essential to carry out necessary preventive interventions in this field.

1. Context

Iran is a developing country that has seen a period of communicable diseases prevalence and is currently facing the spread of non-communicable chronic diseases, which have high morbidity and mortality rate (1-3). Cancer is one of these chronic diseases that affect different parts of the body including the breast (4), brain (5), prostate (6), kidney, digestive system (7), and lung (8). By the way, cancer leads to physical and mental problems in the patient or the caregivers (9).

Lung cancer (LC) is one of the pulmonary systems, which is defined as the uncontrolled growth of cells in the lung tissue. Lung cancer does not show any symptoms in the early stages of the disease. So, when the patient refers to the doctor, it may be in advanced stages and create severe complications of the disease or may lead to death (10-12). According to the type and characteristics of each of the mentioned types, survival chances may be significantly different (13-15).

The high mortality rate of LC is due to the high incidence and low survival rate of this disease, and the metastasis of the disease is one of the factors affecting the survival and longevity of patients. Metastasis can be a new source for the occurrence of cancer in another part of the body, and with the spread of the disease and metastasis to other parts of the body, the patient's condition worsens and the patient's survival becomes a challenge (16-19).

Various factors, including age, affect the occurrence of cancer. So, most cancer patients are in the age range of over 65 years. Also, other factors such as smoking and exposure to industrial compounds (including arsenic, asbestos, and chromium), suffering from chronic lung diseases, occupational exposure, and a previous history of tuberculosis are effective in causing primary carcinoma of the lung (20-22). Each of the LC symptoms can have destructive effects on the quality of life, life expectancy, and mental health of patients and can lower the life expectancy of patients (23-25).

Based on the incidence rate of LC in some countries, this rate has been investigated in published articles. In terms of incidence rate, China is in the first place and the cause of about 30% of cancer deaths, and in the United States, LC is the second most common and cause of about 25% of cancer deaths (26-29). However, in Iran, accurate statistics on the incidence of l LC are not available.

2. Objectives

The present investigation was conducted with the aim of the prevalence of LC in Iran by meta-analysis method.

3. Methods

In this meta-analysis study, articles that were conducted to determine age-standardized incidence rates (ASRs) in the field of LC were included in the study. The inclusion criteria included determining the number of ASRs in Iranian LC patients, reporting the sample size in men and women groups, and publishing articles between 2000 and January 2023.

The search was conducted in the domestic databases of Iran such as SID, MagIran, IranMedex, and IranDoc, and the international databases such as Cochrane, Embase, ScienceDirect, Scopus, PubMed, and Web of Science. If the articles were entered, the inclusion and exclusion criteria of the study were collected according to the checklist made by the researcher (which had questions about the author's name, city, year of publication, sample size, and ASRs). Then, the data were analyzed, using CMA 3 software.

4. Results and Discussion

In this meta-analysis study, 889 articles were found in the initial search, and 23 articles were included in the meta-analysis stage (Figure 1 and Table 1).

Flowcharts for systematic review
Flowcharts for systematic review
Figure 1.

Flowcharts for systematic review

Table 1.

Characteristic of Studies

AuthorsCityYearsSample SizeASRs
MaleFemaleMaleFemale
1Roshandel et al. (30)Registry2014604695162812.75.21
2Sadjadi et al. (31)Ardabil2003207213097.93.6
3Fateh and Emamian (32)Registry2013123410062.711.92
4Mohagheghi et al. (33)Registry2009174071515414.97
5Somi et al. (34)East Azerbaijan2023254611756.693.89
6Somi et al. (35)East Azerbaijan2008279820859.583.70
7Babaei et al. (36)Semnan20059367969.194.57
8Vafajo Diantai et al. (37)Ghom2014196114383.467
9Mousavi et al. (38)Southeast of Iran2003 - 2004-168493.281.23
2004 - 2005-204734.381.51
2005 - 2006-244954.732.08
10Mehrabani et al. (39)Fars2008149516202.180.82
11Amori et al. (40)Iran20161687831322725.121.98
12Zeinalzadeh et al. (41)East Azerbaijan-204717825.25.5
13Salamat et al. (42)Golestan2020127455516.87.2
14Tolou Ghamari (43)Isfahan2018139954813.25.4
139954814.55.5
139954813.86.1
139954813.85.4
15Almasi et al. (44)Registry2016448383999110.35
16Karami et al. (45)Khuzestan201420731992103.7
17Shahesmaeili et al. (46)Kerman20181545129334.213.6
18Keyghobadi et al. (47)Kerman201557934802--
19Norouzirad et al. (48)Dezful201712709325.662.19
20Sadjadi et al. (49)Kerman2007326426207.12.8
21Masoompour et al. (50)Fars201145493810--
22Enayatrad et al. (51)Iran2004 - 200941169328986.12.6

