Bladder Cancer in Iran: An Epidemiological Review

Figures & data

Figure 1 Flowchart of the included studies in the systematic review.

Table 1 The Mortality Rate of Bladder Cancer in Iran

First Author (Year)	Province (District)	Type of Study	Sample Size	(Sex)	Age-Standardized Mortality Rate per 100,000 (ASMR)	Death per 100,000 People
Babaei (2009)^Citation55	Ardabil	—	4,363	MF	0.5
Mazdak (2018)^Citation15	Isfahan	Retrospective study	1,655	MF (2011–2012)	0.56
				2012–2013	0.74
				2013–2014	0.98
				2014–2015	0.84
Pishgar (2018)^Citation9	ALLof iran	—	—	MF (1990)	13.04 (10.04−16.95)
				1995	10.94 (8.56–13.97)
				2000	5.62 (4.46–7.08)
				2005	2.5 (3.16–1.98)
				2010	1.4 (1.78–1.1)
				2015	0.47 (0.61–0.37)
Sadjadi (2005)^Citation77	Golestan, Mazandaran, Kerman, Ardabil Tehran		2,083	MF		1,059
Mahdavi (2015)^Citation78	All of Iran		105	MF (2006)		1.12
				2007		1.09
				2008		1.15
				2009		1.1
				2010		1.09

Table 2 Incidence Rate of Bladder Cancer in Iran

First Author (Year)	Province (District)	Type of Study	Sample Size	Sex	ASR (Age-Standardized Incidence Rate)	Incidence Rate	Incidence Ratio	Mean±SD
Somi (2008)^Citation48	East Azerbaijan	—	4,922	Male Female	15.72 3.68
Akbari (2008)^Citation49	Tehran	—	8,147	Male Female		48.3
Rohani-Rasaf (2012)^Citation50	Tehran	—	—	Male		Sep-01 (6.3) Sep-02 (8.2) Sep-03 (14.2) Sep-04 (15.3)
Ahmadi (2018)^Citation51	Chahrmahal and Bakhtiari		2,918	MF			0.08
Shahesmaeili (2018)^Citation52	Kerman	Retrospective study	2,838	Male	24.70
Akbarzadeh (2012)^Citation53	Mazandaran	Cross-sectional	310	MF	11.4
Aghajani (2016)^Citation54	All of Iran	Retrospective study	301,055	M F	11.25 2.49
Babaei (2009)^Citation55	Ardabil		4,363	Mf	13.1
Basiri (2014)^Citation56	All of Iran	—	—	M (2003) M (2009) F (2003) F (2009)	8.35 12.59 1.49 2.44
Haghdoost (2015)^Citation57	Kerman	Cross-sectional	3,052	MF	15.8
Rafiemanesh (2018)^Citation58	North Khorasan	—	2,165	MF	5.13
Rafiemanesh (2015)^Citation59	Sistan and Baluchistan	—	3,535	MF (2004)	1.24
Zahedi (2015)^Citation60	Hamadan	—	4,592 3,175	M (2004) M (2009) F (2004) F (2009)	72.9 132.0 48.2 115.0
Sadjadi (2003)^Citation61	Ardabil	—	2,072 1,309	Male Female	7.6 1.8
Sadjadi (2007)^Citation62	Kerman	—	3,264 2,620	M F	6.7 1.6
Somi (2018)^Citation63	East Azerbaijan	—	6,655	MF	17.6
Salehiniya (2016)^Citation64	Mazandran and Golstan	Cross- sectional	6,177 15,231	M F	15.41 6.77
Talaiezadeh (2013)^Citation65	Khouzestan	—	16,801	M F	10.69 4.07
Fararouei (2015)^Citation66	Kohgiluyeh and Boyer-Ahmad	Cohort	660	MF	6.94
Keyghobadi (2015)^Citation67	Kerman	Cross-sectional	5,793	M (2004) 2005 2006 2007 2008 2009	7.73 9.71 9.41 11.17 13.20 14.66
Mohagheghi (2009)^Citation68	Tehran	—	26,006	M F	13.3 3.8
Mazdak (2018)^Citation15	Isfahan	Retrospective study	1,655	MF (2011–2012) 2012–2013) 2013–2014) 2014–2015	7.7 8.1 7.5 9.9
Masoompour (2016)^Citation69	Fars	—	—	M (1985–1989) M (1998–2002) M (2007–2010) F (1985–1989) F (1998–2002) F (2007–2010)	7.50 6.8 15.60 2.00 1.90 3.93
Vakili (2014)^Citation70	Yazd	—	4,631	MF	7.5
Yavari (2008)^Citation71	Tehran		597	MF				12.8±61.9
Rahimi (2015)^Citation72	Tehran	—	—	M F	13.3 3.8
	Semnan		—	M F	7.16 3
	Golestan		—	M F	8.7
	East Azerbaijan		—	M F	15.72 3.68
	Khuzestan		—	M F	10.69 4.07
	Shahroud		—	M F	9.39 3.16
Rafiemanesh (2016)^Citation73	QOM	Cross-sectional	3,029	M (2004) 2005 2006 2007 2008	10.46 7.30 6.82 9.49 9.80
Rafiemanesh (2018)^Citation74	All of Iran	Cross-sectional	23,291	F (2003) 2004 2005 2006 2007 2008 M (2003) 2004 2005 2006 2007 2008	2.12 2.49 2.86 2.99 3.32 3.78 8.35 9.9 11.3 11.66 13.03 14.42
Sadjadi (2005)^Citation62	Golestan, Mazandaran, Kerman, Ardabil Tehran	—	51,000	M	8.0
Enayatrad (2016)^Citation75	All of Iran	—	41,169 32,898	M (2004) 2005 2006 2007 2009 F (2004) 2005 2006 2007 2009	11.3 11.7 13.0 14.4 12.6 2.9 2.9 3.3 3.8 3.3
Koohi (2015)^Citation76	All of Iran	Cross-sectional	27,898	MF (2003) 2004 2005 2006 2007 2008 2009	4.69 4.70 4.71 4.71 4.63 4.48 4.49

