Mary Cooter

Ethnic and Regional Differences of Cancer Incidence in Cyprus 1998-2007

In Cyprus, cancer incidence and mortality have recently been acknowledged among the country's leading health concerns. In February of 2011, the President of the Cypriot National Cancer Committee stated that, “the way things are going with our lifestyle changes and an aging population, cancer will soon overtake circulatory diseases to become the leading cause of death in Cyprus”(1). In fact, since 2005 the percent of deaths due to neoplasms has increased every year from 18.7% to 22.7%, while at the same time circulatory disease (the current leading cause of death) has been declining (2). According to the European Cancer Observatory, as of 2008, Breast (18.8%), Prostate (14.6%), Colon (12.1%) and Lung (7.7%) are the four most incident cancer types in Cyprus, and account for over half (53.2%) of all cancer incidents (3). 
The Cyprus Cancer Registry, in its current form, was established in 1998 when Cyprus joined the Middle East Cancer Consortium (MECC). The population-based registry covers the government controlled southern part of the island, which includes the Lefkosia, Larnaka, Lemesos, Pafos and Ammochostos districts (4). Every three to five years since 1998, the Ministry of Health has reported incidence analyses of the registry data which contains sex-specific, age-adjusted incidence rates. The last time district-specific incident rates were calculated was in the “Report for the Triennial 1998-2000” , and ethnic-specific incident rates have never been investigated using the registry data.

For the four most incident cancer types (Breast, Prostate, Colon, and Lung) perform the following:
Calculate the sex-specific, age-adjusted incidence rates of the Cyprus cancer registry for the period 1998-2007 by the five districts of government-controlled Cyprus to identify any regional differences;
Calculate the sex-specific, age-adjusted incidence rates of the Cyprus cancer registry for the period 1998-2007 by the census identified ethnic groups of Cyprus to identify any ethnic differences.
Determine any statistically significant time trends of sex-specific age-adjusted cancer incidence over the 10-year period;
Create hotspot maps of cancer incidence to identify any geospatial patterns in cancer incidence.
This study will be unique because unlike previous analyses it will contain district and ethnic-specific incidence rates over the 10 years of accumulated data. This analysis will identify any regional or ethnic differences in cancer distribution among the 5 districts and common ethnic groups of Cyprus. The hotspot mapping will provide the materials needed for geospatial (GIS) analyses of possible cancer clusters and environmental risk factors of cancer incidence. Future research to examine etiologic factors can then be based on these analyses.

1. AlphaCyprus. Cancer to become leading cause of death, official warns. 5, February 2011. 
2. Health Monitoring Unit. Leading Causes of Death 2004-2009. Ministry of Health of the Republic of Cyprus. 23, December 2011. 
3. European Cancer Observatory. Country fact sheets Country: Cyprus. 23, December 2011.
4. Cyprus Cancer Registry. Report for the Triennial 1998 – 2000. Government of Cyprus Ministry of Health.


About Mary
Mary attended the University of North Carolina at Chapel Hill and graduated in 2011 with Bachelor degrees in biostatistics and mathematics. During her undergraduate studies she worked as a research assistant at the Survey Research Unit participating in survey based study design and analysis. She graduated with a Master of Science degree in biostatistics at the University of Michigan School of Public Health in 2013.