Gastroenterology and hepatology from bed to bench · 2026
Time trend and geographical distribution of colorectal cancer incidence before and after COVID-19 pandemic in southern Iran: an interrupted time series analysis.
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Taheri Soodejani Moslem, Safarpour Ali Reza, Keshavarz Majid, Kazemi Maryam, Bananzadeh Alimohammad
Аннотация
AIM: This study aimed to assess the trend and geographical distribution of colorectal cancer (CRC) in Fars province from 2011 to 2024, and its changes during COVID-19.
BACKGROUND: Research has indicated that the risk of CRC varies significantly across different regions of the world.
METHODS: From 2011 to 2024, data from 1,453 CRC patients who were registered in the Shiraz Colorectal Cancer Surgery (SCORCS) program were analyzed. Using R software (v4.2.0), we applied interrupted time series analysis to evaluate the impact of COVID-19 on CRC incidence and mortality. Spatial distribution was examined with ArcGIS (v10.4.1), and Moran's I test was used to determine high- and low-risk regions. A 5% significance level was applied to all analyses.
RESULTS: In this study, 56.2% of the patients were men and 43.8% were women. Most patients (49%) were between 30 and 59 years old. Rectal cancer was slightly more common (57.7%) than colon cancer (41.8%), and only a very small number (less than 0.5%) had both. About half of the patients were classified as T3, and over 80% already had metastasis. At the pandemic onset, both outcomes showed a significant immediate increase, followed by a significant post-pandemic decline in slope. Among the studied areas, Kazerun and Jahrom had the highest incidence rate, while Zarqan and Kazerun showed the highest mortality rate.
CONCLUSION: This study shows that CRC incidence and mortality declined during COVID-19, likely due to restrictive policies. However, the high rates in some cities of Fars province highlight the need for targeted interventions to reduce the disease burden.
BACKGROUND: Research has indicated that the risk of CRC varies significantly across different regions of the world.
METHODS: From 2011 to 2024, data from 1,453 CRC patients who were registered in the Shiraz Colorectal Cancer Surgery (SCORCS) program were analyzed. Using R software (v4.2.0), we applied interrupted time series analysis to evaluate the impact of COVID-19 on CRC incidence and mortality. Spatial distribution was examined with ArcGIS (v10.4.1), and Moran's I test was used to determine high- and low-risk regions. A 5% significance level was applied to all analyses.
RESULTS: In this study, 56.2% of the patients were men and 43.8% were women. Most patients (49%) were between 30 and 59 years old. Rectal cancer was slightly more common (57.7%) than colon cancer (41.8%), and only a very small number (less than 0.5%) had both. About half of the patients were classified as T3, and over 80% already had metastasis. At the pandemic onset, both outcomes showed a significant immediate increase, followed by a significant post-pandemic decline in slope. Among the studied areas, Kazerun and Jahrom had the highest incidence rate, while Zarqan and Kazerun showed the highest mortality rate.
CONCLUSION: This study shows that CRC incidence and mortality declined during COVID-19, likely due to restrictive policies. However, the high rates in some cities of Fars province highlight the need for targeted interventions to reduce the disease burden.