title: Survival from skin cancer and its associated factors in Kurdistan province of Iran.
abstract: BACKGROUND
  We explored survival of skin cancer and its determinants in Kurdistan province of Iran.
  
  
  METHODS
  In a retrospective cohort design, we identified all registered skin cancer patients in Kurdistan Cancer Registry from year 2000 to 2009. Information on time and cause of death were obtained from Registrar's office and information on type, stage and anatomic locations were extracted from patients' hospital records. Additional demographic information was collected via a telephone interview. We calculated the 3 and 5 years survival. Survival experiences in different groups were compared using log rank test. Cox proportional hazard model was built and hazard ratios and their 95% confidence intervals were calculated.
  
  
  RESULTS
  Of a total of 1353, contact information for 667 patients were available, all of which were followed up. 472 telephone interviews were conducted. Mean follow-up time was 34 months. We identified 78 deaths in this group of patients and 44 of them were because of skin cancer. After controlling for confounding, tumour type, anatomical location, and diseases stage remained significantly associated with survival. Hazard ratios for death because of squamous cell carcinoma was 74.5 (95%CI: 4.8-1146) and for melanoma was 24.4 (95%CI: 1.3-485) compared with basal cell carcinomas. Hazard ratio for tumours in stage 4 was 16.7 (95%CI: 1.8-156.6) and for stage 3 was 16.8 (95%CI: 1.07-260) compared with stage 1 and 2.
  
  
  CONCLUSIONS
  Tumour stage is independently associated with survival. Relatively low survival rates suggest delayed diagnosis. Increasing public awareness through media about the warning signs of skin cancers could increase the chance of survival in these patients.
authors.affiliation: MSc of Epidemiology, Tehran University of Medical Sciences, Tehran, & Social Determinants of Health Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran. arvin_amani@yahoo.com.
authors.forename: Galavizh
authors.initials: G
authors.lastname: Ahmadi
authors.affiliation: PhD of Epidemiology, Iran University of Medical Sciences, Tehran, Iran. mohsen.asadi@yahoo.com.
authors.forename: Mohsen
authors.initials: M
authors.lastname: Asadi-Lari
authors.affiliation: BSc in Public Health, Social Determinants of Health Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran. amani.said@yahoo.com.
authors.forename: Saeid
authors.initials: S
authors.lastname: Amani
authors.affiliation: PhD of Epidemiology, Iran University of Medical Sciences, and Minimally Invasive Surgery Research Centre, Rasoul-e-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran. solaymani.m@iums.ac.ir.
authors.forename: Masoud
authors.initials: M
authors.lastname: Solaymani-Dodaran
keywords: Cox model; Kaplan Meier; Skin cancer; Survival analysis