Epidemiological Pattern of Breast Cancer in Iranian Women: Is there an Ethnic Disparity?

Breast cancer incidence trends in Golestan, Iran: An age-period-cohort analysis by ethnic region, 2004-2018

BACKGROUND

We aimed to examine the effects of age, diagnosis year (calendar period) and birth year (cohort) on the incidence trends of breast cancer among Golestan women, Northeast Iran, 2004-2018.

METHODS

Incidence data were obtained by residential status (urban/rural) and ethnic region (Turkmens/non-Turkmens). We calculated age-standardized incidence rates (ASRs) per 100,000 person-years. The estimated annual percentage change (EAPC) were calculated, and age-period-cohort (APC) models fitted to assess non-linear effects of period and cohort as incidence rate ratios (IRRs).

RESULTS

The total number of female breast cancer cases in Golestan, 2004-2018, were 3853, with an overall ASR of 31.3. We found higher rates in urban population (40.5) and non-Turkmens region (38.5) compared to rural area (20.8) and Turkmens region (20.2), respectively. There were increasing trends in incidence rates overall (EAPC= 4.4; 95%CI: 2.2, 6.7), with greater changes in rural areas (EAPC=5.1), particularly among non-Turkmens (EAPC=5.8). The results of the APC analysis indicate the presence of significant non-linear cohort effects with increasing IRRs across successive birth cohorts (IRR=0.1 and IRR= 2.6 for the oldest and the youngest birth cohorts vs. the reference birth cohort, respectively).

CONCLUSION

We found increasing trends in breast cancer incidence among Golestan women over the study period, with disparities in patterns and trends by residence area and ethnic region. The observed cohort effects suggest an increasing prevalence of key risk factors for breast cancer in this Iranian population. Further investigations are warranted to clarify the relationships between determinants such as reproductive factors and ethnicity in the region.

Nanoparticle-based materials in anticancer drug delivery: Current and future prospects

The past decade has witnessed a breakthrough in novel strategies to treat cancer. One of the most common cancer treatment modalities is chemotherapy which involves administering anti-cancer drugs to the body. However, these drugs can lead to undesirable side effects on healthy cells. To overcome this challenge and improve cancer cell targeting, many novel nanocarriers have been developed to deliver drugs directly to the cancerous cells and minimize effects on the healthy tissues. The majority of the research studies conclude that using drugs encapsulated in nanocarriers is a much safer and more effective alternative than delivering the drug alone in its free form. This review provides a summary of the types of nanocarriers mainly studied for cancer drug delivery, namely: liposomes, polymeric micelles, dendrimers, magnetic nanoparticles, mesoporous nanoparticles, gold nanoparticles, carbon nanotubes and quantum dots. In this review, the synthesis, applications, advantages, disadvantages, and previous studies of these nanomaterials are discussed in detail. Furthermore, the future opportunities and possible challenges of translating these materials into clinical applications are also reported.

Ethnic Disparities in Major Adverse Cardiac and Cerebrovascular Events (MACCEs) and Postoperative Outcomes Following Coronary Artery Bypass in Northeastern Iran (2007-2016)

BACKGROUND

Turkmens are an ethnic group mainly living in northeastern Iran. Despite previous studies on coronary artery bypass surgery (CABG) outcomes among different ethnicities, the effect of Turkmen ethnicity on outcomes of CABG surgery is still unknown. We aimed to assess the association between Turkmen ethnicity and postoperative outcomes following CABG.

METHODS

We used the CABG data from two heart centers in northeastern Iran between 2007 and 2016. We included adult patients undergoing CABG surgery. The study outcomes were in-hospital major adverse cardiac and cerebrovascular events (MACCEs), consisting of myocardial infarction (MI), stroke, and cardiovascular death, and postoperative outcomes, including postoperative arrhythmia, acute atrial fibrillation (AF), major bleeding, and acute renal failure (ARF).

RESULTS

Over the course of one decade, 3632 patients, with an average age (standard deviation) of 59.0 (9.8) years, were studied. Of these, 3,331 patients were of non-Turkmen ethnicity, and 301 patients were Turkmens. According to adjusted analysis, ethnicity was not associated with MACCEs (OR: 1.15, 95 % CI: 0.61, 2.16; P=0.663), postoperative arrhythmia (OR: 1.10, 95% CI: 0.78, 1.54; P=0.588), acute AF (OR: 1.17, 95 % CI: 0.83, 1.66; P=0.359), major bleeding (OR: 1.21, 95 % CI: 0.55, 2.67; P=0.636), or ARF (OR: 2.60, 95 % CI: 0.60, 11.75, P=0.224).

