The incidence and mortality rate of cervix cancer in Iran from 1990 to 2016: A systematic review and meta-analysis Running title: Cervix cancer in Iran

  • Shirin Riahi 1) Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
  • Ali Mohammad Mokhtari 2) Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
  • Mouhebat Vali Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
  • Elham Abdzadeh Department of Biology, Faculty of Science, University of Guilan, Rasht, Iran
  • Shokrollah Mohseni 5) Social Determinants in Health Promotion Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
  • Hamid Salehiniya Department of Epidemiology and Biostatistics, Tehran University of Medical Sciences, Tehran, Iran
  • Soheil Hassanipour Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran


Objective: Cervix Cancer (CC) is one of the major health problems among Iranian women and elsewhere around the world. Considering the importance of this cancer, the present study was conducted to determine the age-standardized incidence rate (ASIR) and age-standardized mortality rate (ASMR) of CC in Iran.
Methods: A search was conducted using international databases (Medline/PubMed, ProQuest, Scopus, Embase and ISI/ web of knowledge), and national databases (Scientific Information Database, MagIran, IranMedex, and IranDoc). This systematic review was carried out according to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) check list in 2018. Thereafter, Persian and English language papers referring to the ASIR and ASMR of CC in Iran were included. Data were independently extracted by two reviewers. The Joanna Briggs checklist was carried out to evaluate the quality of studies.
Result: A total of 522 papers were obtained in the initial search of the databases, and 25 articles were included to the review by further refinement and screening. Based on the random-effect model, the ASIR and ASMR of CC in Iran was 2.14 per 100000, 95% CI (1.89 to 2.38) and 0.93 per 100000, 95% CI (0.81 to 1.05), respectively.
Conclusion: The incidence and mortality of CC in Iran was lower than other parts of the world. It should be noted that because of the high heterogeneity of the results of this study, we must judge with caution regarding the results.
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1. 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: a cancer journal for clinicians. 2018;68(6):394-424.
2. Weiderpass E, Labrèche F. Malignant tumors of the female reproductive system. Safety and health at work. 2012;3(3):166-80.
3. Maheshwari A, Kumar N, Mahantshetty U. Gynecological cancers: A summary of published Indian data. South Asian journal of cancer. 2016;5(3):112-20.
4. Pedersen K, Fogelberg S, Thamsborg LH, Clements M, Nygard M, Kristiansen IS, et al. An overview of cervical cancer epidemiology and prevention in Scandinavia. Acta obstetricia et gynecologica Scandinavica. 2018;97(7):795-807.
5. Shrestha AD, Neupane D, Vedsted P, Kallestrup P. Cervical Cancer Prevalence, Incidence and Mortality in Low and Middle Income Countries: A Systematic Review. Asian Pacific journal of cancer prevention : APJCP. 2018;19(2):319-24.
6. Mokhtari AM, Riahi S, Fathalipour M, Delam H, Hashemnejad M, Hassanipour S. The age-standardized rate of female genital cancers in Iran: A systematic review and meta-analysis. tums-hayat. 2018;24(3):204-19.
7. Torre LA, Islami F, Siegel RL, Ward EM, Jemal A. Global Cancer in Women: Burden and Trends. Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology. 2017;26(4):444-57.
8. Shanta V, Krishnamurthi S, Gajalakshmi CK, Swaminathan R, Ravichandran K. Epidemiology of cancer of the cervix: global and national perspective. Journal of the Indian Medical Association. 2000;98(2):49-52.
9. McGraw SL, Ferrante JM. Update on prevention and screening of cervical cancer. World journal of clinical oncology. 2014;5(4):744-52.
10. Rezaianzadeh A, Mokhtari AM, Hassanipour S, Maghsoudi A, Dehghani SL, Nazarzadeh M, et al. The age-standardized incidence rate of ovarian cancer in iranian women: A systematic review and meta-analysis. Middle East Journal of Cancer. 2018;9(3):171-8.
11. Naing NN. Easy way to learn standardization : direct and indirect methods. The Malaysian journal of medical sciences : MJMS. 2000;7(1):10-5.
12. Funston G, O'Flynn H, Ryan NAJ, Hamilton W, Crosbie EJ. Recognizing Gynecological Cancer in Primary Care: Risk Factors, Red Flags, and Referrals. Advances in therapy. 2018;35(4):577-89.
13. Platz EA. Reducing Cancer Burden in the Population: An Overview of Epidemiologic Evidence to Support Policies, Systems, and Environmental Changes. Epidemiologic reviews. 2017;39(1):1-10.
14. Momenimovahed Z, Salehiniya H. Cervical cancer in Iran: integrative insights of epidemiological analysis. BioMedicine. 2018;8(3):18-.
15. Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gotzsche PC, Ioannidis JP, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration. BMJ (Clinical research ed). 2009;339:b2700.
