title: Epidemiology of cervical cancer and human papilloma virus infection among Iranian women - analyses of national data and systematic review of the literature.
abstract: BACKGROUND
  Few studies have evaluated the epidemiology of cervical cancer in low risk Muslim countries, where the prognosis of cervical cancer is poor and which lack an organized cervical screening program. We studied incidence and mortality rates of cervical cancer and the prevalence of high risk human papilloma virus (HPV) infection in the Islamic Republic (I.R.) of Iran.
  
  
  METHODS
  We analyzed national cancer and mortality registration data and estimated age-standardized incidence (ASR) and mortality (ASMR) rates and age-specific patterns of cervical cancer. Furthermore, based on a systematic review we estimated prevalence of HPV infection in Iran.
  
  
  RESULTS
  The mean cervical cancer ASR was 2.5 per 100,000 in pathology-based cancer registries. However, ASRs were almost double in the population-based cancer registry and reached 6 per 100,000. The mean cervical cancer ASMR for Iran was 1.04 per 100,000. The mortality to incidence ratio was 42%. The cervical cancer incidence rate increased after age 30 and peaked between ages 55 and 65. The prevalence of HPV infection was 76% in cervical cancer patients and 7% among healthy Iranian women. Of the HPV types isolated, HPV 16 (54%), 18 (14%), and 31 (6%) were the most commonly detected in Iranian cervical cancer patients.
  
  
  CONCLUSIONS
  An organized prevention program is needed to fight against cervical cancer in Iran and other low incidence countries. We suggest a screening program starting after age 30 and with at least three screenings tests over each woman's lifetime. With a reservation on cost-effectiveness issue, available HPV vaccine will prevent HPV infection and cervical cancer in Iran.
authors.affiliation: Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Faezeh
authors.initials: F
authors.lastname: Khorasanizadeh
authors.forename: Jaleh
authors.initials: J
authors.lastname: Hassanloo
authors.forename: Nafiseh
authors.initials: N
authors.lastname: Khaksar
authors.forename: Somayeh
authors.initials: S
authors.lastname: Mohammad Taheri
authors.forename: Maryam
authors.initials: M
authors.lastname: Marzaban
authors.forename: Batool
authors.initials: B
authors.lastname: H Rashidi
authors.forename: Ali
authors.initials: A
authors.lastname: Akbari Sari
authors.forename: Kazem
authors.initials: K
authors.lastname: Zendehdel
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D015994:Incidence; D007492:Iran / Q000453:epidemiology; D007514:Islam; D008875:Middle Aged; D030361:Papillomavirus Infections / Q000453:epidemiology* / Q000401:mortality / Q000473:pathology; D015995:Prevalence; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology* / Q000401:mortality / Q000821:virology; D055815:Young Adult