CONCLUSION

This study found that despite ethnic disparity and preoperative differences, Turkmen ethnicity was not associated with in-hospital MACCEs, AF, major bleeding, or ARF after coronary artery bypass.

Anti-cancer Activity of Chrysin in Cancer Therapy: a Systematic Review

Chrysin is a natural bioactive compound that is extracted from many trees, honey, and propolis. Chrysin has several pharmacological activities such as anti-inflammatory, anti-cancer, and antioxidant properties. This study was performed to evaluate the anti-cancer activities of chrysin in cancer therapy. The present study was conducted by systematic review of studies published up to August 2021. Related studies were identified by searching Web of Science (WoS), PubMed, Science Direct, SID, MagIran, Scopus, and Google Scholar databases. The keywords of chrysin, cancer, anti-cancer, and cancer therapy were used for searching. The quality of the studies was assessed by the CONSORT checklist. A total of 21 studies were identified. The results of studies showed that chrysin has an anticancer effect by stimulating apoptosis in a wide range of human cells and rats. Chrysin is also an important factor in inhibiting tumor growth and neoplasticity. Chrysin inhibits the growth and proliferation of cancer cells by inducing cytotoxic effects. Therefore, due to the antitumor effects of chrysin and its safety and non-toxicity towards normal cells, this compound can be considered as an adjuvant along with chemotherapeutic agents in cancer treatment.

Global, regional, and national burden of ovarian cancer and the attributable risk factors in all 194 countries and territories during 2007-2017: A systematic analysis of the Global Burden of Disease Study 2017

BACKGROUND

We estimated the global burden of ovarian cancer (OC) in 194 countries and territories between 2007 and 2017.

METHODS

Data were extracted from the Global Burden of Disease (GBD), Injuries, and Risk Factors 2017 study.

RESULTS

Globally, 286 126.80 (95% UI = 278 075.38-295 311.41) incident cases, 4.67 million (4.53-4.83) disability-adjusted life-years (DALYs), and 175 981.99 (171 384.15-181 198.43) deaths were reported in 2017. The age-standardized incidence and DALY rates increased by 2.05% and 1.34% during 2007-2017, respectively, while the age-standardized mortality rate decreased by -0.14%. The age-standardized incidence, DALY, and mortality rates in 2017 were the highest in the high socio-demographic index (SDI) quintile, but the largest percentage increase during 2007-2017 was in the low-SDI quintile. Among regions, Central Europe showed the highest 2017 age-standardized incidence, DALY, and mortality rates, whereas South Asia and East Asia showed the largest percentage increases in both rates during 2007-2017. Among countries, India showed the largest percentage increase in age-standardized incidence and DALY rates, whereas Iran showed the largest percentage increase in age-standardized mortality rates. Globally, the largest percentage increase in risk-attributable DALYs was associated with metabolic risk factors (e.g., high fasting plasma glucose levels).

CONCLUSION

The global age-standardized incidence, DALYs, and mortality rates of OC remain stable during 2007-2017. However, the low SDI quintile and the greatest burden in South and East Asia, India, and Iran suggested that more targeted strategies should be performed in those regions and countries.

Geographical and socioeconomic inequalities in female breast cancer incidence and mortality in Iran: A Bayesian spatial analysis of registry data

BACKGROUND

In Iran, trends in breast cancer incidence and mortality have generally been monitored at national level. The purpose of this study is to examine province-level disparities in age-standardised breast cancer incidence versus mortality from 2000 to 2010 and their association with socioeconomic status.

METHODS

In this study, data from Iran's national cancer and death registry systems, and covariates from census and household expenditure surveys were used. We estimated the age-standardised incidence and mortality rates in women aged more than 30 years for all 31 provinces in the consecutive time intervals 2000-2003, 2004-2007 and 2008-2010 using a Bayesian spatial model.

RESULTS

Mean age-standardised breast cancer incidence across provinces increased over time from 15.0 per 100,000 people (95% credible interval 12.0,18.3) in 2000-2003 to 39.6 (34.5,45.1) in 2008-2010. The mean breast cancer mortality rate declined from 10.9 (8.3,13.8) to 9.9 (7.5,12.5) deaths per 100,000 people in the same period. When grouped by wealth index quintiles, provinces in the highest quintile had higher levels of incidence and mortality. In the wealthiest quintile, reductions in mortality over time were larger than those observed among provinces in the poorest quintile. Relative breast cancer mortality decreased by 16.7% in the highest quintile compared to 10.8% in the lowest quintile.