16. Almasi-Hashiani A. Farahmand M. Trend of incidence rate for female genital cancers based on cancer registry data in Fars province during 2003-2009. [Article in Persian] KAUMS Journal (FEYZ). 2012;16(4):353-60.
17. Arab M, Noghabaei G. Comparison of age- standard incidence rate trends of gynecologic and breast cancer in Iran and other countries. Iranian Journal of Public Health. 2014;43(10):1372-9.
18. Arab M, Noghabaei G, Kazemi SN. Comparison of crude and age-specific incidence rates of breast, ovary, endometrium and cervix cancers in Iran, 2005. Asian Pacific Journal of Cancer Prevention. 2014;15(6):2461-4.
19. Kiadaliri AA. Social disparity in breast and ovarian cancer incidence in iran, 2003-2009: A time trend province-level study. Journal of Breast Cancer. 2013;16(4):372-7.
20. 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. Archives of Iranian Medicine. 2009;12(1):15-23.
21. Mousavi SM, Gouya MM, Ramazani R, Davanlou M, Hajsadeghi N, Seddighi Z. Cancer incidence and mortality in Iran. Annals of Oncology. 2009;20(3):556-63.
22. Rahimi Z, Kasraei R, Najafi F, Tanhapoor M, Abdi H, Rahimi Z, et al. Cancer notification at a referral hospital of Kermanshah, Western Iran (2006-2009). Asian Pacific Journal of Cancer Prevention. 2015;16(1):133-7.
23. 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. International Journal of Cancer. 2003;107(1):113-8.
24. Sharifian A, Pourhoseingholi MA, Norouzinia M, Vahedi M. Ovarian cancer in Iranian women, a trend analysis of mortality and incidence. Asian Pacific Journal of Cancer Prevention. 2014;15(24):10787-90.
25. Taheri N, Fazel A, Mahmoodzadeh H, Omranpour R, Roshandel G, Gharahjeh S, et al. Epidemiology of female reproductive cancers in Iran: Results of the gholestan population-based cancer registry. Asian Pacific Journal of Cancer Prevention. 2014;15(20):8779-82.
26. Zendehdel K, Sedighi Z, Hassanloo J, Nahvijou A. Audit of a nationwide pathology-based cancer registry in Iran. Basic Clin Cancer Res. 2011;3(2):7-13.
27. Babai M, Mousavi S, Malek M, Danaie N, Jandaghi J, Tousi J, et al. Survey of cancer incidence during a 5-year (1998-2002) period in Semnan province. Koomesh. 2005;6(3):237-44.
28. Sadjadi A, Nouraie M, Mohagheghi MA, Mousavi-Jarrahi A, Malekezadeh R, Parkin DM. Cancer occurrence in Iran in 2002, an international perspective. Asian Pac J Cancer Prev. 2005;6(3):359-63.
29. Sadiadi A, Zahedi MJ, Moghadam SD, Nouraie M, Alimohammadian M, Ghorbani A, et al. The first population-based cancer survey in Kerman Province of Iran. Iranian Journal of Public Health. 2007;36(4):26-34.
30. 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.
31. Babaei M, Jaafarzadeh H, Sadjadi AR, Samadi F, Yazdanbod A, Fallah M, et al. Cancer Incidence and Mortality in Ardabil: Report of an Ongoing Population-Based Cancer Registry in Iran, 2004-2006. Iranian Journal of Public Health. 2009;38(4):35-45.
32. Masoompour SM, Yarmohammadi H, Rezaianzadeh A, Lankarani KB. Cancer incidence in southern Iran, 1998-2002: Results of population-based cancer registry. Cancer Epidemiology. 2011;35(5):e42-e7.
33. Fateh M, Emamian MH. Cancer incidence and trend analysis in Shahroud, Iran, 2000 - 2010. Iranian Journal of Cancer Prevention. 2013;6(2):85-94.
34. 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).
35. Singh GK, Azuine RE, Siahpush M. Global Inequalities in Cervical Cancer Incidence and Mortality are Linked to Deprivation, Low Socioeconomic Status, and Human Development. International journal of MCH and AIDS. 2012;1(1):17-30.
36. Khorasanizadeh F, Hassanloo J, Khaksar N, Taheri SM, Marzaban M, Rashidi BH, et al. Epidemiology of cervical cancer and human papilloma virus infection among Iranian women - Analyses of national data and systematic review of the literature. Gynecologic oncology. 2013;128(2):277-81.
37. Mehrabani D, Tabei SZ, Heydari ST, Shamsina SJ, Shokrpour N, Amini M, et al. Cancer Occurrence in Fars Province, Southern Iran. Iranian Red Crescent Medical Journal. 2008;10(4):314-22.
38. Fallah M. Cancer Incidence in Five Provinces of Iran: Ardebil, Gilan, Mazandaran, Golestan and Kerman, 1996-2000: Tampere University Press; 2007.