Abbreviation: ASRs, age-standardized incidence rates.

The prevalence of LC was 3.7% (95% CI, 2.6 - 5.3) in women and 7.1% (95% CI, 5.7 - 9) in males. (Figures 2 and 3). Also, the funnel plot diagram is shown in Figures 4 and 5, and the regression of LC incidence in Figures 6 and 7.

Prevalence of lung cancer in Iranian women (I-squared = 99.708, Q-value = 6504.051)
Prevalence of lung cancer in Iranian women (I-squared = 99.708, Q-value = 6504.051)
Figure 2.

Prevalence of lung cancer in Iranian women (I-squared = 99.708, Q-value = 6504.051)

Prevalence of lung cancer in Iranian males (I-squared = 99.740, Q-value = 7314.729)
Prevalence of lung cancer in Iranian males (I-squared = 99.740, Q-value = 7314.729)
Figure 3.

Prevalence of lung cancer in Iranian males (I-squared = 99.740, Q-value = 7314.729)

Funnel plot diagram for lung cancer in Iranian women
Funnel plot diagram for lung cancer in Iranian women
Figure 4.

Funnel plot diagram for lung cancer in Iranian women

Funnel plot diagram for lung cancer in Iranian males
Funnel plot diagram for lung cancer in Iranian males
Figure 5.

Funnel plot diagram for lung cancer in Iranian males

Regression of lung cancer (LC) incidence in Iranian women according to the number of patients (I2 = 99.6%, Q = 0.95, P = 0.32)
Regression of lung cancer (LC) incidence in Iranian women according to the number of patients (I2 = 99.6%, Q = 0.95, P = 0.32)
Figure 6.

Regression of lung cancer (LC) incidence in Iranian women according to the number of patients (I2 = 99.6%, Q = 0.95, P = 0.32)

Regression of lung cancer (LC) incidence in Iranian males according to the number of patients (I2 = 99.67%, Q = 0.19, P = 0.66)
Regression of lung cancer (LC) incidence in Iranian males according to the number of patients (I2 = 99.67%, Q = 0.19, P = 0.66)
Figure 7.

Regression of lung cancer (LC) incidence in Iranian males according to the number of patients (I2 = 99.67%, Q = 0.19, P = 0.66)

The prevalence of LC was 3.7% (95% CI, 2.6 - 5.3) in women and 7.1% (95% CI, 5.7 - 9) in males. In the meta-analysis study by Hassanipour et al., which reviewed 14 original articles on the incidence of LC; the incidence rate was 6.33% in men and 2.57% in women (52). From the difference between this meta-analysis study and Hassanipour et al. study, 14 articles in the group of women and 14 articles in the group of men were included in the meta-analysis study between 1996 and 2010 (52). In this meta-analysis study, 21 articles for the group of men and 20 articles for the group of women were included in the study.

The incidence rate of LC in men was 7.1%, which was found in 21 reviewed articles between 2021 and 2023. Sun et al. reported an incidence of 50.04 per 100 000 (53), which was higher than the results of this study. Also, regarding women in the study of DeRouen et al., the incidence of LC among women who had no history of smoking was 13.1%, and among women who smoked was 17.1%, which is much higher than the results of this study (54).

