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A Comparative Study of Spatial Distribution of Gastrointestinal Cancers in Poverty and Affluent Strata (Kermanshah Metropolis, Iran)

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Abstract

Introduction

The trend of cancers has witnessed a twofold rise in the last three decades, which is expected to be fivefold by 2030. On the other hand, gastrointestinal cancers have turned into one of the health issues in many societies. Given the presence of gastrointestinal cancer hot spots and evidence of health inequalities across Kermanshah Metropolis and the results of studies signaling the association between gastrointestinal cancers and socioeconomic status of individuals as well as evidence of unequal socioeconomic opportunities in this metropolis, the present study aimed to investigate the spatial distribution of gastrointestinal cancers in the poverty and affluent strata of Kermanshah Metropolis, Iran.

Materials and Methods

In this descriptive-analytical study, the recorded data of patients, suffering from gastrointestinal cancers, in Kermanshah-based Pathology Centers and Vice Chancellery of Kermanshah University of Medical Sciences (2007–2012) were used. Moreover, to examine the status of gastrointestinal cancers in socioeconomic classes based on the census data collected during 2007–2012, 33 social, cultural, and structural indexes were extracted from the statistical blocks. Additionally, for data analysis and factor analysis, Kruskal–Wallis Test in the environment of SPSS and kernel density estimation (KDE) and Moran’s I tests in the GIS environment were employed.

Findings

The results of the present study revealed that the distribution of poverty (Z score = 48.916518, p value = 0.000000) and affluent strata (Z score = 14.345028, p value = 0.000000) followed clustered patterns (p < 0.01). Additionally, the results indicated that the spatial distribution pattern of the upper gastrointestinal cancer was clustered (Z score = 1.896996, p value = 0.007828), whereas the spatial distribution pattern of the lower gastrointestinal cancer was inclined to a randomized clustered pattern (Z score = 1.338121, p value = 0.000857) (p < 0.01). Finally, seven main hot spots were identified from the poverty stratum in Kermanshah, which perfectly overlapped the hot spots of upper gastrointestinal cancer. Similarly, four main hot spots were identified from the affluent stratum in Kermanshah, which overlapped the hot spots of lower gastrointestinal cancer. The results of the Kruskal–Wallis Test demonstrated that the poverty and affluent strata were significantly different from each other in terms of gastrointestinal cancer: upper gastrointestinal cancer (p < 0.05 and X2=10.064) and lower gastrointestinal cancer (p < 0.05 and X2=10.253).

Conclusion

The results of the present study showed that the ratio of patients with lower gastrointestinal cancers was higher than the incidence of upper gastrointestinal cancers over the 5-year period under study. Moreover, in Kermanshah Metropolis, there was a significant difference between the upper gastrointestinal cancer in the poverty stratum and the lower gastrointestinal cancer in the affluent stratum. Hence, it is suggested that GIS be applied as a tool for identifying the patterns of effective factors of this type of cancer in each social class, and it is recommended that some effective policies be presented and adopted by health managers according to the role and importance of socioeconomic, environmental, and nutritional factors in the poverty and affluent strata of society, and people at risk be equipped with preventive training programs in this respect.

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References

  1. Bener A, Moore MA, Ali R, El Ayoubi HR. Impacts of family history and lifestyle habits on colorectal cancer risk: a case-control study in Qatar. Asian Pac J Cancer Prev. 2010;11(4):963–8.

    PubMed  Google Scholar 

  2. Folley TJ, Nylander-French LA, Joubert DM, Gibson JM. Estimated burden of disease attributable to selected occupational exposures in the United Arab Emirates. Am J Ind Med. 2012;55(10):940–52.

    Article  PubMed  Google Scholar 

  3. Rahimi F, Heidari M. Time trend analysis of stomach cancer incidence in the west of Iran. J Health Dev. 2012;1(2):100–11.

    Google Scholar 

  4. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2015. CA Cancer J Clin. 2015;65(1):5–29.

    Article  PubMed  Google Scholar 

  5. Amani F, Sadrkabir M, Ahari SS, Barzghari S, Yazdanbod A, Sabzevari A, et al. Epidemiology of gastric cancer in Northwest Iran: 2003–2011. MEJC. 2015;6(3):189–93.