CONCLUSIONS

Breast cancer incidence has increased over time, with lower incidence in the poorest provinces likely driven by underdiagnoses or late-stage diagnosis. Although the reported mortality rate is still higher in wealthier provinces, the larger decline over time in these provinces indicates a possible future reversal, with the most deprived provinces having higher mortality rates. Ongoing analysis of incidence and mortality at sub-national level is crucial in addressing inequalities in healthcare systems and public health both in Iran and elsewhere.

Clinical effects of curcumin in enhancing cancer therapy: A systematic review

BACKGROUND

Curcumin is herbal compound that has been shown to have anti-cancer effects in pre-clinical and clinical studies. The anti-cancer effects of curcumin include inhibiting the carcinogenesis, inhibiting angiogenesis, and inhibiting tumour growth. This study aims to determine the Clinical effects of curcumin in different types of cancers using systematic review approach.

METHODS

A systematic review methodology is adopted for undertaking detailed analysis of the effects of curcumin in cancer therapy. The results presented in this paper is an outcome of extracting the findings of the studies selected from the articles published in international databases including SID, MagIran, IranMedex, IranDoc, Google Scholar, ScienceDirect, Scopus, PubMed and Web of Science (ISI). These databases were thoroughly searched, and the relevant publications were selected based on the plausible keywords, in accordance with the study aims, as follows: prevalence, curcumin, clinical features, cancer.

RESULTS

The results are derived based on several clinical studies on curcumin consumption with chemotherapy drugs, highlighting that curcumin increases the effectiveness of chemotherapy and radiotherapy which results in improving patient's survival time, and increasing the expression of anti-metastatic proteins along with reducing their side effects.

CONCLUSION

The comprehensive systematic review presented in this paper confirms that curcumin reduces the side effects of chemotherapy or radiotherapy, resulting in improving patients' quality of life. A number of studies reported that, curcumin has increased patient survival time and decreased tumor markers' level.

Recent cancer incidence trends and short-term predictions in Golestan, Iran 2004-2025

BACKGROUND

We examine recent trends in the major cancers occurring in the Golestan province, a high-risk region for upper gastrointestinal cancers in Northern Iran, and provide short-term cancer predictions of the future cancer burden.

METHODS

New cancer cases diagnosed in Golestan 2004-2016 were obtained from the Golestan population-based cancer registry (GPCR) database, and age-standardized rates by cancer site, year and sex calculated per 100,000 person-years. Using IARC's DepPred package we fitted time-linear age-period models to the available GPCR data to predict the cancer incidence burden in the year 2025. We calculated the contribution of demographic changes versus changes in risk to the overall changes in incidence from 2016 to 2025.

RESULTS

The number of new cancer cases (excluding non-melanoma skin cancers) in 2025 is predicted to increase by 61.3% from 2678 cases in 2016 to 4319 cases. While a 17.6% reduction in the number of esophageal cancer cases is predicted by 2025, the number of new cases for each of the remaining major cancers is predicted to increase over the next decade, including cancers of the stomach (a 36.1% increase from 2016 to 2025), colorectum (56.2%), lung (67.8%), female breast (93.2%), prostate (101.8%) and leukemia (96.1%). The changes in the population structure and risk contributed 37.8% and 23.5% respectively, to the overall increase in incidence.

CONCLUSION

Other than for the major upper gastrointestinal cancer types, the incidence rates of common cancers observed in the province are on the rise, reinforcing the need for continuous surveillance, as well as the design and implementation of effective cancer control programs.

Incidence trend of breast Cancer in women of eastern Mediterranean region countries from 1998 to 2019: A systematic review and meta-analysis

BACKGROUND

This study was conducted to provide evidence on the current status of breast cancer and its incidence trend in Eastern Mediterranean Region during 1998-2019. Also, this study aimed to investigate the association between the incidence of breast cancer and Human Development Index and some factors related to this index, including total fertility rate, and obesity, using a meta-analysis.

METHOD

Data on incidence of breast cancer were collected from various sources, including PubMed, Embase, Web of Science, and WHO, from 1998 to 2019 using systematic review and meta-analysis. Pooled age standardized rate was calculated based on study duration and quality of data using a subgroup analysis and random effect meta-analysis.

RESULTS

A total of 80 studies (545 data points) were analyzed. Pooled age standardized rate of breast cancer for Eastern Mediterranean Region was 37.1 per 100,000 person-year (95% confidence interval [CI], 34.5, 39.8) during 2011-2019. age standardized rate of breast cancer had an upward trend in Eastern Mediterranean Region from 2005 to 2019. However, the increasing trend was found to be slightly different in various regions based on quality of data. Moreover, pooled age standardized rate had a significant association with Human Development Index [- 89.2 (95% CI, - 119.8, - 58.7)] and obesity [1.2 (95% CI, 0.9, 1.5)].