In this meta-analysis study, the incidence rate of LC was higher in men (7.1%). In the study of Sun et al. in China (53) and the study of Yang et al. in China and the United States, the incidence rate was 69% in men and 31%in women (55), which was consistent with the results of this study. On the other hand, in the study of Jemal et al. in the United States and the group born in 1950 in people aged 45 to 49 years, the incidence rate in women was 27% per 100 000, and in men, it was 36.5% per 100 000. In the group born in 1965, the incidence in women was 24.5% per 100 000, and in men, it was 23.1% per 100 000 (56). One of the reasons for the difference between this meta-analysis study and Jemal et al.'s study is the difference in the risk factors that cause cancer. In Iran, smoking, as one of these risk factors, is less common in women than in men. The prevalence of chronic diseases is increasing and all the efforts of the health and treatment staff are to reduce chronic diseases. For this reason, prevalence studies in the field of chronic diseases are a priority (57, 58).

Among the strengths of this study, we can mention updating the data related to the occurrence of LC in Iran. By updating the incidence of LC, health policymakers can make the necessary decisions in the field of prevention and early detection of LC.

5. Conclusions

Considering that the incidence rate of LC in this study was high, it is essential to carry out necessary preventive interventions in this field.

References

  • 1.

    Ghobadi H, Sharghi A, Sadat-Kermani J. [Epidemiology and Risk Factors for Lung Cancer in Ardabil, Iran]. J Ardabil Univ Med Sci. 2013;13(2):220-8. Persian.

  • 2.

    Karbasfrushan A, Karimiyarandi H. Role of vitamin D on knee osteoarthritis pain: a systematic review. Eurasian Chem Commun. 2022;4(12):1241-50. https://doi.org/10.22034/ecc.2022.351411.1505.

  • 3.

    Komlakh K, Karbasfrushan A. The effect of Pregabalin on the pain status of patients with disc and spinal surgeries: A systematic review of drug therapy. Eurasian Chem Commun. 2022;4(11):1147-55. https://doi.org/10.22034/ecc.2022.348692.1491.

  • 4.

    Razavi M, Sepidarkish M, Maleki-Hajiagha A, Vesali S, Almasi-Hashiani A, Najdi N, et al. Preterm Birth and Breast Cancer Risk: A Systematic Review and Meta-Analysis. Asian Pac J Cancer Prev. 2023;24(1):25-35. [PubMed ID: 36708549]. https://doi.org/10.31557/APJCP.2023.24.1.25.

  • 5.

    Solati H, Sahebalzamani M, Adhami Moghadam F. [Effect of Family-Based Care Training by Tele-nursing on Emotional Reactions in Mothers of Children with Bone Marrow Transplantation]. J Mazandaran Univ Med Sci. 2021;30(192):156-61. Persian.

  • 6.

    Murray NP, Aedo S, Fuentealba C, Reyes E, Salazar A. Increasing Immune Dysfunction is Associated with Increasing Matrix-Metalloproteinase-2 Expression and Predicts Biochemical Failure in Men with Bone Marrow Micro-Metastasis Positive Localized Prostate Cancer. Asian Pac J Cancer Prev. 2022;23(7):2497-505. [PubMed ID: 35901359]. [PubMed Central ID: PMC9727333]. https://doi.org/10.31557/APJCP.2022.23.7.2497.

  • 7.

    Borji M, Tarjoman A, Abdi A, Otaghi M. Efficacy of Implementing Home Care Using Eye Movement Desensitization and Reprocessing in Reducing Stress of Patients with Gastrointestinal Cancer. Asian Pac J Cancer Prev. 2019;20(7):1967-71. [PubMed ID: 31350952]. [PubMed Central ID: PMC6745210]. https://doi.org/10.31557/APJCP.2019.20.7.1967.

  • 8.

    Lin L, Xu F, Zhou C, Quan Z, Jiang H. Association of MiR-149 with Nutritional Risk Assessment and Postoperative Complications of Patients with Colorectal Cancer. Iran Red Crescent Med J. 2021;23(12):e1259. https://doi.org/10.32592/ircmj.2021.23.12.1259.

  • 9.

