THE CHARACTERISTICS OF THE POPULATION AFFECTED BY CANCER DISEASES IN THE MIDDLE EUPHRATES GOVERNORATES FOR THE YEAR

Objective: This study investigates the spatial variation of cancer prevalence in the Middle Euphrates Governorates, aiming to identify the types of cancer with the highest incidence rates and the demographic groups most affected by the disease. Theoretical framework: With the understanding that cancer is a significant global health issue, this research explores how its distribution varies across different geographic areas. By analyzing the spatial patterns of cancer prevalence, the study contributes to our knowledge of the disease's distribution in the Middle Euphrates Governorates. Methods: The study utilizes available data on cancer cases from the Middle Euphrates Governorates, conducting a comprehensive analysis to determine the prevalence rates of different cancer types. Demographic factors such as age, occupation, and education level are considered to identify the demographic groups most impacted by cancer. Results and conclusion: The analysis reveals that breast cancer is the most common type of cancer in the Middle Euphrates region. Incidence rates are highest among individuals aged 50-54, 55-59, and 65-69. Notably, there is an alarming increase in cancer cases among housewives. The study also finds a higher incidence of cancer among individuals with lower education levels, particularly the illiterate population. These findings underscore the urgent need for awareness campaigns and early detection efforts to alleviate the burden of cancer in the region.


INTRODUCTION
Recently, many geographical studies have emerged and focused on studying human diseases. These studies are based on identifying the causes which affect the human body, as well as the most important factors affecting the increase in the incidence rates resulted by these diseases, whether they are natural or human-made (Al-Hassan, 2013).
The population studies are important to detect the levels of cancer incidence, its different trends, geographical distribution, and temporal variation. These studies help to identify the extent of human exposure to various diseases due to natural and human factors or climate changes. Despite the importance of the subject, population geography studies are still limited in this regard, which calls for more detailed studies on administrative units. Based on this, the researchers have taken the Middle Euphrates provinces as a demonstrative model to detect the spatial variation of cancer incidence and the most affected age groupsj. The study also focus on the most important economic and social characteristics of the affected individuals. Based on the information provided. This research carries significant justifications, both in terms of theoretical and practical contributions. Theoretically, the study contributes to expanding the existing body of knowledge by shedding light on the characteristics of individuals affected by cancer in the Middle Euphrates provinces. By examining the spatial variation of these characteristics and identifying the most vulnerable age groups, the research fills a gap in population geography studies and enhances our understanding of the distribution and determinants of cancer. Additionally, the research provides valuable insights into cancer epidemiology by analyzing incidence rates, gender-specific differences, and the prevalence of different cancer types, such as breast cancer. These findings contribute to the field's theoretical foundation and can guide future research endeavors focused on understanding the complexities of cancer development and distribution.
Practically, the research has several implications for public health strategies. By identifying the most affected age groups, policymakers and healthcare professionals can design targeted interventions and preventive measures, such as age-specific screening programs and awareness campaigns. This approach can improve early detection rates and overall health outcomes. Moreover, the spatial analysis of cancer characteristics among provinces provides important information for resource allocation and healthcare planning. By understanding the variations in cancer burden across regions, policymakers can distribute healthcare resources more effectively, ensuring that areas with higher prevalence receive adequate support.
Additionally, the research findings on demographic, social, and economic characteristics of affected individuals can inform the development of tailored interventions and support systems. This knowledge can guide the implementation of initiatives such as public education programs, counseling services, and socioeconomic support to mitigate the impact of cancer on vulnerable populations.
In summary, the research justifications lie in its theoretical contributions to the understanding of cancer epidemiology and its practical implications for public health strategies. By expanding the knowledge base, the study provides insights into the characteristics of individuals affected by cancer and their spatial distribution, enabling targeted interventions and resource allocation. Ultimately, the research aims to improve cancer prevention, early detection, and management strategies, ultimately leading to better health outcomes and reduced burden on individuals and healthcare systems in the Middle Euphrates provinces.
The research aims to shed light on the most important characteristics of individuals affected by cancer, clarify their spatial variation among the provinces of the study area, determine the incidence rates for both males and females, and identify the age groups that are most affected by the disease.