    Google Scholar 

  6. Borji A, Bayat M, Shamsabadi F, Amini F, Dayyani M, Mehrad Majd H. Epidemiology of gastrointestinal cancers (stomach, esophageal and colorectal) in Neyshabur City during 2006–2012. J Neyshabur Univ Med Sci. 2016;3(4):37–44.

    Google Scholar 

  7. Belpomme D, Irigaray P, Sasco A, Newby J, Howard V, Clapp R, et al. The growing incidence of cancer: role of lifestyle and screening detection (review). Int J Oncol. 2007;30(5):1037–50.

    CAS  PubMed  Google Scholar 

  8. Brown R, Kerr K, Haoudi A, Darzi A. Tackling cancer burden in the Middle East: Qatar as an example. Lancet Oncol. 2012;13(11):501–8.

    Article  Google Scholar 

  9. Greenlee RT, Howe HL. County-level poverty and distant stage cancer in the United States. Cancer Causes Control. 2009;20(6):989–1000.

    Article  PubMed  Google Scholar 

  10. Hemminki K, Li X. Level of education and the risk of cancer in Sweden. Cancer Epidemiol Biomark Prev. 2003;12(8):796–802.

    Google Scholar 

  11. Hemminki K, Zhang H, Czene K. Socioeconomic factors in cancer in Sweden. Int J Cancer. 2003;105(5):692–700.

    Article  CAS  PubMed  Google Scholar 

  12. Pisa F, Barbone F, Montella M, Talamini R, La Vecchia C, Franceschi S. Migration, socio-economic status and the risk of colorectal cancer in Italy. Eur J Cancer Prev. 2000;9(6):409–16.

    Article  CAS  PubMed  Google Scholar 

  13. Nguyen DK, Maggard-Gibbons M. Age, poverty, acculturation, and gastric cancer. Surgery. 2013;154(3):444–52.

    Article  PubMed  Google Scholar 

  14. Tomatis L. Poverty and cancer. IARC Sci Publ. 1996;138:25–39.

    Google Scholar 

  15. Hydary L, Mokhtari Hesari P. Common breast cancer family care giving problems. IJBD. 2015;8(2):7–14.

    Google Scholar 

  16. Madise NJ, Ziraba AK, Inungu J, Khamadi SA, Ezeh A, Zulu EM, et al. Are slum dwellers at heightened risk of HIV infection than other urban residents? Evidence from population-based HIV prevalence surveys in Kenya. Health Place. 2012;18(5):1144–52.

    Article  PubMed  Google Scholar 

  17. Dalton SO, Schüz J, Engholm G, Johansen C, Kjær SK, Steding-Jessen M, et al. Social inequality in incidence of and survival from cancer in a population-based study in Denmark, 1994–2003: summary of findings. Eur J Cancer. 2008;44(14):2074–85.

    Article  PubMed  Google Scholar 

  18. Almasi A, Shamsi M, Eshrati B, Farzam R, Alimoradi K, Rahmati L. The epidemiology of gastrointestinal cancers (stomach, esophageal, colorectal) in Markazi province during 2005–2010. J Neyshabur Univ Med Sci. 2014;2(2):22–7.

    Google Scholar 

  19. Lopez AD, Mathers CD, Ezzati M, Jamison DT, Murray CJ. Global and regional burden of disease and risk factors, 2001: systematic analysis of population health data. Lancet. 2006;367(9524):1747–57.

    Article  PubMed  Google Scholar 

  20. Ramezani GB, Hanifi A. Recognition of geographical diffusion of stomach cancer in gilan province. J Environ Sci Technol. 2011;13(2):81–94.

    Google Scholar 

  21. Safe A, Rashidi M, Rouzbahani R, Dehdashti NS, Poursafa P. Application of GIS in strategic medical research for disease prevention. JIMS. 2012;29(164):1–7.

    Google Scholar 

  22. Reshadat S, Saedi S, Zangeneh A, Amooie MR, Karbasi A. Equity in access to health care using geographic information system: a Kermanshah case study. J Mazandaran Univ Med Sci. 2014;24(115):134–40.

    Google Scholar 

  23. Reshadat S, Zangeneh A, Saeidi S, Ghasemi SR, Rajabi Gilan N, Abbasi S. Investigating the economic, social and cultural factors influencing total fertility rate in Kermanshah. J Mazandaran Univ Med Sci. 2015;25(127):108–12.

