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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.
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Neoplasias da Mama , Humanos , Feminino , Neoplasias da Mama/epidemiologia , Incidência , Irã (Geográfico)/epidemiologia , Fatores de Risco , Estudos de Coortes , Sistema de RegistrosRESUMO
BACKGROUND: We investigated the effects of factors including age, birth year (cohort) and diagnosis year (period) on colorectal cancer (CRC) incidence trends in Golestan, Northeast of Iran, 2004-2018. METHODS: We obtained data on incidence cases of CRC from the Golestan Population-based Cancer Registry by sex and area of residence (urban/rural). Age-standardized incidence rates (ASRs) were calculated using the World standard population and presented per 100,000 person-years. We calculated the estimated annual percentage change (EAPC) with 95 % confidence intervals (95 % CI) fitted age-period-cohort (APC) models to assess non-linear period and cohort effects as incidence rate ratios (IRRs). RESULTS: Overall, 2839 new cases of CRC (ASR = 13.7) were registered in the GPCR over 2004-2018. Our findings suggested significantly increasing trends in CRC incidence rates from 2004 to 2018 (EAPC = 3.7; 95%CI: 0.4, 7.1), with the greatest changes occurring in rural women (EAPC= 4.7; 95%CI: 0.4, 9.2). We observed a strong cohort effect with a consistent increase in the IRR across successive birth cohorts, starting with the oldest birth cohort (1924) (IRR= 0.1 versus the reference birth cohort of 1955) through to the most recent cohort born in 1983 (IRR= 1.9). The largest cohort effects were found among rural females (IRR = 0.0, and IRR = 2.5 for the oldest and the youngest birth cohorts vs. the reference birth cohort, respectively). CONCLUSION: The increasing trends in CRC rates in Golestan are largely driven by generational changes in exposure to underlying risk factors. Further investigations are warranted to deliver effective prevention strategies for the control of CRC in Golestan.
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Neoplasias Colorretais , Humanos , Feminino , Adulto , Incidência , Irã (Geográfico)/epidemiologia , Sistema de Registros , Estudos de Coortes , Neoplasias Colorretais/epidemiologiaRESUMO
Golestan province in the northeast of Iran is part of the Asian esophageal cancer belt and is known as a high-risk area for esophageal (EC) and gastric cancers (GC). Data on incident cases of EC and GC during 2004 to 2018 were obtained from the Golestan Population-based Cancer Registry (GPCR). The age-standardized incidence rates (ASRs) were calculated and presented per 100 000 person-years. The estimated annual percentage change (EAPC) with 95% confidence interval (95% CI) were calculated. We also fitted age-period-cohort (APC) models to assess nonlinear period and cohort effects as incidence rate ratios (IRRs). Overall, 3004 new cases of EC (ASR = 15.7) and 3553 cases of GC (ASR = 18.3) were registered in the GPCR. We found significant decreasing trends in incidence rates of EC (EAPC = -5.0; 95% CI: -7.8 to -2.2) and less marked nonsignificant trends for GC (EAPC = -1.4; 95% CI: -4.0 to 1.4) during 2004 to 2018. There was a strong cohort effect for EC with a consistent decrease in the IRR across successive birth cohorts, starting with the oldest birth cohort (1924; IRR = 1.9 vs the reference birth cohort of 1947) through to the most recent cohort born in 1988 (IRR = 0.1). The marked declines in EC incidence rates in Golestan relate to generational changes in its underlying risk factors. Despite favorable trends, this population remains at high risk of both EC and GC. Further studies are warranted to measure the impact of the major risk factors on incidence with a view to designing effective preventative programs.