CONCLUSION

Pooled age standardized rate of breast cancer in Eastern Mediterranean Region was lower than the global average. Also, the age standardized rate value and its incremental trend have been higher in countries with high-quality data than in other countries of this region in recent years. Data quality or physiological factors, such as increase in obesity rates, could be the reasons for this incremental trend.

All-cancer incidence in Tehranian adults: more than a decade of follow-up-results from the Tehran Lipid and Glucose Study

OBJECTIVES

To investigate the incidence rates for different malignancies and assess the risk factors for all-cancer incidence in Tehran.

STUDY DESIGN

Cohort study.

METHODS

This study consists of 8599 participants aged ≥ 30 years who were free of cancer (3935 men). Cancer diagnosis was based on pathology reports. Sex-stratified crude incidence rates and age-standardized incidence rates (ASRs) using Segi's method were calculated for all-cancers. Multivariate Poisson regression models were used to evaluate associations of potential risk factors, including sex, age, obesity status (body mass index [BMI]: 25-30 kg/m² as reference), education, smoking status, and diabetes mellitus with the incidence of cancers among the population. Incidence rate ratios (IRRs) with 95% confidence interval (CI) were also reported.

RESULTS

During a median follow-up of 13.9 years, there were 130 and 129 incident cancers for men and women, respectively; the corresponding ASRs were 356.1 and 243.6 per 100,000 person-years, respectively. The three most incident cancers among men were gastrointestinal (GI) (ASR = 127.5), hematopoietic (ASR = 99.5), and reproductive system malignancies (ASR = 46.3). The most common incident cancers in women were breast cancer (ASR = 92.1), GI (ASR = 65.4), and reproductive system malignancies (ASR = 16.8). Among risk factors for cancer incidence, age (IRR [95% CI]: 1.05 [1.03-1.06]) and having a BMI < 25 kg/m² (IRR [95% CI]: 1.38 [1.01-1.90]) had a statistically significant association with incident cancer.

CONCLUSIONS

The high rates of cancers in Tehran during more than a decade of follow-up calls for a need to define risk factors as well as to implement programs for early screening.

Prevalence of Severe Depression in Iranian Women with Breast Cancer: A Meta-Analysis

BACKGROUND

Breast cancer is one of the most common cancers in women and has mental and emotional effects, which lead to a decline in their quality of life. This study is aimed at determining the prevalence of severe depression in Iranian women with breast cancer.

METHODS

This meta-analysis study was conducted at Zabol University of Medical Sciences in 2019. Seven electronic databases were searched and evaluated for original research papers published on the prevalence of severe depression in Iranian women with breast cancer. Finally, 13 articles were selected and analyzed via Comprehensive Meta-Analysis software.

RESULTS

Overall, the prevalence of severe depression in Iranian women with breast cancer was 11% (95% CI (7.2, 16.5)). The highest prevalence was 44% in Tehran City in 2015 (95% CI (31, 57.9)), and the lowest prevalence was 0.8% in Qom City in 2017 (95% CI (0.01, 6.2)). A significant statistical correlation was observed between the prevalence of severe depression and sample size (p < 0.05).

CONCLUSION

According to the results of this study, the prevalence of severe depression affects more than one-tenth of women with breast cancer.

Marked increase in breast cancer incidence in young women: A 10-year study from Northern Iran, 2004-2013

INTRODUCTION

Breast cancer is the most frequent cancer among women worldwide. Breast cancer incidence in young women is a health issue of concern, especially in middle-income countries such as Iran. The aim of this study is to report the breast cancer incidence variations in Golestan province, Iran, over a 10-year period (2004-2013).

METHODS

We analyzed data from the Golestan Population-based Cancer Registry (GPCR), which is a high-quality cancer registry collecting data on primary cancers based on standard protocols throughout the Golestan province. Age-standardized incidence rates (ASRs) and age-specific incidence rates per 100,000 person-years were calculated. Time trends in ASRs and age-specific rates were evaluated using Joinpoint regressions. The average annual percentage change (AAPC) with correspondence 95% confidence intervals (95%CIs) were calculated.

RESULTS

A total of 2106 new breast cancer cases were diagnosed during the study period. Most cases occurred in women living in urban areas: 1449 cases (68%) versus 657 cases (31%) in rural areas. Statistically significant increasing trends were observed over the 10-year study period amongst women of all ages (AAPC = 4.4; 95%CI: 1.2-7.8) as well as amongst women in the age groups 20-29 years (AAPC = 10.0; 95%CI: 1.7-19.0) and 30-39 years (AAPC = 5.1; 95%CI: 1.4-9.0).