    Google Scholar 

  24. Reshadat S, Saedi S, Zangeneh A, Ghasemi S, Gilan N, Karbasi A, et al. Spatial accessibility of the population to urban health centres in Kermanshah, Islamic Republic of Iran: a geographic information systems analysis. East Mediterr Health J. 2015;21(6):389–95.

    Article  CAS  PubMed  Google Scholar 

  25. Reshadat S, Zangeneh A, Saeidi S, Khademi N, Izadi N, Ghasemi SR, et al. The spatial clustering analysis of HIV and poverty through GIS in the metropolis of Kermansha, western Iran. Acta Medica Mediterranea. 2016;32:1995–9.

    Google Scholar 

  26. Khademi N, Reshadat S, Zanganeh A, Saeidi S, Ghasemi S, Zakiei A. Identifying HIV distribution pattern based on clustering test using GIS software, Kermanshah, Iran. HIV AIDS Rev. 2016;15(4):147–52.

    Article  Google Scholar 

  27. Khademi N, Reshadat S, Zangeneh A, Saeidi S, Ghasemi S, Rajabi-Gilan N, et al. A comparative study of the spatial distribution of HIV prevalence in the metropolis of Kermanshah, Iran, in 1996–2014 using geographical information systems. HIV Med. 2017;18(3):220–4.

    Article  CAS  PubMed  Google Scholar 

  28. Reshadat S, Zangeneh A, Saeidi S, Izadi N, Ghasemi SR, Rajabi-Gilan N. A feasibility study of implementing the policies on increasing birth rate with an emphasis on socio-economic status: a case study of Kermanshah Metropolis, Western Iran. Soc Indic Res. 2018:1–18.

  29. Zangeneh A, Najafi F, Karimi S, Saeidi S, Izadi N. Spatial-temporal cluster analysis of mortality from road traffic injuries using geographic information systems in West of Iran during 2009–2014. J Forensic Legal Med. 2018;55:15–22.

    Article  Google Scholar 

  30. Reshadat S, Saeidi S, Zangeneh A, Ziapour A, Choobtashani M, Saeidi F. A study of children’s geographic access to health services (health care centers and clinical laboratories) in Kermanshah City, Iran. Int J Pediatr. 2018;6(2):7241–51.

    Google Scholar 

  31. Reshadat S, Saeidi S, Zangeneh A, Ziapour A, Choobtashani M, Saeidi F. The study of children and adolescents’ access to hospitals and emergency centers in Kermanshah, west of Iran. Int J Pediatr. 2018;6(5):7697–707.

    Google Scholar 

  32. Reshadat S, Zangeneh A, Saeidi S, Ziapour A, Saeidi F, Choobtashani M. A study of the application of GIS in 0-14-year-old children’s access to pharmacies (a case study of Kermanshah, west of Iran). Int J Pediatr. 2018;6(2):7241–51.

  33. Tanser F, Le Sueur D. The application of geographical information systems to important public health problems in Africa. Int J Health Geogr. 2016;1(4):9–15.

    Google Scholar 

  34. Samat N, Shattar AKA. Spatial accessibility of colorectal cancer patients to health care facilities in Kelantan state: a study on medical geography. World Appl Sci J. 2014;31(10):1772–82.

    Google Scholar 

  35. Musa GJ, Chiang P-H, Sylk T, Bavley R, Keating W, Lakew B, et al. Use of GIS mapping as a public health tool—from cholera to cancer. HSI. 2013;6(1):111–6.

    Google Scholar 

  36. Mohammadpour Tahamtan RA, Yazdani J, Zare S, Fakheri HT, Bagheri S. Geographical mapping of gastrointestinal cancer mortality rates in Mazandaran and Golestan provinces, Iran. J Mazandaran Univ Med Sci. 2014;23(110):125–35.

    Google Scholar 

  37. Askarian M, Goli A, Oroei M, Faramarzi H. The geographical clusters of gastrointestinal tract cancer in Fars province, southern Iran. Int J Prev Med. 2014;5(7):857–62.

    PubMed  PubMed Central  Google Scholar 

  38. Freeman HP. Poverty, culture, and social injustice: determinants of cancer disparities. CA Cancer J Clin. 2004;54(2):72–7.

