The national trend of the gastric cancer burden in Iran from 1990 to 2017

Futures of gastric cancer: The fundamental level of prevention in health promotion using casual layered analysis

Gastric cancer is the leading cause of cancer mortality among men and the second leading cause among women in Iran. Given the high incidence and mortality rates of this disease in the country, a deeper investigation into its effective causes is essential. One effective approach to uncovering the unknowns related to gastric cancer is the application of critical-deconstructive future-thinking tools, particularly Causal Layer Analysis (CLA). This qualitative study involved a review of theoretical foundations and meta-documents, along with interviews with a group of experts. By employing triangulation, the findings from the literature review were integrated with thematic analysis of the interviews through the CLA framework. At the litany layer, gastric cancer is identified as the second most prevalent and deadly cancer in Iran. The systemic layer explores the "social, technological, economic, environmental, and political" origins of gastric cancer, highlighting factors such as globalization, governance weaknesses, and cultural shifts. The third layer challenges the conceptualization of cancer as a metaphysical sin, advocating for a new narrative centered on Fundamental Prevention. Effective cancer control should focus on preventing the emergence and institutionalization of factors at the worldview and metaphorical levels that contribute to economic, political, social, and cultural attitudes, ultimately manifesting in high-risk behaviors and pathogenic processes. Designing complex social nudges is crucial for establishing this new narrative based on fundamental prevention. This study effectively combines a systematic literature review and semi-structured interviews to investigate the factors influencing gastric cancer in Iran through Causal Layer Analysis (CLA) and proposes a new layer to the conventional three-pronged prevention model called "fundamental level prevention." The findings suggest that interventions targeting worldviews and cultural beliefs can promote behavior change and enhance health outcomes, particularly among marginalized groups. Furthermore, prioritizing fundamental changes at these layers can lead to positive reductions in disease incidence. This research holds significant implications for international audiences, highlighting the complexities of gastric cancer and the necessity for cultural interventions and global collaboration to address this pressing health issue.

Analysis of Factors Influencing Hospitalization Expenses of Patients With Gastric Cancer in Shanghai, 2014-2021: Based on Grey Relational Analysis and Structural Equation Modeling

OBJECTIVES

This study analyzed the basic condition and the influencing factors of hospitalization costs of patients with gastric cancer in Shanghai from 2014 to 2021, so as to provide a scientific reference for promoting the reform of the medical and healthcare system.

METHODS

The study data were obtained from the electronic medical record system of Shanghai Hospital. The grey relational analysis was applied to analyze the correlation strength of various expenses with hospitalization costs. The structural equation modeling was constructed to analyze the influences of factors on the hospitalization expenses, as well as the relationship between each factor.

RESULTS

A total of 23 335 study subjects were included. The results of grey relational analysis showed that the total cost of drugs had the strongest correlation with hospitalization expenses, followed by material expenses and surgery cost, whereas those of others were lower. The results of the structural equation modeling showed that age had the greatest influence on hospitalization expenses with a path coefficient of 0.618. Other influencing factors included surgery history, length of stay, hospital level, gender, and medical insurance.

CONCLUSIONS

The total cost of drugs had the strongest correlation with hospitalization expenses. Factors such as gender, age, and hospital level all affect the hospitalization expenses. In the future, it is necessary to take further measures to control the cost of drugs and constantly optimize the structure of hospitalization costs. Meanwhile, the reform of the medical and healthcare system should be deepened to reasonably regulate the medical behaviors and reduce the financial burden of patients.

The Effect of an Educational Intervention Based on the Health Belief Model (HBM) on Nutritional Performance Related to Gastric Cancer in Rural Women in Northern Regions of Iran

Gastric cancer is a common cause of cancer death in the world. This study examined 120 rural women. The educational program included four sessions for each group based on the health belief model. The mean age of the women was 34.51 ± 9.16. The mean score of the perceived barriers significantly decreased in the experimental group (11.08 ± 0.37) compared to the control group (14.92 ± 0.42) (P < .001), and the mean score of knowledge, performance and HBM constructs, increased significantly 2 months after the education (P < .001).It is recommended that educational interventions be designed by HBM to improve nutritional behaviors related to GC in the female population.

Trend of geographical distribution of stomach cancer in Iran from 2004 to 2014

BACKGROUND

Among different common types of cancer, gastric cancer (GC) is a worldwide health priority in both developing and developed countries. The aim of this study was to map the distribution of incident cases of GC in Iran to provide a geographical presentation of the incidence of the disease.

METHODS

This study used the Iranian National Cancer Registry (INCR) data from 2004 to 2014. We calculated the crude and age-standardized incidence rates of GC for each province and also defined the frequency distribution of different types and locations of GC by the provinces.

RESULTS

According to the results of the present study, the patients were predominantly male 49,907 (70.0%) and the most prevalent type of tumour was A1 (almost 96.4%) and C3‌ (2.0%). Also, a significant difference was observed between males and females in the distribution of the types of tumour (P < 0.001). In addition, a comparison of the distribution of the types of GC in Iran suggested that a significant difference exists between the provinces (P < 0.001). A significant difference was observed when the distribution of the location of GC tumors was compared between males and females and provinces (P < 0.001). Accordingly, pylori and cardia are the most common location of GC cancer among the study population (28.1% and 31.3% respectively).

CONCLUSIONS

The results of the current study suggested a higher rate of GC incidence in Iran when compared to the global figure in both females and males. Our study also revealed significant disparities between provinces with regard to the distribution of types, and location of GC. This may suggest involving different factors in GC in different parts of Iran. Further studies are needed to better understand the epidemiology and etiology of the disease in Iran.