METHODOLOGY
The researchers adopted a descriptive-analytical methodology to describe and analyze the available data about the study area. They also used a quantitative approach to analyze statistic information to achieve accuracy in studying the subject and to reach detailed results that reflect the reality of the situation. The temporal scope of the study was limited to the statistical data available for the year 2022. The study focused on distribution of cancer patients in the Middle Euphrates provinces.
The Middle Euphrates provinces are located in the central and southwestern part of Iraq, between latitudes 34-45 degrees north and longitudes 42.9-33.3 degrees to the east (Ibrahim, 2003). The provinces are bordered by Baghdad to the north, Wasit and Dhi Qar to the east, Al- 4 Basrah to the south, and Al-Anbar to the west. The southern border of the study area is adjacent to the Razaza area with Saudi Arabia, (Figure 1). The study was conducted in 2022, and the study area covers 98,870 square kilometers, which represents 22% of Iraq's total area of 434,128 square kilometers. This research study has been divided into several section, where the introduction focused on the theoretical framework of the research. In the first section, the focus was on demographic characteristics, while the second section focuses on social characteristics. In the third section, the focus was on economic characteristics. The research also included conclusions and recommendations, as well as a list of sources that were relied upon in preparing the research. Determining the demographic characteristics of infected people is one of the priorities on which most studies are based, whether geographical, demographic or medical. These characteristics play a great role in determining the variation or the size of the gap in the incidence of diseases. Since the second half of the 20 th century, geographers have developed a medical geography atlas classified the size of the gap in the incidence of diseases and deaths resulting from infection with these diseases in 1963 (Jaber, & Al-Banna, 2004;Prysthon et al, 2023).

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The study of the relative distribution of any population (i.e., males and females) is of great importance which has been increasing during the last two decades of the twentieth century (Sahawneh & Samha, 2020). Because this study has a great importance in clarifying the disparity between both males and females in all life domains, including the incidence of diseases. Yet, the provinces of the Middle Euphrates has showed variation in injured due to the gender.

RESULTS AND DISSCUSSION
The highest injury among males was recorded in Najaf governorate, followed by Diwaniyah and Muthanna governorates, and then Babil governorate, and the lowest injuries were in Karbala governorate. The percentage of ingury in each governerate was (57.1%, 17%, 13%, 10.8%, 1.8%) respectively. As for female injuries, the governorates of the Middle Euphrates came in the same order, and there is no difference in the percentage of minor injuries (Table 1). The study of the population by age in any place is affected by several factors that may leave their mark on the population (Al-Khafaf, 1999). Furthermore, the division of the population into age groups is of great importance in geographical and population studies as well as medical studies. Such a study has a major role in diagnosing diseases and determining the type of treatment that is commensurate with the age of the patient. The injuries varied among the infected people according to their age groups. The injuries increased in the age groups (50-54), (55-59) and (65-69). Their numbers reached (253, 248, 258) respectively, while the least affected age group is the category of children under 4 years old.
Table 2 and Figure 2 show that the highest rates of infections were recorded for all age groups in the holy city of Najaf compared to other governorates, and the highest rates of injuries were in the age group (55-59), reaching 151 people. While the lowest number of injuries was recorded in Karbala governorate, it recorded 2 injuries in 2022 whereas the rest of the governorates came in the middle.  Table 3 shows that the marital status of the affected individuals with cancer has a significant impact on the variation of cases between the provinces. Table 3 indicates that that the highest number of cases were among the married men and women, followed by widows and unmarried women. The total number of injuries reached (804,782,237,114) respectively. The least number of effected cases were among male children in which just 9 cases were affected. Similarly, the province of Najaf recorded the highest number of cases, especially 458 among married men and 455 married women, while divorced individuals had the lowest number of one cases. Figure 3 displays that the Diwaniyah provinces recorded the second-highest number of cases among married women, followed by married men and then widows, with numbers reaching (136,133,48) respectively. The lowest number of cases were among divorced men and children, with only one case registered. Furthemore, this is followed by the province of Muthanna which recorded 106 cases among married individuals, but no cases were registered among divorced individuals or children. Finally, the provinces of Babil and Karbala recorded no cases in any category.  7   1  0  1  0  2  36  91  106  8  9  Muthanna  6  7  17  1  12  133  455  458  75  46  Najaf  1  1  3  0  1  16  74  93  11  4  Babil  0  0  0  0  0  4  26  14  0  3  Karbala  10  9  26  2  18  237  782  804  114  81  Total Source: Prepared by the authors (2023).