    Article  PubMed  Google Scholar 

  39. Boscoe FP, Johnson CJ, Sherman RL, Stinchcomb DG, Lin G, Henry KA. The relationship between area poverty rate and site-specific cancer incidence in the United States. Cancer. 2014;120(14):2191–8.

    Article  PubMed  Google Scholar 

  40. Weiderpass E, Pukkala E. Time trends in socioeconomic differences in incidence rates of cancers of gastro-intestinal tract in Finland. BMC Gastroenterol. 2006;6(1):41–50.

    Article  PubMed  PubMed Central  Google Scholar 

  41. Rostaei S, Ahadnejad Reveshty M, Asghari Zamani A, Zangenh A. Assessment of urban poverty spatial distribution in Kermanshah City. SWQ. 2012;12(45):77–101.

    Google Scholar 

  42. Gooya MM, Soroush M, Khademi N, Mokhtari-Azad T, Janbakhsh A, Yeilaghi S, et al. An evaluation of the effects of influenza vaccination on HIV/AIDS-stricken patients in Kermanshah Province, western Iran. ATMPH. 2017;10(3):628.

    Google Scholar 

  43. Reshadat S, Saeidi S, Zangeneh AR, Khademi N, Khasi K, Ghasemi S, et al. Spatiotemporal distribution of gastrointestinal tract cancer through GIS over 2007–2012 in Kermanshah-Iran. APJCP. 2014;16(17):7737–42.

    Google Scholar 

  44. Fritz A, Percy C, Jack A, Shanmugaratnam K, Sobin L, Parkin DM, et al. International classification of diseases for oncology. Geneva: World Health Organization; 2000. p. 1–240.

    Google Scholar 

  45. Safaee A, Moghimi DB, Fatemi SR, Maserat E, Fatemeh G, Zali MR. Risk estimation of upper gastrointestinal cancers in people with family history of cancer. JKH. 2012;7(2):65–9.

    Google Scholar 

  46. Goovaerts P, Jacquez GM. Detection of temporal changes in the spatial distribution of cancer rates using local Moran’s I and geostatistically simulated spatial neutral models. J Geogr Syst. 2005;7(1):137–59.

    Article  PubMed  PubMed Central  Google Scholar 

  47. Rohani Rasaf M, Rohani Rasaf M, Rahimi F, Mehrazma M, Golmohammadi A, Motiedoost R, et al. Distribution of cancer incidence in districts and neighbourhoods of a number of Tehran districts in 1386. RJMS. 2011;18(89):34–45.

    Google Scholar 

  48. Zahedi M, Darvishmoghadam S, Hayatbakhsh Abbasi M, Zeinalinejad H. The incidence rate of gastrointestinal tract cancers in Kerman province during 1996–2000. JKMU. 2005;12(3):153–8.

    Google Scholar 

  49. Gelband H, Sankaranarayanan R, Gauvreau CL, Horton S, Anderson BO, Bray F, et al. Costs, affordability, and feasibility of an essential package of cancer control interventions in low-income and middle-income countries: key messages from Disease Control Priorities. Lancet. 2016;387(10033):2133–44.

    Article  PubMed  Google Scholar 

  50. 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  Google Scholar 

  51. 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.

    Article  CAS  PubMed  Google Scholar 

  52. Nejad FN, Daryasari RR, Ghafari F. Epidemiology of cancer in Mazandaran province 2006. J Mazand Univ Med Sci. 2009;19(72):61–5.

    Google Scholar 

  53. Lankarani KB, Mowla A, Asadian F, Tabei S, Panjeshahin M. Changing epidemiology of esophageal cancer in Fars Province, Iran. IJMS. 2015;27(1):4–10.

    Google Scholar 

  54. Yazdanbod A, Nasseri-Moghaddam S, Malekzadeh R. Upper gastrointestinal cancer in Ardabil, north west of Iran: a review. Arch Iranian Med. 2004;7(3):173–7.

    Google Scholar 

  55. Vakili M, Pirdehghan A, Adimi M, Sadeghian M, Akhondi M. Epidemiology and Trend of cancer in Yazd, a central province of Iran. 2005–2009. JRHS. 2014;14(3):210–3.

