Study of the avoidable mortality in iran: kerman province

Contributions of avoidable mortality to the sex gap in life expectancy and life disparity in Iran

BACKGROUND

Public health policies and healthcare quality play a pivotal role on the health outcome level and disparities across sociodemographic groups. However, there is little evidence on their role on disparities in life expectancy (LE) and life disparity (LD) in low and middle income countries. The present study aimed to assess the contributions of avoidable mortality, as a measure of inter-sectoral public health policies and healthcare quality, into the sex gap in LE (SGLE) and LD (SGLD) in Iran.

METHODS

Latest available data of death causes, according to the ICD codes, for Iran was obtained from the WHO mortality database for the period 2015-2016. An upper age limit of 75 years was applied to define avoidable causes of death. LD was measured as the average years of life lost at birth. The SGLE and SGLD (both females minus males) were decomposed by age and cause of death using a continuous-change model.

RESULTS

Females, on average, outlived males for 3.8 years (80.0 vs. 76.2 years) with 1.9 lower life years lost (12.6 vs. 14.4 years). Avoidable causes accounted for 2.5 (67%) and 1.5 (79%) years of the SGLE and SGLD, respectively. Among avoidable causes, injury-related deaths followed by ischaemic heart disease had the greatest contributions to both SGLE and SGLD. Across age groups, the age groups 55-59 and 60-64 accounted for the greatest contributions of avoidable causes to SGLE (0.3 years each), while age groups 20-24 and 55-59 had the greatest contributions to SGLD (0.15 years each). Lower mortality rates for females than males in age groups 50-74 years accounted for about half of the SGLE, while age groups 20-29 and 50-64 years accounted for around half of SGLD.

CONCLUSION

More than two third of the SGLE and SGLD in Iran were attributed to the avoidable mortality, particularly preventable causes. Our results suggest the need for public health policies targeting injuries in young males as well as lifestyle risk factors including smoking in middle aged males in Iran.

Pancreatic Cancer in Iran - Result of the Iranian National Cancer Registry Program

OBJECTIVE

In this article, we aimed to report the incidence rate of PC at the national and regional levels of Iran from 2014 to 2017 for the first time based on the IARC protocols.

METHODS

The data was recruited from the Iranian national program of cancer registry, a national cancer registry program reformed in 2014 after including cancer diagnosis based on clinical judgment and death certificates. This registry includes data from the pathology laboratories and clinical sectors included with death certificates from 60 medical universities in 31 provinces of Iran. Age-standardized incidence rates were calculated at the national and regional levels.

RESULTS

From 2014 to 2017, 8851 new cases (males=60.46%) were diagnosed, with a mean age of 66.2 ± 19.6. Forty-one percent of the patients were diagnosed by microscopic verification, and 51% were diagnosed based on clinical judgment without microscopic verification and death certificates. The age-standardized incidence rate was measured as 3.45 per 100,000 in 2017, with the highest rates in individuals older than 85 (30.91 per 100,000), and the provinces of Qom, Tehran, and Isfahan recorded the highest incidence rates with 3.87, 3.85, and 3.66 per 100,000 respectively.

CONCLUSIONS

PC incidence in Iran is still lower than in western countries. However, the incidence from 2014 to 2017 is higher than previous national and regional reports and should not be overlooked. Improvement in the national cancer registry program and documentation may be reasons for this difference.

Pancreatic Cancer in Iran: an Epidemiological Review

PURPOSE

Pancreatic cancer is the seventh cause of death in men in the world and also is one of the most common malignancies worldwide with poor prognosis. Due to the lack of epidemiological aspects of pancreatic cancer in Iran, this study aimed to investigate the epidemiological aspects of pancreatic cancer in Iran.

METHODS

In February 2019, A search was conducted with the keywords "Pancreatic Neoplasm," "Pancreas Neoplasms," "Cancer of Pancreas," "Pancreas Cancer," "Pancreatic Cancer," "Cancer of the Pancreas," and "Iran" in their title or abstract and MeSH. The databases of Medline, Web of Science, Scopus, SID, IranMedex, and Google Scholar were searched. The title and abstract of the papers were reviewed, and articles that addressed the epidemiological aspects of pancreatic cancer were included; in total, 20 full papers were reviewed.

RESULTS

According to studies, the incidence and mortality rate of pancreatic cancer is steadily increasing with age. Actually, men are more likely to develop this carcinoma than women. Smoking, aging, and lifestyle changes are the most important risk factors for pancreatic cancer in Iran. Due to the lack of initial symptoms or a specific marker for early diagnosis of pancreatic cancer, this cancer is detected lately and therefore low survival rate is observed.

CONCLUSION

Mortality and incidence of pancreatic cancer is increasing in Iran. Pancreatic cancer is more common in men than women. Based on the results of this study, pancreatic cancer depends largely on the lifestyle. Survival of pancreatic cancer is low in untreated patients.