Educational attainment has a significant impact on cancer patients in the Middle Euphrates provinces. Cancer affects their ability to understand the seriousness of the disease and the need to deal with it seriously through regular medical checkups and medication, as well as their ability to raise awareness among other patients about accepting their condition. Therefore, the highest number of effected cases were recorded among illiterate individuals, reaching 803 in all provinces under the study, while the lowest number of cases were among those with higher education degrees, with only 15 cases recorded.
The study area witnessed a clear variation between its provinces, as can be seen in Table  4, with the highest number of registered cases among illiterate individuals and those with primary education in Najaf Al-Ashraf province. On the contrary, the lowest number of cases were among those with a master's degree, with numbers reaching (416, 328, 11) respectively. Diwaniyah province came next with 163 cases among illiterate individuals, while the number of cases among those with higher education degrees was very limited.
As for the provinces of Babil, Karbala, and Muthanna, the recorded effecte cases were lower than those in Najaf and Diwaniyah provinces, for all educational levels. In fact, no cases were recorded among individuals with higher education degrees in Muthanna and Karbala provinces, while only one case was recorded among individuals with a master's degree in Babil province, as can be seen in Figure 3.  Studying the economic characteristics is no less important than the study of other characteristics, whether demographic or social in all its ramifications (Fathi, 1993). It is evident from Table 5 that the study area has witnessed a significant variation among the governorates regarding the infected individuals based on their occupations. Overall, the number of infected housewives has increased, followed by workers, then employees and retirees, with their numbers being 949, 458, 348, and 297, respectively. Map 4 shows that Al-Najaf Al-Ashraf governorate had the highest number of infections, especially among housewives with a total of 540 cases, while the lowest number of infections was among children with only 23 cases. The second high infectious were in Al-Diwaniyah governorate, then Al-Muthanna and Babil. The lowest number of infections was recorded in Karbala governorate, especially among children.  Cancer is one of the ancient diseases that attacks its victims silently, and therefore it is considered one of the dangerous diseases or malignant diseases (Makki, 1990, Rocha et al., 2021. There are significant variations in the main causes of cancer and death in all countries worldwide (Al-Dulaimi, 2009). The incidence of cancer varies not only globally but also at the level of administrative units, depending on various factors such as lifestyle, dietary habits, and income levels (Jaber & Al-Banna, 2004). Table 6 shows that Middle Euphrates governorates have witnessed a clear variation among each govermentate in terms of the types of cancer, with breast cancer being the highest among other types, with a total of 552 cases followed by prostate cancer with 144 cases.As for colon, rectum, and bladder cancers, the number of cases was relatively similar, with 112, 101, and 102 cases respectively. The lowest number of cases was recorded for AML with only 39 cases. The remaining types of cancer were in between these numbers as shown in Figure 5.  29  24  5  97  21  18  41  11  17  17  12  54  4  18  Diwaniyah  9  11  4  55  12  10  27  7  13  9  21  50  8  18  Muthanna  77  68  25  323  64  62  99  43  62  52  62  151  39  83  Najaf  17  6  4  60  12  8  12  5  8  8  1  34  4  25  Babil  2  3  1  17  3  3  6  2  2  2  0  4  2  0  Karbala  134  112  39  552  112  101  185  68  102  88  96  293  57  144  Total Source: Prepared by the authors (2023).

CONCLUSION
In conclusion, the results obtained in this research hold significant implications for both society and academia, showcasing their potential contributions and benefits.