    PubMed  Google Scholar 

  56. Sano Y, Byeon JS, Li XB, Wong M, Chiu HM, Rerknimitr R, et al. Colorectal cancer screening of the general population in East Asia. Dig Endosc. 2016;28(3):243–9.

    Article  PubMed  Google Scholar 

  57. Busweiler L, Wijnhoven B, van Berge Henegouwen M, Henneman D, van Grieken N, Wouters M, et al. Early outcomes from the Dutch Upper Gastrointestinal Cancer Audit. Br J Surg. 2016;103(13):1855–63.

    Article  CAS  PubMed  Google Scholar 

  58. Hataiehad HFR, Mohammadpour JM. Analysis of social inequality in prosperity of urban services land uses. HGRQ. 2008;4(65):71–85.

    Google Scholar 

  59. Colonna M, Sauleau E-A. How to interpret and choose a Bayesian spatial model and a Poisson regression model in the context of describing small area cancer risks variations. Rev Epidemiol Sante Publique. 2013;61(6):559–67.

    Article  CAS  PubMed  Google Scholar 

  60. Lemke D, Mattauch V, Heidinger O, Pebesma E, Hense H-W. Detecting cancer clusters in a regional population with local cluster tests and Bayesian smoothing methods: a simulation study. Int J Health Geogr. 2013;12(1):1–18.

    Article  Google Scholar 

  61. Al-Ahmadi K, Al-Zahrani A. Spatial autocorrelation of cancer incidence in Saudi Arabia. Int J Environ Res Public Health. 2013;10(12):7207–28.

    Article  PubMed  PubMed Central  Google Scholar 

  62. Mohebbi M, Wolfe R, Jolley D, Forbes AB, Mahmoodi M, Burton RC. The spatial distribution of esophageal and gastric cancer in Caspian region of Iran: an ecological analysis of diet and socio-economic influences. Int J Health Geogr. 2011;10(1):1–13.

    Article  Google Scholar 

  63. Gao Y, Hu N, Han X, Giffen C, Ding T, Goldstein A, et al. Family history of cancer and risk for esophageal and gastric cancer in Shanxi, China. BMC Cancer. 2009;9(1):1–10.

    Article  CAS  Google Scholar 

  64. Vettore MV, Faerstein E, Baker SR. Social position, social ties and adult’s oral health: 13 year cohort study. J Dent. 2016;44(13):50–6.

    Article  PubMed  Google Scholar 

  65. Howard J. Nonstandard work arrangements and worker health and safety. Am J Ind Med. 2017;60(1):1–10.

    Article  PubMed  Google Scholar 

  66. O’Leary VB, Kirwan JP. Adiponectin, obesity, and cancer. In: Reizes O, Berger N, editors. Adipocytokines, energy balance, and cancer. Energy balance and cancer, vol 12. Cham: Springer; 2017. p. 21–38.

    Google Scholar 

  67. Senesse P, Tadmouri A, Culine S, Dufour PR, Seys P, Radji A, et al. A prospective observational study assessing home parenteral nutrition in patients with gastrointestinal cancer: benefits for quality of life. J Pain Symptom Manag. 2015;49(2):183–91.

    Article  Google Scholar 

  68. Dolatkhah H, Somi M, Estakhri R, Dolatkhah N, Mirza-Aghazadeh A, Nourazarian M, et al. Severity of oxidative DNA damage in gastric tissue of smoker and non-smoker patients. MLJ. 2010;4(1):74–9.

    Google Scholar 

  69. Troisi RJ, Freedman AN, Devesa SS. Incidence of colorectal carcinoma in the US. Cancer. 1999;85(8):1670–6.

    Article  CAS  PubMed  Google Scholar 

  70. Powell J, McConkey CC, Gillison EW, Spychal RT. Continuing rising trend in oesophageal adenocarcinoma. Int J Cancer. 2002;102(4):422–7.

    Article  CAS  PubMed  Google Scholar 

  71. Daneshi-Maskooni M, Dorosty-Motlagh AR, Hosseini SM, Zendehdel K, Kashani A, Safarpour M, et al. Food insecurity and some associated socioeconomic factors among upper gastrointestinal cancer patients. IRJABS. 2013;4(2):482–6.

