Gastroenterology and Hepatology from Bed to Bench

Time trend and geographical distribution of colorectal cancer incidence before and after COVID-19 pandemic in southern Iran: an interrupted time series analysis

Gastroenterology and Hepatology from Bed to Bench, , 2 March 2026 , Page 1-8 (e7)
https://doi.org/10.22037/ghfbb.v19i01.3269

Abstract

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.

Keywords:
  • Colorectal cancer
  • geographical distribution
  • trend
  • Fars province
  • covid 19

How to Cite

Taheri Soodejani, M., Safarpour, A. R., Keshavarz, M., Kazemi , M., & Bananzadeh , A. (2026). Time trend and geographical distribution of colorectal cancer incidence before and after COVID-19 pandemic in southern Iran: an interrupted time series analysis. Gastroenterology and Hepatology from Bed to Bench, 19(01), 1–8 (e7). https://doi.org/10.22037/ghfbb.v19i01.3269

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