CONCLUSION

The incidence of breast cancer increased between 2004 and 2013 in Golestan province amongst all age groups, and in particular amongst women aged 20-39 years. Breast cancer should be considered a high priority for health policy making in our community.

Structural effects of Diamond nanoparticles and Paclitaxel combination on calf thymus DNA

The combination effects of nanodiamonds (NDs) and Paclitaxel (PTX) on the DNA structure were examined. The UV-Visible, steady-state and time-resolved fluorescence spectroscopy, CD, viscosity and zeta potential results showed that PTX + NDs could form a complex via groove binding mechanism. The values of binding constants, ΔG° and ΔH° and ΔS° values showed that PTX + NDs interact strongly with DNA and the hydrophobic force plays main role in this interaction. The ΔG25ο and T_m study indicated the instability of DNA in presence of PTX + NDs. This study demonstrated that NDs could enhance the effect of PTX on DNA structure as well as its affinity and binding to DNA.

Building cancer registries in a lower resource setting: The 10-year experience of Golestan, Northern Iran

INTRODUCTION

The Golestan population-based cancer registry (GPCR) was established in Golestan province, Northern Iran, within the Asian belt with predominance of upper-gastrointestinal cancers. We aimed to present the experiences of the registry in a resource-limited setting over the 10 years since its inception (2004-2013).

METHODS

The GPCR was established as a research project to enable sustainable funding. A clear plan was developed for use of the GPCR data. New primary cancers were registered based on international standards, indices of data quality were routinely assessed and age-standardized incidence rates (ASR) per 100,000 person-years calculated using IARC's CanReg-5 software.

RESULTS

Overall, 19807 new cancer cases were registered during the study period, an average of 1981 cases per annum, with overall ASR of 175.0 and 142.4 in males and females, respectively. The GPCR data suggested gastrointestinal and breast cancers as the most common malignancies in Golestan province. We observed increasing incidence rates of breast and colorectal cancers but declining trends of esophageal cancer. Overall, indices of data quality were within acceptable ranges.

CONCLUSIONS

The GPCR data have been included in IARC's Cancer Incidence in Five Continents series, were used in 21 research projects, and published as 30 research papers. The key ingredients for the successful establishment and maintenance of the GPCR included sustainable sources of funding, a clear action plan for the use of data as well as stakeholder cooperation across all areas of the registration. The GPCR may be considered as a model for planning population-based cancer registries in lesser-resourced settings.

Survival Rates for Breast Cancer in Iranian Patients: a Meta- Analysis

BACKGROUND

Breast cancer is the most common cancer among Iranian women. Since development of the disease in Iranian women occurs relatively early, the survival rate matters considerably. In different countries, survival of breast cancer patients varies considerably. Therefore, the one-year, three-year, five-year, and ten- year survival rates for breast cancer in Iran were assessed using a meta-analysis.

MATERIALS AND METHODS

This systematic review and meta-analysis was based on valid Iranian sources including SID, MAGIRAN and IRANMEDEX, along with reliable English databases, namely, PUBMED and SCOPUS. In domestic databases, a search was conducted based on key words of breast cancer and survival rate, and in international databases, with "breast cancer" and the equivalent of "neoplasm" of Mesh Word, "survival rate" and "Iran. " Then all reviewed papers and theses which met the inclusion criteria were selected for investigation. To conduct the analysis STATA 11.2 software and random-effects models were used.

RESULTS

In 24 studies, 22,745 participants were included. The one-year, three-year, five-year and ten-year survival rates were 0.956, 0.808, 0.695 and 0.559, respectively. The minimum and maximum survival rates for 5-years were 0.48 and 0.87. The average age of the onset of the disease was 48.3.

CONCLUSIONS

As in Iran, since the onset of the disease is at low age, in spite of the relatively high survival rate as compared to other cancers, prevention and screening programs at early age for early stage diagnosis seems necessary.

Breast Cancer Trend in Iran from 2000 to 2009 and Prediction till 2020 using a Trend Analysis Method

BACKGROUND

Breast cancer is the most common cancer in women worldwide with a rising incidence rate in most countries. Considering the increase in life expectancy and change in lifestyle of Iranian women, this study investigated the age-adjusted trend of breast cancer incidence during 2000-2009 and predicted its incidence to 2020.