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Neoplasias Esofágicas , Neoplasias Gástricas , Humanos , Adulto , Incidência , Neoplasias Gástricas/epidemiologia , Neoplasias Esofágicas/epidemiologia , Irã (Geográfico)/epidemiologia , Sistema de Registros , Estudos de CoortesRESUMO
BACKGROUND: Epidemiological research on the high-risk population might be helpful in early detection and prevention of biliary tract malignancies. This study assesses the prevalence of biliary tract cancer (BTC) in the Golestan province, northeastern Iran, between 2004 and 2016. METHODS: The current study used information from the Golestan Population-based Cancer Registry (GPCR) to access the epidemiology of BTC across a 13-year period while taking into account temporal and geographic differences. The number of cases, crude rates, age-standardized incidence rates (ASRs) per 100,000 person-years, average annual percent change (AAPC), age-specific incidence rates, and 95% confidence intervals (CI) were reported for each year with respect to gender and place of residence. RESULTS: Totally, 224 instances of BTC overall (54% of whom were females) were reported throughout the research period. The ASR of BTC was 1.7 (95% CI: 1.4â2) for females and 1.4 (95% CI: 1.1â1.6) for men, respectively. Males exhibited a growing time trend in incidence (AAPC: 7.18; CI: 0.06â14.81; P-value:0.048), whereas females had a decreasing trend (AAPC: 0.82; CI: -5.94â4.57; P-value: 0.740). Both sexes saw an increase in age-specific incidence rates starting at the age of 45; however, males experienced a significant increase in incidence in the age group of 75 to 79 while the female rates grew steadily. CONCLUSION: The focus for cancer control in this region may be given to demographic groups with a combination of risk factors, including male gender, older age, and urban residence.
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Neoplasias , Humanos , Masculino , Feminino , Idoso , Irã (Geográfico)/epidemiologia , Sistema de Registros , Neoplasias/epidemiologia , Incidência , Fatores de RiscoRESUMO
BACKGROUND: Due to the high transmission rate of SARS-CoV-2, diagnostic tests have become tools for identifying patients. The key points were the virus genomes survey to design RT-LAMP primers; comparing the sensitivity and specificity of RT-LAMP and RT-qPCR; and determining the relationship among clinical symptoms, CT scan, RT-qPCR, and RT-LAMP results. METHODS: This cohort study included 444 symptomatic patients. The specificity and sensitivity of RT-LAMP were assayed. The five statistical models, simultaneously, by RapidMiner to find the best method for detecting the virus were done through the correlation between the clinical symptoms, RT-LAMP, RT-qPCR, and CT scan results. The chi-square test by SPSS 26.0 was used to calculate kappa agreement. RESULTS: The virus genome was detected in all the positive samples (198) by RT-qPCR and RT-LAMP. In addition, 246 samples were negative by RT-qPCR, while 88 were positive by RT-LAMP. Data mining analysis indicated that there were most associations between the RT-LAMP and CT scan data compared to RT-qPCR and CT scan data. CONCLUSIONS: RT-LAMP could detect SARS-CoV-2 with great simplicity, speed, and cheapness. Therefore, it is logical to screen, a large number of patients by RT-LAMP, and then RT-qPCR can be used on the limited samples.
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BACKGROUND: Golestan Population-based Cancer Registry (GPCR) with more than 15-years experiences developed an in-house online software called Cancer Data Collection and Processing (CanDCap) to improve its data collection operations from the conventional offline method to new online method. We aimed to report the methods and framework that GPCR applied to design and implementation of the CanDCap. METHODS: CanDCap was designed based on International Agency for Research on Cancer (IARC) protocols and standards and according to the GPCR workflow. CanDCap has two parts including a web-based online part for data collection and a windows-based part for data processing consisting of quality control and deduplication of repeated records. Questionnaire for User Interface Satisfaction (QUIS) was used in order to assess user interaction satisfaction. RESULTS: CanDCap was implemented in 2018 and could improve the quality of the GPCR data during its first three years of activity (2018-2020), during which about 9,000 records were registered. The coverage for optional items including national ID, father name, address and telephone number were improved from 23 %, 32 %, 83 % and 82 % in conventional offline method (2015-2017) to 83 %, 81 %, 87 %, and 90 % after using the CanDCap (2018-2020), respectively. The timeliness was also improved from 4 years to 2 years. Overall, user interaction satisfaction was acceptable (7.8 out of 9). CONCLUSION: CanDCap could resulted in improvement in data quality and timeliness of the GPCR as a cancer registry unit with limited resources. It has the potential to be considered as a model for population-based cancer registries in lower-resource settings.