    Shokri M, Tarjoman A, Borji M, Solaimanizadeh L. Investigating psychological problems in caregiver of pediatrics with cancer: A systematic review. J Child Adolesc Psychiatr Nurs. 2020;33(4):229-38. [PubMed ID: 32275101]. https://doi.org/10.1111/jcap.12269.

  • 10.

    Alipour E, Shekarabi M, Moosavi SAJ, Delbandi AA, Kouranifar S, Teimourian S, et al. [Prevalence of Latent Tuberculosis infection in lung cancer patients and compare it with healthy individuals]. Razi J Med Sci. 2018;25(2):49-57. Persian.

  • 11.

    Bursalioglu EO. Effect of cow colostrum, mare milk, and human milk on the viability of lung healthy and cancer cell lines. Iran Red Crescent Med J. 2021;23(5):e409. https://doi.org/10.32592/ircmj.2021.23.5.409.

  • 12.

    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. [PubMed ID: 30207593]. https://doi.org/10.3322/caac.21492.

  • 13.

    Kwak EL, Bang YJ, Camidge DR, Shaw AT, Solomon B, Maki RG, et al. Anaplastic lymphoma kinase inhibition in non-small-cell lung cancer. N Engl J Med. 2010;363(18):1693-703. [PubMed ID: 20979469]. [PubMed Central ID: PMC3014291]. https://doi.org/10.1056/NEJMoa1006448.

  • 14.

    Kasper DL, Fauci AS, Hauser SL, Longo DL, Jameson JL, Loscalzo J. Harrison's principles of internal medicine, Vol. 1. 19th ed. New York: McGraw Hill; 2015.

  • 15.

    Babanejhad F, Yazdani Charati J, Shbankhani B, Aliyannejhad R, Saber S, Ghasemkhani S. [Survival Analysis of Patients with Lung Cancer Using Cox Regression Model]. J Mazandaran Univ Med Sci. 2018;28(161):66-74. Persian.

  • 16.

    Mohajeri G, Kolahdouzan M, Eghbal A. [Evaluation of the Odds of Survival of Patients with Micrometastasis of Lung Cancer to Rib]. J Isfahan Med Sch. 2021;39(621):262-9. Persian.

  • 17.

    Badaoui S, Shahnam A, McKinnon RA, Abuhelwa AY, Sorich MJ, Hopkins AM. The predictive utility of patient-reported outcomes and performance status for survival in metastatic lung cancer patients treated with chemoimmunotherapy. Transl Lung Cancer Res. 2022;11(3):432-9. [PubMed ID: 35399575]. [PubMed Central ID: PMC8988084]. https://doi.org/10.21037/tlcr-21-938.

  • 18.

    Baeradeh N, Mirzae M, Zamani M. [Epidemiology of Prevalent Cancers In Khorasan Razavi province in 2008]. Med J Mashhad Univ Med Sci. 2015;57(8):926-31. Persian. https://doi.org/10.22038/mjms.2015.3635.

  • 19.

    Hashemzadeh S, Hashemzadeh K. Epidemiological Study of Lung Cancer in East Azerbaijan, Iran. J Cardiovasc Thorac Res. 2009;1(4):7-12.

  • 20.

    Boktour M, Hanna H, Ansari S, Bahna B, Hachem R, Tarrand J, et al. Central venous catheter and Stenotrophomonas maltophilia bacteremia in cancer patients. Cancer. 2006;106(9):1967-73. [PubMed ID: 16565968]. https://doi.org/10.1002/cncr.21846.

  • 21.

    Malani PN. Harrison’s Principles of Internal Medicine. Jama. 2012;308(17):1813. https://doi.org/10.1001/jama.308.17.1813-b.

  • 22.

    Abbasi M, Moradi F, Esna-Ashari F, Seifrabiei MA. [Epidemiological and Pathological Study of Lung Cancer in Patients Referred to Ekbatan and Shahid Beheshti Hospitals in Hamadan during 2001-2016]. Avicenna J Clin Med. 2019;25(4):236-43. Persian. https://doi.org/10.21859/ajcm.25.4.236.

  • 23.