MATERIALS AND METHODS

The 1997 and 2006 census results were used for the projection of female population by age through the cohort-component method over the studied years. Data from the Iranian cancer registration system were used to calculate the annual incidence rate of breast cancer. The age-adjusted incidence rate was then calculated using the WHO standard population distribution. The five-year-age-specific incidence rates were also obtained for each year and future incidence was determined using the trend analysis method. Annual percentage change (APC) was calculated through the joinpoint regression method.

RESULTS

The bias adjusted incidence rate of breast cancer increased from 16.7 per 100,000 women in 2000 to 33.6 per 100,000 women in 2009. The incidence of breast cancer had a growing trend in almost all age groups above 30 years over the studied years. In this period, the age groups of 45-65 years had the highest incidence. Investigation into the joinpoint curve showed that the curve had a steep slope with an APC of 23.4% before the first joinpoint, but became milder after this. From 2005 to 2009, the APC was calculated as 2.7%, through which the incidence of breast cancer in 2020 was predicted as 63.0 per 100,000 women.

CONCLUSIONS

The age-adjusted incidence rate of breast cancer continues to increas in Iranian women. It is predicted that this trend will continue until 2020. Therefore, it seems necessary to prioritize the prevention, control and care for breast cancer in Iran.

Relation between Mammographic Parenchymal Patterns and Breast Cancer Risk: Considering BMI, Compressed Breast Thickness and Age of Women in Tabriz, Iran

BACKGROUND

Mammographic density determined according paranchymal patterns is a risk factor for breast cancer and its relationships with body and other breast characteristics of women is important. The purpose of the present study was to correlate breast parenchymal patterns and mammography abnormality findings with women's BMI, compressed breast thickness (CBT) and age in Tabriz city, Iran.

MATERIALS AND METHODS

From 1,100 mammograms interpreted by radiologists, breast parenchymal was classified into four categories from Types 1 (mostly fatty) through 4 (mostly fibroglandular tissue). Age, BMI, and CBT were recorded and their relation with risk for the development of breast abnormalities in mammograms was analyzed.

RESULTS

In women with a mean age of 45.8±8.63 years 17.7% were in the high density group (Type 3 and 4). A comparison of four types of breast paranchymal with BMI, CBT and age showed inverse relations to breast density. Abnormal mammographic findings were 25.8% of all reported mammograms with a circular mass (12.7%) as the most common abnormality. About 21% abnormal cases were in less than 40 years. Increasing of BMI had significant relation with breast abnormality but in CBT was not observed.

CONCLUSIONS

Measurement of women's body characteristics is useful for assistance in mammography diagnosis as well as selection of imaging instrument by high sensitivity for following patient in future. The effects of age, CBT and BMI groups on the breast paranchymal were significant.

Epidemiology and trend of cancers in the province of Kerman: southeast of Iran

BACKGROUND

According to increase in elderly populations, and change in lifestyle and cancer-causing behavior, the global burden of cancer is increasing. For prevention and control of disease, knowledge of population statistics of cancers and their trends is essential. This study aimed to investigate the epidemiology and trends of cancer in the province of Kerman: southeast of Iran.

MATERIALS AND METHODS

This analytical and cross-sectional study was carried out based on cancer registry data at the Disease Management Center of the Health Ministry from 2004 to 2009 in the province of Kerman in Iran. Common cancers were defined as the number of reported cases and standardized incidence rates. To compute the annual percentage change (APC), joinpoint 4.1.1.1 software was applied.

RESULTS

Of 10,595 registered cases, 45.3% (4802 cases) were in women and 56.7% (5,793 cases) occurred in men. The standardized incidence rates for both females and males were increasing during the six years studied. The most common cancers in both sexes during six years of studied were skin (13.4%), breast (9.35%), bladder (7.8%), stomach (7.45%), leukemia (7.05%), colorectal(5.57%), lung(4.92%), trachea(3.51%) and prostate(2.48%).

CONCLUSIONS

Our findings revealed that the cancer incidence is demonstrating increasing trends in both sexes in the province of Kerman. This may be because of changes in lifestyle, increasing exposure to risk factors for cancer and increase of life expectancy. If this is the case, increasing public awareness of cancer risk factors is a high priority, together with introduction of large-scale screening techniques.

A diversity of cancer incidence and mortality in West Asian populations

BACKGROUND

Western Asia comprises a large proportion of the world population with different ethnicities and religions inhabiting areas of diverse geographic features. The countries of this region have experienced rapid economic growth over the latter half of the 20th century, which continues to this day, resulting in major changes in lifestyle of the population.

OBJECTIVES

The aim of this study was to compare the incidence and mortality of cancer in West Asia using the estimates reported by the International Agency for Research on Cancer (IARC) in Globocan-2012.