Table 3 The Survival Rate Associated with Bladder Cancer in Iran

First Author (Year)	Province (District)	Type of Study	Sex	Sample Size	Average Survival Rate	Survival Rate	Cumulative Survival Rate
Ahmad (2003)^Citation13	Fars	Cohort Historical	MF	76	24.2 (18.3–30.1)	—	—
Mohammadbeigi (2011)^Citation14	Fars	Retrospective study	MF	514	—	One-year survival = 0.9 3 years = 0.7 5 years = 0.6 10 years = 0.2	0.9582
Vahedian-Ardakani (2018)^Citation47	Yazd	Retrospective cohort study	MF	340	—	—	One-year survival = 91 3 years = 58 5 years = 51.4

Table 4 The Prevalence of Bladder Cancer in Iran

First Author (Year)	Province (District)	Type of Study	Sample Size	Sex	Prevalence	5 Year Prevalence
Nikfarjam (2014)^Citation79	Mashhad	–	4606	MF	4.10
Farahmand (2009)^Citation80	Fars	–	1440	Mf(2002) 2003 2004 2005 2006	173 201 207 351 314
Mazdak (2018)^Citation15	Isfahan	Retrospective study	1655	MF (2011–2015)	33.2
Rahimi (2015)^Citation73	Kermanshah	–	7695	MF	12.8
Roshani (2016)^Citation81	All of iran	Cross-sectional	75,500	MF	9.6
Sadjadi (2005)^Citation77	Golestan, Mazandaran, Kerman, Ardabil Tehran	–	2083	MF	–	5970

