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INTRODUCTION
Gastric cancer (GC) is a multifactorial neoplasm; its development is affected by both environmental and genetic determinants.[
1] GC constitutes the fifth common neoplasm following lung, breast, colorectal, and prostate cancers and the third most common cause of cancer-related mortality worldwide.[
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3] In Southeast Asia, GC constitutes the most common etiology of cancer.[
1] In 2015, around 1.3 million new GC cases had been diagnosed worldwide leaving behind 819,000 deaths.[
4] GC has also caused 17.4 million disabilities as 98% of them contributed as the lost years of life, delivering the highest ratio among all cancers.[
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More than 70% of GC new cases are diagnosed in developing countries.[
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The incidence of GC in Iran has been higher than other countries in the west of Asia. This higher rate has been attributed to factors such as obesity, genetic determinants, nutritional habits, and lifestyle.[
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A relationship has also been suggested between air pollution and GC development in men.[
9] Nevertheless, the disability-adjusted life years trend of GC in Iran showed a 38% decrease from 1990 to 2010.[
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There are some studies on the trend of GC incidence in Iran and the world. However, to establish preventive measures and policies, there is a need for performing the trend analyses in local level. This is important as the risk factors of GC may vary in different regions of a country. According to the annual reporting of Ministry of Health of Iran, the incidence of GC was high in this province, and this province was identified as one of the high-risk provinces of Iran. In addition, lifestyle factors of Iranian population were changed during decades, including nutrition factors related to the GC. Therefore, there was a need to know the pattern of change of GC in parallel with the mentioned changes. On the other hand, in other regions of Iran, the traditional methods were applied to investigate the trend of cancer, but in this study, we were applied a new approach to estimate the trend of GC.
As there were no studies on the incidence rate and trend of GC in Kurdistan, a western province of Iran, here, we aimed to estimate the trend, age-standardized incidence rate (ASR), and annual percentage change (APC) of GC incidence using the archives of the regional Cancer Registering Database from 2001 to 2014. For this purpose, we applied joinpoint regression statistical software which is used to develop simple joinpoint models for cancer incidence trend.