METHODS

Countries with high-quality data or national data (based on the definition of the Globocan-2012) were included in the analysis. These included Bahrain, Iran, Jordan, Kuwait, Lebanon, Oman, Qatar, Saudi Arabia, and Turkey. We also found high-quality cancer data from regional cancer registries in 3 Iranian and 3 Turkish provinces. Data on cancer incidence and mortality were collected and described in tables and graphs. Spearman's correlation test was used to assess the correlation between geographic coordinates and the incidence age-standardized rate (ASR; per 100,000 person-years) of cancers.

FINDINGS

Nine countries and 6 regional registries were included. Cancers of the lung (ASR, 33.3), prostate (24.9), bladder (19.1), stomach (16.5), and colorectal (15.9) were the most common malignancies in men. The most common cancers in women were those of the breast (35.4), colorectal (12.1), thyroid (10.3), stomach (9.2), and lung (6.7). The incidence rates of upper gastrointestinal and lung cancers were considerably higher in the northern part of this region, including Turkey and northern Iran compared with southern countries. High incidences of breast, colorectal, prostate, and bladder cancers were found in countries located in the northwest including Jordan, Lebanon, and Turkey.

CONCLUSIONS

The most common cancers differed by country. Consequently, cancer control programs must be tailored to the most common types of cancers in each country. Lack of high-quality data for some West Asian countries was the major limitation of this study. Therefore, as the first step of cancer control programs, it is recommended that well-structured population-based cancer registries be established in all of these countries.

The Effect of Stress Management Model in Quality of Life in Breast Cancer Women

Background:

Breast cancer associates with severs severe distress and stress. Since Because of that, the stress management program can train necessary skills to cope with stress; therefore, the current study investigates the effectiveness of stress management on enhancement of quality of life.

Objectives:

The aim of the current study is to examine the effectiveness of stress management model in quality of life for breast cancer patients.

Patients and Methods:

This research is a quasi-experimental study with pre and post-tests. The 21 subjects were selected from cancer institute of Imam Khomeini in Tehran in 2014. The participants were allocated to two matched groups based on their pre-test scores. They were assigned randomly to the control and experimental groups. Stress management was conducted with the experimental group during 10 sessions. Then the questionnaire was administered at post-test. Statistical analysis was conducted by using the independent t-test and analysis of variance. The research instrument was the core quality of life questionnaire QLQ-C30.

Results:

The results of the independent t-test showed that there is a significant difference between the pretest and post-test scores in the experimental group (P < 0.05). Also, there is no significant difference between means of quality of life subscales and socio demographic of the patients such as; age, education and disease stage (P < 0.05).

Conclusions:

The results indicate that stress management can change the irrational and distortion thoughts. So, it enhances the quality of life in breast cancer patients.

Risk of cancer with combined oral contraceptive use among Iranian women

Oral contraceptive use is the most common type of contraception. More than 300 million women worldwide take oral contraceptives every day. However, there is a concern about the relationship with the incidence of cancer. This analytical retrospective study aimed to investigate the relationship between the incidence of cervical and breast cancers and oral contraceptive use in 128 Iranian patients with cervical cancer, 235 with breast cancer and equal numbers of controls. Data were collected through interviews with an organized set of questions. Details were also extracted from patient files. Data were analyzed using Student's t-test, chi-square and Fisher's exact tests, and Pearson's correlation analysis. The result revealed correlations between both cervical and breast cancers and history of contraceptive pills use. While cervical cancer significantly correlated with duration of use of pills, breast cancer had significant correlations with the type of oral contraceptive and age at first use. No significant relationships were found between the two types of cancer and age at discontinuation of oral contraceptives, patterns of use, and intervals from the last use. The use of oral contraceptives may triple the incidence of cervical cancer and doubles the incidence of breast cancer. Therefore, performing Pap smears every six months and breast cancer screening are warranted for long-term oral contraceptive users.

Lack of any association of the CTLA-4 +49 G/A polymorphism with breast cancer risk in a North Indian population

Cytotoxic T-lymphocyte antigen 4 (CTLA-4) is an important protein involved in the regulation of the immune system. The +49 G/A polymorphism is the only genetic variation in the CTLA-4 gene that causes an amino acid change in the resulting protein. It is therefore the most extensively studied polymorphism among all CTLA-4 genetic variants and contributions to increasing the likelihood of developing cancer are well known in various populations, especially Asians. However, there have hiterto been no data with respect to the effect of this polymorphism on breast cancer susceptibility in our North Indian population. We therefore assayed genomic DNA of 250 breast cancer subjects and an equal number of age-, sex- and ethnicity-matched healthy controls for the CTLA-4 +49 G/A polymorphism but no significant differences in either the gene or allele frequency were found. Thus the CTLA-4 +49 G/A polymorphism may be associated with breast cancer in other Asians, but it appears to have no such effect in North Indians. The study also highlights the importance of conducting genetic association studies in different ethnic populations.