Table 5 Risk Factors Associated with Bladder Cancer in Iran

First Author (Year)	Province (District)	Type of Study	Sample Size	Sex	Risk Factors	OR	Mean (SD; Min, Max)	N (%)	Median 95% Cl
Akbari (2015)^Citation18	Fars	Case-control	198 (case) 396 (control)	Male Female	Opium	3.9 (1.3–12.0)
					Tobacco	2.5 (1.3–4.8)
					Alcohol	2.9 (1.2–7.1)
Aminian (2014)^Citation36	Tehran	Case-control	160 (case) 160 (control)	Male	Occupational risk: 1-bus and truck driving	3.62 (1.04–12.89)
					2-mechanics, working in refinery and Petrochemical, plastic	2.71 (1.03–7.59)
					3-Textile industry, Spinning, Hosiery	2.23 (0.70–7.15)
					4-House Keeping	1.79 (0.90–3.67)
					5-barberry, painting, Dye Manufacturing	1.81 (0.69–4.83)
					6-Shoe-making, production, seat cover, Embroidered bag, Repairing shoes	1.12 (0.34–4.57)
					7-welding, metal working, plumbing, turning	2.46 (0.99–6.28)
					8-driving	1.57 (0.69–3.49)
					9-office job	1.15 (0.65–2.0)
					10-carpentry, Mosaic work, cabinet making	1.14 (0.27–4.07)
Ahmadi (2012)^Citation6	Mazandaran	Cross-sectional	112	MF	Opium			21.4
					Tobacco			45.5
					History of cancer in family			22.32
Khoubi (2013)^Citation34	Isfahan	Case-control	300 (case) 500 (control)		Health professionals	0.4 (0.04–4.80)
					Petroleum and natural gas refining plant operators	0.4 (0.18–1.50)
					Clerks	0.2 (0.11–2.49)
					Domestic housekeepers	5.9 (2.61–11.62)
					Sales workers	2.8 (0.81–2.01)
					Shop assistants	3.4 (0.91–7.21)
					Skilled agricultural, forestry, and fishery workers	6.0 (2.32–15.72)
					Animal producers	2.5 (0.70–9.04)
					Building and related trades workers, excluding electricians	3.8 (1.33–3.21)
					Carpenters and joiners	2.9 (0.77–12.13)
					Painters and related workers	1.8 (0.20–4.21)
					Sheet and structural metal workers, molders and welders	6.0 (2.84–14.08)
					Food processing and related trades workers	1.0 (0.22–3.52)
					Car, van, and motorcycle drivers	0.6 (0.07–5.60)
					Heavy truck and bus drivers	11.3 (1.32–92.50)
					Mining and construction laborers	1.2 (0.30–4.41)
Hosseini (2010)^Citation37	Tehran	Case-control	179 (case) 179 (control)		Opium	4.60 (3.53–6.28)
Shakhssalim (2010)^Citation7	Tehran, Khorasan, Khoozestan, Isfahan and East Azarbayjan	Case-control	692 (case) 692 (control)	MF	Opium	2.57 (1.55–4.26)
					Hair dye	1.99 (1.04–3.82)
					Excessive analgesics use	1.41 (1.02–1.94)
					Sausage	0.98 (0.70–1.34)
					Ham	1.24 (0.87–1.78)
					Smoked fish	0.78 (0.50–1.20)
					Can	0.80 (0.60–1.07)
					Pickles	0.93 (0.88–0.99)
					Fruits	0.97 (0.94–1.00)
					Vegetables	0.93 (0.89–0.97)
Farzaneh (2017)^Citation38	Yazd	Case-control	200 (case) 200 (control)	MF	Chronic or recurrent urinary	5.92 (3.47–10.09)
					History of chronic or recurrent urinary tract infection 2–3 years	8.18 (2.18–30.69)
					Analgesic use	2.21 (1.30–3.75)
					History of analgesic use ≥4 years	11.81 (2.83–49.18)
					Irradiation to pelvis	1.69 (1.10–2.58)
					History of irradiation to pelvis ≥4-times	12.68 (3.51–45.76)
					Kidney and bladder stones	3.44 (2.06–5.75)
					History of kidney and bladder stones ≥2 years	8.07 (2.48–26.22)
					History of diabetes	2.15 (1.29–3.59)
					History of other kidney diseases	2.84 (1.8–4.46)
					History of hypertension	1.81 (1.08–3.02)
					History of smoking	2.87 (1.47–5.59)
Ghadimi (2015)^Citation39	Kurdistan	Case–control	152	MF	Ex-smoker Current smoker	2.549 (1.287–5.048)
					Occupational risk: Driver	1.714 (0.824−3.563)
					Loom	5.134 (0.593−44.47)
					Carpenter	3.039 (0.312–29.551)
					Cleaner	0.688 (0.376−1.258)
					Painter	1.342 (0.295−6.101)
					Metal	10.629 (1.343–84.093)
					Construction worker	0.814 (0.434–1.528)
					Farmer	0.819 (0.513–1.308)
					Governmental employee	1.128 (0.571−2.228)
					BMI>25	1.041 (0.657−1.649)
Lotfi (2016)^Citation40	Yazd	Case-control	200 (case) 200 (control)	MF	Cigarette smoking	3.16 (2.04–4.9)
					Opium History	3.01(1.73–5.23)
					History of Hubble bubble and pipe	2.63(1.48–4.64)
					History of alcohol	2.57 (1.04–6.35)
					Oil Animal	3.19 (1.64–6.21)
					Fried food (per week)	4.02 (2.32–6.95)
					Red Meat >4	5.61 (3.02–10.41)
Mohseni (2004)^Citation41	Tehran	Case-control	185	MF	Smoking in the patients with high-grade tumors	15.9 (6.7–36.9)
Motamed (2018)^Citation42	Fars	Retrospective	756	MF	Hookah consumption	1.44 (1.01–2.1)
					Hypertension	1.36 (1.00–1.86)
					Gender	1.46 (0.99–2.15)
Mirsafa (2015)^Citation43	Tehran	Case-control	55 (case) 110 (control)		Animal fat FAT	19.76 12.92
					Junk foods	8.1
					Organ meat	5.47
					Processed meat	5.34
					Sweets	3.62
Jafari-Koshki (2017)^Citation44	All of Iran	—	17,792		BMI>25 (2006)		43.28±6.65
					BMI>25 (2007)		44.59±6.18
					BMI>25 (2008)		42.99±4.93
					Cigarette (2006)		11.94±1.92
					Cigarette (2007)		12.75±1.74
					Cigarette (2008)		11.64±1.94
					Fruit (2006)		1.13±0.24
					Fruit (2007)		1.32±0.27
					Fruit (2008)		1.42±0.40
					Vegetables (2006)		1.25±0.38
					Vegetables (2007)		1.38±0.42
					Vegetables (2008)		1.41±0.44
					Low activity (2006)		30.67±7.46
					Low activity (2007)		34.88±8.38
					Low activity (2009)		38.30±8.15
Mahaki (2011)^Citation45	All of Iran	—	62,037	MF	Smoking				0.97 (0.43–2.11)
					Socioeconomic				0.92 (0.45–1.88)
Islami (2007)^Citation46	Tehran	Case-control	147 (case) 39 (control)	MF	HPV virusei			34.7 7.6

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