    Peravali M, Joshi I, Ahn J, Kim C. A Systematic Review and Meta-Analysis of Clinical Characteristics and Outcomes in Patients With Lung Cancer with Coronavirus Disease 2019. JTO Clin Res Rep. 2021;2(3):100141. [PubMed ID: 33437971]. [PubMed Central ID: PMC7790456]. https://doi.org/10.1016/j.jtocrr.2020.100141.

  • 24.

    Martin RE, Loomis DM, Dean GE. Sleep and quality of life in lung cancer patients and survivors. J Am Assoc Nurse Pract. 2021;34(2):284-91. [PubMed ID: 34225324]. [PubMed Central ID: PMC8720315]. https://doi.org/10.1097/JXX.0000000000000625.

  • 25.

    Masoompour SM, Lankarani KB, Honarvar B, Tabatabaee SH, Moghadami M, Khosravizadegan Z. Changing Epidemiology of Common Cancers in Southern Iran, 2007-2010: A Cross Sectional Study. PLoS One. 2016;11(5):e0155669. [PubMed ID: 27219458]. [PubMed Central ID: PMC4878731]. https://doi.org/10.1371/journal.pone.0155669.

  • 26.

    Chen W, Zheng R, Baade PD, Zhang S, Zeng H, Bray F, et al. Cancer statistics in China, 2015. CA Cancer J Clin. 2016;66(2):115-32. [PubMed ID: 26808342]. https://doi.org/10.3322/caac.21338.

  • 27.

    American Thoracic Society; European Respiratory Society. American Thoracic Society/European Respiratory Society International Multidisciplinary Consensus Classification of the Idiopathic Interstitial Pneumonias. This joint statement of the American Thoracic Society (ATS), and the European Respiratory Society (ERS) was adopted by the ATS board of directors, June 2001 and by the ERS Executive Committee, June 2001. Am J Respir Crit Care Med. 2002;165(2):277-304. [PubMed ID: 11790668]. https://doi.org/10.1164/ajrccm.165.2.ats01.

  • 28.

    Mehrvar A, Faranoush M, Hedayati Asl AA, Tashvighi M, Fazeli MA, Qaddoumi I, et al. Childhood central nervous system tumors at MAHAK's Pediatric Cancer Treatment and Research Center (MPCTRC), Tehran, Iran. Childs Nerv Syst. 2014;30(3):491-6. [PubMed ID: 23943227]. https://doi.org/10.1007/s00381-013-2256-8.

  • 29.

    Esmail Nasab N, Moradi G, Zareie M, Ghaderi E, Gheytasi B. [Survey of epidemilogic status and incidence rates of cancers in the patients above 15 years old in Kurdistan province]. Sci J Kurdistan Univ Med Sci. 2007;11(4):18-25. Persian.

  • 30.

    Roshandel G, Ghanbari-Motlagh A, Partovipour E, Salavati F, Hasanpour-Heidari S, Mohammadi G, et al. Cancer incidence in Iran in 2014: Results of the Iranian National Population-based Cancer Registry. Cancer Epidemiol. 2019;61:50-8. [PubMed ID: 31132560]. https://doi.org/10.1016/j.canep.2019.05.009.

  • 31.

    Sadjadi A, Malekzadeh R, Derakhshan MH, Sepehr A, Nouraie M, Sotoudeh M, et al. Cancer occurrence in Ardabil: results of a population-based cancer registry from Iran. Int J Cancer. 2003;107(1):113-8. [PubMed ID: 12925965]. https://doi.org/10.1002/ijc.11359.

  • 32.

    Fateh M, Emamian MH. Cancer incidence and trend analysis in Shahroud, Iran, 2000 - 2010. Iran J Cancer Prev. 2013;6(2):85-94. [PubMed ID: 25250116]. [PubMed Central ID: PMC4142911].

  • 33.

    Mohagheghi MA, Mosavi-Jarrahi A, Malekzadeh R, Parkin M. Cancer incidence in Tehran metropolis: the first report from the Tehran Population-based Cancer Registry, 1998-2001. Arch Iran Med. 2009;12(1):15-23. [PubMed ID: 19111024].