Trends of breast cancer incidence in Iran during 2004-2008: a Bayesian space-time model

BACKGROUND

Breast cancer is the most frequently diagnosed cancer in women and estimating its relative risks and trends of incidence at the area-level is helpful for health policy makers. However, traditional methods of estimation which do not take spatial heterogeneity into account suffer from drawbacks and their results may be misleading, as the estimated maps of incidence vary dramatically in neighboring areas. Spatial methods have been proposed to overcome drawbacks of traditional methods by including spatial sources of variation in the model to produce smoother maps.

MATERIALS AND METHODS

In this study we analyzed the breast cancer data in Iran during 2004-2008. We used a method proposed to cover spatial and temporal effects simultaneously and their interactions to study trends of breast cancer incidence in Iran.

RESULTS

The results agree with previous studies but provide new information about two main issues regarding the trend of breast cancer in provinces of Iran. First, this model discovered provinces with high relative risks of breast cancer during the 5 years of the study. Second, new information was provided with respect to overall trend trends o. East-Azerbaijan, Golestan, North-Khorasan, and Khorasan-Razavi had the highest increases in rates of breast cancer incidence whilst Tehran, Isfahan, and Yazd had the highest incidence rates during 2004-2008.

CONCLUSIONS

Using spatial methods can provide more accurate and detailed information about the incidence or prevalence of a disease. These models can specify provinces with different health priorities in terms of needs for therapy and drugs or demands for efficient education, screening, and preventive policy into action.

Cancer incidence in southwest of iran: first report from khuzestan population-based cancer registry, 2002-2009

BACKGROUND

Cancer incidence rates are increasing particularly in developing countries. It is crucial for policy makers to know basic cancer epidemiology in each region to design comprehensive prevention plans. There have hitherto been no population-based data available for cancer in Khuzestan province. The present report is a first from the regional population-based cancer registry for the period of 2002-2009.

MATERIALS AND METHODS

Data were collected retrospectively reviewing all new cancer patients whom were registered in Khuzestan province cancer registry during an 8-year period (2002-2009). All cases were coded based on the ICD-O-3 coding system and collected data were computerized using SPSS (Chicago, IL) software, version 11.5. The age standardized incidence rates (ASRs) per 100,000 person-year for all cancers were computed using the indirect method of standardization to the world population.

RESULTS

During the 8-year study period, 16,801 new cancer cases were registered. Based on the computed ASRs, the five most frequent malignancies in females were breast (26.4 per 100,000), skin (13.6), colorectal (5.72), stomach (4.31) and bladder(4.07) and in males, the five most frequent were skin (16.0 per 100,000), bladder (10.7),prostate (7.64), stomach (7.17), and colorectal (6.32).The ASR for all malignancies in women was 92.5 per 100,000, and that for men was 87.4.

CONCLUSIONS

The observed patterns from the analysis of Khuzestan cancer registry data will lead to better understanding of the epidemiology of various malignancies in this part ofthe country and consequently provide a useful guide for authorities to make efficacious decisions and policies about a cancer control program for south-west Iran.

Social disparity in breast and ovarian cancer incidence in iran, 2003-2009: a time trend province-level study

Purpose

This pioneering study aimed to investigate social disparities in breast cancer (BC) and ovarian cancer (OC) incidence rates among women across Iran's provinces from 2003 to 2009.

Methods

Provincial level population distribution data pertaining to women were obtained from the Statistical Centre of Iran. Age-standardized incidence rates of BC and OC were gathered from the National Cancer Registry. Human Development Index was used as the provinces' social rank (SR), and rate ratio and Kunst and Mackenbach relative index of inequality were used to assess social disparities. Annual percentage change (APC) was calculated using joinpoint regression, and Spearman rank correlation was used to examine the association between APC and SR.

Results

It was found that over the study period, annual incidence rates rose by 11.6% and 9.7% for BC and OC, respectively. Social disparities were substantial and stable in favor of provinces with lower SR in Iran, and were more profound for BC than OC. Correlations between APC and SR were small and nonsignificant for both BC and OC.

Conclusion

The results showed that both BC and OC incidence increased in Iran during 2003 to 2009. There were positive associations between BC and OC incidence rates and the provinces' SR. This study's recommendations provide valuable information for health resource allocation pertaining to BC and OC control programs across provinces in Iran.