Prevalence of cancer cases among population of Kirkuk, Iraq from 2016-2020

Abstract

Objective: To present a clear picture of the cancer cases reported in Kirkuk between 2016 and 2020 and to identify the top 10 instances in both genders. Methodology: This cohort/retrospective study was conducted at oncology/hematology center in Kirkuk governorate from January, 2021 to May, 2022. The data were collected from the official records of oncology/hematology center in Kirkuk governorate and consisted of 4917 cancer cases during the five years period from 2016 to 2020. Results: A total of 4719 cases of all cancer types in Kirkuk were recorded from 2016-2020. Of these, 64.2% were females and 35.8% males. Age of 65.8% cases was between 41-70 years, with a mean of 52.624±22.593 years. For both genders, breast cancer was the most common (1532), followed by lung cancer. Conclusion: Breast cancer is on the top of ten cancers and is on the rising trend. The Ministry of health should plan for a strategy of regular screening for breast cancer in women and increasing the awareness of the women regarding breast self-examination for early detection.

Full text

3 Rawal Medical Journal: Vol. 48, No. 1, Jan-Mar 2023
Original Article
Prevalence of cancer cases among population of Kirkuk, Iraq from 2016-2020
Hussein Ali Mohammed,1 Jenan Akbar Shakoor,2 Nazar Ahmed Mahmood,3 Abid Salih Kumait,4
Araz Mohammed Kareem5
Department of 1,4Adult Nursing,2 Public Health, 3Community Health, University of Kirkuk, College of
Nursing,5Ministry of Health, Oncology and Hematology Center, Kirkuk, Iraq
Objective: To present a clear picture of the cancer
cases reported in Kirkuk between 2016 and 2020 and
to identify the top 10 instances in both genders.
Methodology: This cohort/retrospective study was
conducted at oncology/hematology center in Kirkuk
governorate from January, 2021 to May, 2022. The
data were collected from the official records of
oncology/hematology center in Kirkuk governorate
and consisted of 4917 cancer cases during the five
years period from 2016 to 2020.
Results: A total of 4719 cases of all cancer types in
Kirkuk were recorded from 2016 – 2020. Of these,
64.2% were females and 35.8% males. Age of 65.8%
cases was between 41 – 70 years, with a mean of
52.624 ± 22.593 years. For both genders, breast cancer
was the most common (1532), followed by lung
cancer.
Conclusion: Breast cancer is on the top of ten cancers
and is on the rising trend. The Ministry of health
should plan for a strategy of regular screening for
breast cancer in women and increasing the awareness
of the women regarding breast self-examination for
early detection.
Keywords: Prevalence, cancer, lung cancer, breast
cancer, Kirkuk, Iraq.
INTRODUCTION
Uncontrolled cell division is the root cause of cancer
and other malignant disorders. The proliferating cells
can either migrate into different tissues directly or
through the circulatory system.1 The study of the
prevalence and distribution of various cancer forms in a
given location is referred to as cancer epidemiology.2
Iraq has a variety of malignancies, including
gastrointestinal, colorectal, lung, lymph node, breast,
and colorectal cancers.3-6 Breast cancer is the type of
cancer that occurs most frequently. In 2016, 855 breast
cancer patients were noted in Iraq. In the 45–54 age
range, 35 percent of breast cancer patients were
females.7
The incidence of cancer has significantly increased
throughout Iraq. The cause may be related to the use of
combat weaponry, severe environmental contamination,
and the buildup of garbage of all kinds in the Iraqi
environment.8The length of time that cancer patients get
medical care has increased due to better cancer
prognoses and a decreased risk of dying from non-
cancer causes, which has had a significant impact on the
needs for health services.9-12
Several methods have been developed to collect precise
prevalence data. The majority of administrative
procedures rely on direct extraction or assessment of
prevalence from the available health data. So, utilizing
population-based data acquired by cancer registries
(CR), methods for predicting cancer prevalence have
been developed in the USA and Europe.13 The aim of
the study was to provide a clear picture of the cancer
cases registered in Kirkuk during the period 2016-2020,
as well as to determine the top ten cases among both
genders.
METHODOLOGY
This cohort/retrospective study was conducted at
oncology/hematology center in Kirkuk governorate,
from January, 2021 to May, 2022. The data were
collected from the official records of oncology/
hematology center in Kirkuk governorate and consisted
of 4917 cancer cases for the period of five years from
2016 to 2020. Prior to actual collection of data, a formal
administrative approval was obtained from the scientific
committee at college of nursing and Kirkuk Directorate
of Health.
The data included the age, gender, level of education,
residence, occupation, geographical areas which
included the urban and rural with sub rural areas of
Kirkuk governorate and types of cancer in patients who
were attending the center. The total population number
of Kirkuk governorate were obtained from the central
statistical organization in Kirkuk governorate.
Statistical Analysis: This study analyzed all data by
SPSS version 25.