From a societal perspective, the findings of this research provide valuable insights that can help inform and guide public health strategies, healthcare policies, and interventions aimed at reducing the burden of cancer in the Middle Euphrates provinces. The identification of the most vulnerable age groups and the prevalence of specific cancer types, such as breast cancer, enables policymakers and healthcare professionals to allocate resources effectively and develop targeted screening, prevention, and treatment programs. This can lead to earlier detection, improved outcomes, and ultimately a reduction in cancer-related mortality and morbidity. Furthermore, the research highlights the increasing incidence among housewives, indicating the need for tailored support systems and initiatives to address their unique challenges. The understanding of educational disparities in cancer incidence also emphasizes the importance of targeted awareness campaigns and educational programs to empower and educate individuals with lower educational attainment. By translating research findings into actionable strategies, this research can contribute to improving the overall well-being and health outcomes of individuals affected by cancer in the Middle Euphrates provinces. Academically, this research adds to the existing body of knowledge in the field of cancer epidemiology and population geography. The identification of age-specific patterns, spatial variations, and the prevalence of certain cancer types enriches the theoretical understanding of cancer development, distribution, and risk factors. The research findings can serve as a foundation for further investigations, allowing researchers to delve deeper into the underlying causes, social determinants, and geographical factors associated with cancer incidence. Moreover, the methodology employed in this research, such as spatial analysis and demographic profiling, contributes to the methodological toolkit of population geography and can inspire future studies in similar contexts. By sharing the research outcomes with the academic community, scholars can build upon this work and advance knowledge in the field, leading to more effective cancer prevention and control strategies. Overall, the results obtained in this research have significant societal implications, facilitating evidence-based decision-making, informing public health strategies, and addressing the specific needs of vulnerable populations. Academically, the findings  contribute to the theoretical understanding of cancer epidemiology and provide a platform for future research endeavors. By bridging the gap between academia and society, this research aims to improve cancer outcomes and ultimately enhance the well-being of individuals in the Middle Euphrates provinces affected by this challenging disease. The research question sought to answer: What are the most vulnerable age groups to cancer disease in the Middle Euphrates provinces? Based on the findings of the study, it can be concluded that the age groups most affected by cancer in the Middle Euphrates provinces are those aged 50-54, 55-59, and 65-69. These age ranges showed the highest incidence rates, highlighting the need for targeted interventions and screening programs for early detection and prevention within these age groups.
Sample Size and Generalizability: The research may have limitations regarding the sample size and representativeness of the Middle Euphrates provinces. The findings may not fully capture the diversity and nuances of the entire population in the region. Future studies could aim to include larger and more diverse samples to enhance the generalizability of the results.
Data Availability and Accuracy: The research's findings are dependent on the availability and accuracy of the data sources used. There may be limitations in data collection methods, potential biases, or missing information that could impact the accuracy and reliability of the results. Future studies should strive to collect data from multiple reliable sources and employ rigorous data validation processes.
Lack of Detailed Socioeconomic Factors: The research primarily focused on demographic characteristics and educational attainment as socioeconomic indicators. Future studies could consider incorporating additional socioeconomic factors such as income, occupation, and access to healthcare services. These factors can provide a more comprehensive understanding of the socioeconomic disparities associated with cancer incidence.
Temporal Analysis and Longitudinal Perspective: The research provides a snapshot of cancer incidence and characteristics within a specific time frame. However, cancer patterns and trends may change over time due to various factors such as advancements in medical technology, changes in lifestyle behaviors, and implementation of preventive measures. Future research could adopt a longitudinal approach to examine temporal changes in cancer incidence and explore the factors contributing to these changes.
In-Depth Analysis of Risk Factors: Future research could delve deeper into the risk factors associated with cancer incidence in the Middle Euphrates provinces. This may involve investigating lifestyle factors, environmental exposures, genetic predisposition, and occupational hazards. Understanding these risk factors can guide targeted interventions and prevention strategies.
Comparative Analysis: Conducting a comparative analysis between the Middle Euphrates provinces and other regions within the country or internationally can provide valuable insights into regional differences and similarities in cancer incidence. Comparative studies can identify potential contextual factors and inform region-specific interventions.
Long-Term Follow-up Studies: Long-term follow-up studies tracking cancer patients over an extended period can assess treatment outcomes, survival rates, and recurrence rates. These studies can shed light on the effectiveness of treatment protocols and identify areas for improvement in cancer care.
Intervention Studies: Future research should focus on evaluating the effectiveness of specific interventions aimed at reducing cancer incidence and improving outcomes. This could include evaluating the impact of awareness campaigns, targeted screening programs, lifestyle interventions, and access to affordable healthcare services.
Socioeconomic Determinants: Further exploration of socioeconomic determinants of cancer incidence is warranted. Future research can investigate the influence of income