39. Roshandel G, Boreiri M, Sadjadi A, Malekzadeh R. A diversity of cancer incidence and mortality in west Asian populations. Annals of Global Health. 2014;80(5):346-57.
40. Salehiniya H, Dashdebi SG, Rafiemanesh H, Mohammadian-Hafshejani A, Enayatrad M. Time trend analysis of cancer incidence in Caspian Sea, 2004-2009: A population-based cancer registries study (northern Iran). Caspian Journal of Internal Medicine. 2016;7(1):25-30.
41. Saadat S, Yousefifard M, Asady H, Moghadas Jafari A, Fayaz M, Hosseini M. The Most Important Causes of Death in Iranian Population; a Retrospective Cohort Study. Emergency (Tehran, Iran). 2015;3(1):16-21.
42. Rezaianzadeh A, Hassanipour Azgomi S, Mokhtari AM, Maghsoudi A, Nazarzadeh M, Dehghani SL, et al. The incidence of breast cancer in Iran: A systematic review and meta-analysis. Journal of Analytical Oncology. 2016;5(4):139-45.
43. Hassanipour S, Mokhtari A, Fathalipour M, Salehiniya H. The Incidence of Lung Cancer in Iran: A Systematic Review and Meta-Analysis. World Cancer Research Journal. 2017;4(4).
44. Rezaianzadeh A, Jalali M, Maghsoudi A, Mokhtari AM, Azgomi SH, Dehghani SL. The overall 5-year survival rate of breast cancer among Iranian women: A systematic review and meta-analysis of published studies. Breast Dis. 2017;37(2):63-8.
45. Hassanipour S, Fathalipour M, Salehiniya H. The incidence of prostate cancer in Iran: a systematic review and meta-analysis. Prostate International. 2018;6(2):41-5.
46. Hassanipour S, Namvar G, Fathalipour M, Salehiniya H. The incidence of kidney cancer in Iran: A systematic review and meta-analysis. BioMedicine (France). 2018;8(2):22-7.
47. Salehiniya H, Hassanipour S, Mansour-Ghanaei F, Mohseni S, Joukar F, Abdzadeh E, et al. The Incidence of Esophageal Cancer in Iran: A Systematic Review and Meta-analysis. Biomedical Research and Therapy. 2018;5(7):2493-503.
48. Chung HH, Jang MJ, Jung KW, Won YJ, Shin HR, Kim JW, et al. Cervical cancer incidence and survival in Korea: 1993-2002. International journal of gynecological cancer : official journal of the International Gynecological Cancer Society. 2006;16(5):1833-8.
49. Yeole BB. Trends in cancer incidence in female breast, cervix uteri, corpus uteri, and ovary in India. Asian Pacific journal of cancer prevention : APJCP. 2008;9(1):119-22.
50. Bener A, Ayub H, Kakil R, Ibrahim W. Patterns of cancer incidence among the population of Qatar: a worldwide comparative study. Asian Pacific journal of cancer prevention : APJCP. 2008;9(1):19-24.
51. Esmaeili R, Ahmadi F, Mohammadi E, Tirgari Seraj A. Life Threatening: The Most Important Concern of Patients Confronting Cancer Diagnosis. tums-hayat. 2013;18(5):12-22.
52. Yang X, Cheng Y, Li C. The role of TLRs in cervical cancer with HPV infection: a review. Signal transduction and targeted therapy. 2017;2:17055-.
53. Chaichian S, Khateri S, Moradi Y, Shadmani FK, Mansori K, Khazaei Z, et al. Trends in cervical cancer incidence in Iran from 2003 to 2009. Middle East Journal of Cancer. 2018;9(1):57-63.
54. Refaei M, Dehghan Nayeri N, Khakbazan Z, Pakgohar M. Cervical Cancer Screening in Iranian Women: Healthcare Practitioner Perceptions and Views. Asian Pacific journal of cancer prevention : APJCP. 2017;18(2):357-63.
55. Keramatinia A, Hassanipour S, Nazarzadeh M, Wurtz M, Monfared AB, Khayyamzadeh M, et al. Correlation Between Nitrogen Dioxide as an Air Pollution Indicator and Breast Cancer: a Systematic Review and Meta- Analysis. Asian Pacific journal of cancer prevention : APJCP. 2016;17(1):419-24.
56. Zheng W, Shu XO, McLaughlin JK, Chow WH, Gao YT, Blot WJ. Occupational physical activity and the incidence of cancer of the breast, corpus uteri, and ovary in Shanghai. Cancer. 1993;71(11):3620-4.
How to Cite
RIAHI, Shirin et al. The incidence and mortality rate of cervix cancer in Iran from 1990 to 2016: A systematic review and meta-analysis Running title: Cervix cancer in Iran. Journal of Contemporary Medical Sciences, [S.l.], v. 5, n. 1, feb. 2019. ISSN 2413-0516. Available at: <>. Date accessed: 23 mar. 2019.