  • 34.

    Somi MH, Mousavi SM, Rezaeifar P, Naghashi SH. Cancer incidence among the elderly population in the Northwest of Iran: A population based study. Iran J Cancer Prev. 2009;2(3):117-26.

  • 35.

    Somi MH, Farhang S, Mirinezhad SK, Naghashi S, Seif-Farshad M, Golzari M. Cancer in East Azerbaijan, Iran: results of a population-based cancer registry. Asian Pac J Cancer Prev. 2008;9(2):327-30. [PubMed ID: 18712985].

  • 36.

    Babaei M, Mousavi S, Malek M, Tosi G, Masoumeh Z, Danaei N, et al. Cancer occurrence in Semnan Province, Iran: results of a population-based cancer registry. Asian Pac J Cancer Prev. 2005;6(2):159-64. [PubMed ID: 16101326].

  • 37.

    Vafajo Diantai Z, Abedini Z, Ahmari Tehran H, Mohamadgholizade L. [Epidemiology of cancer in Qom, Iran 2008-2011]. Payesh. 2014;13(2):155-63. Persian.

  • 38.

    Mousavi SM, Gouya MM, Ramazani R, Davanlou M, Hajsadeghi N, Seddighi Z. Cancer incidence and mortality in Iran. Ann Oncol. 2009;20(3):556-63. [PubMed ID: 19073863]. https://doi.org/10.1093/annonc/mdn642.

  • 39.

    Mehrabani D, Tabei SZ, Heydari ST, Shamsina SJ, Shokrpour N, Amini M. Cancer Occurrence in Fars Province, Southern Iran. Iran Red Crescent Med J. 2008;10(4):314-22.

  • 40.

    Amori N, Aghajani M, Asgarian FS, Jazayeri M. Epidemiology and trend of common cancers in Iran (2004-2008). Eur J Cancer Care (Engl). 2017;26(5):e12449. [PubMed ID: 26811194]. https://doi.org/10.1111/ecc.12449.

  • 41.

    Zeinalzadeh AH, Hosseini R, Abdullahi L. [Survey of Epidemiology of Cancers in the Patients above 15 Years Old in East Azerbaijan Province, Iran 2013]. J Ardabil Univ Med Sci. 2015;15(1):46-55. Persian.

  • 42.

    Salamat F, Khandashpour M, Naeimi-Tabiei M, Ariannia A, Ashaari M, Sedaghat S, et al. Increasing trends of lung cancer in Golestan province, Northern Iran (2004-2016). Cancer Epidemiol. 2020;65:101687. [PubMed ID: 32087554]. https://doi.org/10.1016/j.canep.2020.101687.

  • 43.

    Tolou Ghamari Z. Prevalence of lung cancer in Isfahan Province, Iran. J Egypt Natl Canc Inst. 2018;30(2):57-9. [PubMed ID: 29691096]. https://doi.org/10.1016/j.jnci.2018.03.001.

  • 44.

    Almasi Z, Mohammadian-Hafshejani A, Salehiniya H. Incidence, mortality, and epidemiological aspects of cancers in Iran; differences with the world data. J BUON. 2016;21(4):994-1004. [PubMed ID: 27685925].

  • 45.

    Karami K, Cheraghi M, Amori N, Pedram M, Sobhani A. Common cancers in Khuzestan province, south west of Iran, during 2005-2011. Asian Pac J Cancer Prev. 2014;15(21):9475-8. [PubMed ID: 25422242]. https://doi.org/10.7314/apjcp.2014.15.21.9475.

  • 46.

    Shahesmaeili A, Malekpour Afshar R, Sadeghi A, Bazrafshan A. Cancer Incidence in Kerman Province, Southeast of Iran: Report of an ongoing Population-Based Cancer Registry, 2014. Asian Pac J Cancer Prev. 2018;19(6):1533-41. [PubMed ID: 29936728]. [PubMed Central ID: PMC6103577]. https://doi.org/10.22034/APJCP.2018.19.6.1533.

  • 47.

