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01.12.2015 | Research article | Ausgabe 1/2015 Open Access

BMC Public Health 1/2015

Increased colorectal cancer incidence in Iran: a systematic review and meta-analysis

BMC Public Health > Ausgabe 1/2015
Roya Dolatkhah, Mohammad Hossein Somi, Iraj Asvadi Kermani, Morteza Ghojazadeh, Mohamad Asghari Jafarabadi, Faris Farassati, Saeed Dastgiri
Wichtige Hinweise

Competing interests

The authors declare that they have no competing interests.

Authors’ contributions

RD designed the study, carried out the study, prepared the manuscript. MHS, IAK and FF conceived of the study, edited the manuscript. MG participated in the design of the study and performed the statistical analysis. MAJ helped to draft the manuscript. SD designed the study, carried out the study, and edited the manuscript. All authors read and approved the final manuscript.

Authors’ information

Not applicable.



Colorectal cancer is the third most common cancer in Iran. The increasing trend of colorectal cancer incidence in Iran and the close relationship with the geographical location are the underlying reasons for this study.


Data source: Eleven databases, including MEDLINE, EMBASE, SCOPUS, and four other databases, for articles in Persian were searched from April 2014 to October 2014. Additional data were obtained from an online survey of the Central Library of Tabriz Faculty of Medicine. Study eligibility criteria: In this systematic review and meta-analysis, we included studies reporting different measures of incidence, age-standardized incidence rates, and crude incidence rates. All rates (per 100,000 person-years) were standardized to the world standard population. Study appraisal and synthesis methods: A preliminary review of the title and abstracts of these articles was used to exclude any that were clearly irrelevant. The full text review determined whether the article was relevant to our topic. All the potentially relevant manuscripts were reviewed by two other investigators (S.D., M.G.). A total of 39 studies (10 Persian and 29 English articles) from different provinces and diverse areas of Iran, were analyzed in this study using comprehensive meta-analysis software. For accuracy studies, we used estimated rates for males and females with 95 % confidence intervals.


Age-standardized incidence rates were obtained based on the random effects model and were 8.16 (95 % CI: 6.64 to 9.68) and 6.17 (95 % CI: 5.01 to 7.32) for males and females, respectively. The random crude rates were 5.58 (95 % CI: 4.22 to 6.94) for males and 4.01 (95 % CI: 3.06 to 4.97) for females.


Colorectal cancer incidence rates rise due to individual and environmental risk factors as well as improvement in the registry system and increase in access to health services. A more executed organized and structured system for collecting cancer data, in all cities and rural areas of the country, is an essential priority.
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