Spatial Epidemiology of Myeloproliferative and Myelodysplastic Syndromes in Iran: Hotspot Analysis and Trend Forecasting to 2030 Publisher

Summary: Where is blood-cancer burden highest in Iran? Modeling flagged Khuzestan for incidence and Tehran for disability burden, with a possible rebound by 2030. #Hematology #PublicHealth

Kheiri G ; Jorjani G ; Taherian M R ; Kheiri S ; Yaghmaie M ; Rouzbahani H ; Babaeifard S ; Janbabaei G ; Barkhordar M
Source: Health Scope Published:2026

Abstract

Background: Comprehensive national data on the epidemiology of myelodysplastic/myeloproliferative neoplasms (MDS/MPN) in Iran are lacking. Objectives: This study aimed to characterize the spatial distribution and temporal trends of the MDS/MPN burden across Iran to identify high-risk regions and inform public health planning. Methods: Using data from the Global Burden of Disease (GBD) 2021 study, we extracted age-standardized rates of incidence, prevalence, mortality, and disability-adjusted life years (DALYs) for Iran’s 31 provinces from 1990 to 2021. We applied spatial autocorrelation methods (global and local Moran’s I) and hotspot analysis (Getis-Ord Gi*) to identify significant geographic clusters. We used an ARIMAX time-series model to forecast trends through 2030. Results: In 2021, the national age-standardized incidence rate was 8.52 per million, and the prevalence was 170.84 per million. Significant geographic heterogeneity was observed. Hotspot analysis identified Khuzestan Province as a high-risk cluster for incidence and prevalence (P < 0.05), whereas Tehran emerged as a hotspot for DALYs. Temporal analysis showed that incidence and prevalence peaked in 2005, declined through 2021, and are projected to show a modest rebound by 2030. Mortality rates increased modestly from 1990 to 2005, remained relatively stable through 2021, and were projected to increase by 2030. A consistent male predominance was observed across all burden metrics. Conclusions: This study reveals marked and evolving geographic disparities in the burden of MDS/MPN across Iran. The identified high-risk clusters, particularly in the industrially dense south and southwest, suggest potential roles for environmental and occupational exposures. These findings provide evidence to guide targeted resource allocation, strengthen early detection programs, and inform future etiologic research into the drivers of MDS/MPN in Iran and similar regions. © 2026, Kheiri et al.