Prevalence of cancer cases among population of Kirkuk, Iraq from 2016-2020
4 Rawal Medical Journal: Vol. 48, No. 1, Jan-Mar 2023
RESULTS
A total of 4719 cases of all cancer types in Kirkuk were
recorded from 2016 – 2020. Of these, 64.2% were
females and 35.8% males. Age of 65.8% of the cases
was between 41-70 years, with a mean of 52.624 ±
22.593 years. More than half of the cases (62.5%) were
from an urban area and 23.4% were from rural areas.
The educational background of only 5.5% of the cases
was known. Of these, 1.6% were from primary schools
and the rest 94.5% were either unknown or missing.
Fig. 1: Ten most common cancers among adult males and
females in Kirkuk throughout a 5-year period from 2016
to 2020.
Most cases were from Kirkuk city and Hawija (Table 1).
Breast and lung cancers were the commonest cancers
and were rising with time (Table 2). Breast cancer in
Table 1: Total cancer cases in Kirkuk distributed by
geographic area from 2016-2020 (n = 4917).
Geographic Area Number %
Kirkuk city 2949 62.5
Hawija 451 9.6
Daquq 127 2.7
Taza and basheer 93 2.0
Dibis 71 1.5
Altunkopri 47 1.0
Laylan 45 1.0
Kara hingeer 25 0.5
Yaychi 23 0.5
Riyadh 22 0.5
Shwan 20 0.4
Mull abdulla 15 0.3
Zab 9 0.2
Rashad 3 0.1
Sarkaran 3 0.1
Other area 816 16.6
females and prostate cancer in males were the top
cancers (Fig. 1). Trend in overall cancer incidence rate
per 100,000 population, Kirkuk, 2016-2020 is shown in
Fig. 2. Most of the cases were registered among
housewives (43.5%).
Table 2: Estimated prevalence of Kirkuk's top 10 cancers from 2016 to
2020.
Types of cancer 2016 2017 2018 2019 2020 Total
Breast 298 313 254 332 335 1532
Lung 67 87 83 89 70 396
Prostate 62 52 48 51 52 265
Colorectal 52 40 56 48 54 250
Bladder 42 36 44 38 30 190
Uterus and cervix 19 26 37 49 38 169
Stomach 43 24 26 25 30 148
Lymphoid cancer 32 32 30 32 13 139
Ovarian 29 27 26 29 27 138
Pancreases 24 21 33 34 16 128
DISCUSSION
The current study documents the
varying epidemiological patterns for
different cancers in the Iraqi province
of Kirkuk from 2016 to 2020. This
variation is assumed to be caused by a
number of variables, mostly security-
related, such as following the recovery
of ISIS-held territory, notably after
2017. Due to the high incidence of
breast cancer, which accounted for
100% of all reported cases, females
made up the majority of cancer cases.
In addition to its effects on women's
health, the gender gap in cancer
prevalence among women must be
addressed in order to acknowledge
women's contributions to society, the
economy, and family care.14

Prevalence of cancer cases among population of Kirkuk, Iraq from 2016-2020
5 Rawal Medical Journal: Vol. 48, No. 1, Jan-Mar 2023
Fig. 2: Trend in overall cancer incidence rate per 100,000
population, Kirkuk, 2016-2020.
Cancer Institute indicated, adults were more afflicted by
cancer, even though some malignancies are more
common in young people.15 The chronological order of
age factors may be the cause of this disparity. Contrary
to what the National Cancer Institute indicated, adults
were more afflicted by cancer, even though some
malignancies are more common in young people.
In both rural and urban parts of China, cancer is the
second most common cause of death. Finding
socioeconomic factors that affect the disease may be
aided by differences in cancer incidence, death, and
survival rates between urban and rural populations.
Being a housewife has been linked to both short- and
long-term financial difficulties among cancer
survivors.17,18
Breast cancer accounted for the majority of the cases of
cancer in Kirkuk between 2016 and 2020, accounting
for 1532 cases over four years, followed by lung cancer,
which had 396 cases. It's possible that Kirkuk City’s
findings on the prevalence of cancer among men and
women would differ from those of earlier research
conducted in other Iraqi cities. The variations mostly
rely on where in the city and when they happen.
According to estimates from 2011, the most prevalent
cancer kinds in Fallujah City, which located in western
Iraq, were breast cancer, ovary cancer, and uterine
cancer for women and lung cancer, stomach cancer, and
bladder cancer for men.19,20 Cancer can be very stressful
for patients and families.21 According to data from the
American Joint Committee on Cancer (2017), there
were 65.4% and 62.7% cancer cases per 100,000 people
in Kirkuk City in 2016 and 2019, respectively.
According to Siegel and colleagues, men's rates
remained consistent between 2001 and 2007, declined
by an average of 2.2% year between 2007 and 2013, and
then stabilized between 2013 and 2017.22
CONCLUSION
Breast cancer was one of the top ten cancers for the
period of five years in the study.Ministry of health
should plan for a strategy of regular screening for breast
cancer of the women with increasing the awareness of
the women regrading breast self-examination for early
detection.
Author Contributions:
Conception and design: Hussein A. Mohammed.
Collection and assembly of data: Abid S. Kumait.
Analysis and interpretation of data: Jenan A. Shakoor.
Drafting of the article: Abid S. Kumait.
Critical revision of article for important intellectual content: Abid S.
Kumait.
Statistical expertise: Araz M. Kareem.
Final approval and guarantor of the article: Nazar A. Mahmood.
Corresponding author email: Abid Salih Kumait:
abid_master2014@uokirkuk.edu.iq
Conflict of Interest: None declared.
Rec. Date: Nov 19, 2022 Revision Rec. Date: Nov 26, 2022 Accept Date:
Dec 21, 2022.
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