    Keyghobadi N, Rafiemanesh H, Mohammadian-Hafshejani A, Enayatrad M, Salehiniya H. Epidemiology and trend of cancers in the province of Kerman: southeast of Iran. Asian Pac J Cancer Prev. 2015;16(4):1409-13. [PubMed ID: 25743807]. https://doi.org/10.7314/apjcp.2015.16.4.1409.

  • 48.

    Norouzirad R, Khazaei Z, Mousavi M, Adineh HA, Hoghooghi M, Khabazkhoob M, et al. Epidemiology of common cancers in Dezful county, southwest of Iran. Immunopathol Persa. 2018;4(1):e10. https://doi.org/10.15171/ipp.2018.10.

  • 49.

    Sadjadi A, Zahedi MJ, Darvish Moghadam S, Nouraie M, Alimohammadian M, Ghorbani A, et al. The First Population-Based Cancer Survey in Kerman Province of Iran. Iran J Public Health. 2007;36(4):26-34.

  • 50.

    Masoompour SM, Yarmohammadi H, Rezaianzadeh A, Lankarani KB. Cancer incidence in southern Iran, 1998-2002: results of population-based cancer registry. Cancer Epidemiol. 2011;35(5):e42-7. [PubMed ID: 21840285]. https://doi.org/10.1016/j.canep.2011.05.018.

  • 51.

    Enayatrad M, Mirzaei M, Salehiniya H, Karimirad MR, Vaziri S, Mansouri F, et al. Trends in Incidence of Common Cancers in Iran. Asian Pac J Cancer Prev. 2016;17(S3):39-42. [PubMed ID: 27165205]. https://doi.org/10.7314/apjcp.2016.17.s3.39.

  • 52.

    Hassanipour S, Mokhtari AM, Fathalipour M, Salehiniya H. The incidence of lung cancer in Iran: a systematic review and meta-analysis. World Cancer Res J. 2017;4(4):e980.

  • 53.

    Sun KX, Zheng RS, Zeng HM, Zhang SW, Zou XN, Gu XY, et al. [The incidence and mortality of lung cancer in China, 2014]. Zhonghua Zhong Liu Za Zhi. 2018;40(11):805-11. Chinese. [PubMed ID: 30481929]. https://doi.org/10.3760/cma.j.issn.0253-3766.2018.11.002.

  • 54.

    DeRouen MC, Canchola AJ, Thompson CA, Jin A, Nie S, Wong C, et al. Incidence of Lung Cancer Among Never-Smoking Asian American, Native Hawaiian, and Pacific Islander Females. J Natl Cancer Inst. 2022;114(1):78-86. [PubMed ID: 34345919]. [PubMed Central ID: PMC8755498]. https://doi.org/10.1093/jnci/djab143.

  • 55.

    Yang D, Liu Y, Bai C, Wang X, Powell CA. Epidemiology of lung cancer and lung cancer screening programs in China and the United States. Cancer Lett. 2020;468:82-7. [PubMed ID: 31600530]. https://doi.org/10.1016/j.canlet.2019.10.009.

  • 56.

    Jemal A, Miller KD, Ma J, Siegel RL, Fedewa SA, Islami F, et al. Higher Lung Cancer Incidence in Young Women Than Young Men in the United States. N Engl J Med. 2018;378(21):1999-2009. [PubMed ID: 29791813]. [PubMed Central ID: PMC7717174]. https://doi.org/10.1056/NEJMoa1715907.

  • 57.

    Daryabari SH, Asadollah A, Adhami Moghadam F, Dorostkar R, Bahramifar A, Aghamollaei H. Detection of COVID-19 in tears of ICU-admitted patients with SARS-CoV-2 infection. Int Ophthalmol. 2022;42(3):723-7. https://doi.org/10.1007/s10792-021-01938-3.

  • 58.

    Mazlominezhad A, Moghadam FA. Evaluation of quality of life and self-efficacy in adolescents with amblyopia. J Med Life. 2022;15(4):499-503. [PubMed ID: 35646181]. [PubMed Central ID: PMC9126460]. https://doi.org/10.25122/jml-2020-0035.