    Google Scholar 

  72. Najafianzadeh M, Mobarak-Abadi A, Ranjbaran M, Nakhaei M. Relationship between the prevalence of food insecurity and some socioeconomic and demographic factors in the rural households of Arak, 2014. NNFTRI. 2015;9(4):35–44.

    Google Scholar 

  73. Kasiri K, Amin-Shokravi F, Shahnazi H. Feeding behavior associated with gastric cancer. Iran J Health Educ Health Promot. 2015;3(2):83–94.

    Google Scholar 

  74. Pasdar Y, Darbandi M, Nachvak SM. Nutritional status of working children as a neglected group in Kermanshah. J Commun Health Res. 2014;3(2):124–31.

    Google Scholar 

  75. Baldwin C, Parsons TJ. Dietary advice and nutritional supplements in the management of illness-related malnutrition: systematic review. Clin Nutr. 2004;23(6):1267–79.

    Article  PubMed  Google Scholar 

  76. Ruggeri E, Agostini F, Fettucciari L, Giannantonio M, Pironi L, Pannuti F. Home artificial nutrition in advanced cancer patients. Tumori. 2013;99(2):218–24.

    Article  PubMed  Google Scholar 

  77. Ford E, Li C, Zhao G, Tsai J. Trends in obesity and abdominal obesity among adults in the United States from 1999–2008. Int J Obes. 2011;35(5):736–43.

    Article  CAS  Google Scholar 

  78. Pasdar Y, Darbandi M, Niazi P, Alghasi S, Roshanpour F. The prevalence and the affecting factors of obesity in women of Kermanshah. Jorjani. 2015;3(1):82–97.

    Google Scholar 

  79. Akbari MR, Malekzadeh R, Nasrollahzadeh D, Amanian D, Sun P, Islami F, et al. Familial risks of esophageal cancer among the Turkmen population of the Caspian littoral of Iran. Int J Cancer. 2006;119(5):1047–51.

    Article  CAS  PubMed  Google Scholar 

  80. Wells R. Mediating the spaces of diet and health: a critical analysis of reporting on nutrition and colorectal cancer in the UK. Geoforum. 2016;5(1):14–21.

    Google Scholar 

  81. Parkin DM. Global cancer statistics in the year 2000. Lancet Oncol. 2001;2(9):533–43.

    Article  CAS  PubMed  Google Scholar 

  82. MacKenzie R, Chapman S, McGeechan K, Holding S. ‘A disease many people still feel uncomfortable talking about’: Australian television coverage of colorectal cancer. Psycho-Oncology. 2010;19(3):283–8.

    Article  PubMed  Google Scholar 

  83. Reshadat S, Saedi S, Zangeneh A, Ghasemi S, Gilan N, Karbasi A, et al. Spatial accessibility of the population to urban health centres in Kermanshah, Islamic Republic of Iran: a geographic information systems analysis. East Mediterr Health J. 2015;21(6):389–94.

    Article  CAS  PubMed  Google Scholar 

  84. Rashidi M, Ghias M, Rouzbahani R, Rameshat MH, Poursafa P, Gharib H. Relationship between spatial distribution of malignant diseases and plumb element in Isfahan Province. JIMS. 2011;29(135):1–8.

    Google Scholar 

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Acknowledgements

The kind support and assistance of our honorable colleagues in Kermanshah University of Medical Sciences are genuinely appreciated.

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Authors and Affiliations

  1. Social Development and Health Promotion Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran

    Sohyla Reshadat, Alireza Zangeneh, Fariba Saeidi & Maryam Choobtashani

  2. Social Development and Health Promotion Research Center, Kermanshah University of Medical Sciences, Maskan Town, at Golha Boulevard, Samen Al-Aimeh Health Center, Kermanshah, Iran

    Shahram Saeidi

  3. Research Center for Environmental Determinants of Health (RCEDH), Kermanshah University of Medical Sciences, Kermanshah, Iran

    Arash Ziapour

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  1. Sohyla Reshadat
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Reshadat, S., Saeidi, S., Zangeneh, A. et al. A Comparative Study of Spatial Distribution of Gastrointestinal Cancers in Poverty and Affluent Strata (Kermanshah Metropolis, Iran). J Gastrointest Canc 50, 838–847 (2019). https://doi.org/10.1007/s12029-018-0163-7

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