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Neoplasias , Confiabilidade dos Dados , Coleta de Dados , Humanos , Irã (Geográfico)/epidemiologia , Neoplasias/epidemiologia , Sistema de Registros , Inquéritos e QuestionáriosRESUMO
Natural killer (NK) cells are innate lymphocytes that can kill tumor cells via different pathways, including the secretion of cytotoxic granules in immunological synapses and the binding of apoptosis-inducing ligands with cognate death receptors on tumor cells. These ligands are also soluble in NK cells conditioned medium (NK-CM). However, novel preclinical in vitro models are required for solid tumors such as colorectal cancer (CRC) to investigate apoptosis induction of activated NK-CM in a tissue-like structure. In the present study, we established a patient-derived CRC organoid culture system as a new tool for CRC research in the last decade. Tumor organoids were stained with hematoxylin and eosin (H&E) and compared with the original tumor taken from the patient. Goblet cell differentiation and mucus secretion were evaluated using periodic acid-Schiff and alcian blue histochemical staining. Moreover, tumor organoids were stained for CDX2 and Ki67 markers with immunohistochemistry (IHC) to investigate gastrointestinal origin and proliferation. Histopathological evaluations indicated tumor organoids represent patient tumor characteristics. Primary NK cells were isolated and characterized using CD56 marker expression and the lack of the CD3 marker. Flow cytometry results showed the purity of isolated CD3-and CD56 + NK cells about 93%. After further ex vivo expansion, IL-2-activated NK-CM was collected. Secretions of IFN-γ and TNF-α were measured to characterize activated NK-CM. Cytokines levels were significantly elevated in comparison to the control group. Soluble forms of apoptosis-inducing ligands, including TNF-related apoptosis-inducing ligand (TRAIL) and FasL, were detected by western blot assay. Colon cancer organoids were treated by IL-2-activated NK-CM. Apoptosis was assessed by Annexin V-FITC/PI staining and quantified by flow cytometry. In conclusion, despite the activated NK-CM containing apoptosis-inducing ligands, these ligands' soluble forms failed to induce apoptosis in patient-derived colon cancer organoids. Nevertheless, we report a reliable in vitro assessment platform in a personalized setting.
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Background: Considering the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) pandemic, which causes coronavirus disease 2019 (COVID-19), we aimed to report the clinical features of 427 patients with COVID-19 and the outcomes after one-month admission to major teaching hospitals in the northeast of Iran. Materials and Methods: Data of patients hospitalized with COVID-19 from 20 February 2020 to 20 April 2020 was analyzed using the R software. The cases and their outcomes were monitored up to one month following their admission. Results: Among 427 patients with a median age of 53 years (50.8% male), 81 (19%) were directly admitted to the ICU ward, and 68 (16%) died during the study. The mean (SD) lengths of hospital stay were significantly higher in the non-survivors (6 (9) days) than survivors (4 (5) days) (P = 0.018). Ventilation need was reported in 67.6% of the non-survivors and 0.8% of the survivors (P < 0.001). Cough (72.8%), fever (69.3%), and dyspnea (64.0%) were the most common symptoms. There were more comorbidities in the severe cases (73.5%) and non-survivor (77.5%). Liver and kidney damage were significantly more common in non-survivors. Ninety percent of the patients had at least one abnormal chest CT scan finding, including crazy paving and consolidation patterns (27.1%), followed by the ground-glass opacity (24.7%). Conclusion: Results showed that the patients' age, underlying comorbidities, levels of SpO2, and laboratory findings at the time of admission may predict the progress of the disease and can be considered mortality-related factors.
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BACKGROUND: We aimed to further clarify the epidemiological and clinical characteristics of 2019-nCoV pneumonia and risk factors associated for mortality. METHODS: In this study, we included inpatient with acute respiratory distress syndrome at Golestan Hospitals who had been discharged or had died in 2020. Epidemiological, and clinical data were extracted from electronic medical records and compared between recovered and died cases. We used multiple logistic regression methods to explore the risk factors associated with in-hospital death. RESULTS: Overall 2,835 acute respiratory distress syndrome patients were included in this study, and 874 (30.83%) were positive for 2019-nCoV. Five hundred and sixty-three patients (19.86%) died, 1,687 patients (59.51%) were recovered. Of the total deaths, only 288 (10.15%) were attributed to COVID-19. The most common symptoms at onset of illness were respiratory distress [1,795 (63.32%)], fever [1,601 (56.47%)], dry cough [1,595 (56.26%)], sore throat [445 (15.70%)], and myalgia [342 (12.06%)]. One thousand and twelve (35.7%) had 1 or more coexisting medical conditions. In multiple logistic regression analysis, risk factors associated with the death included older age [OR (Odds Ratio) = 1.03; 95% CI; 1.02-1.04], blood oxygen level (SPO2 < 93%) (OR = 2.44; 95% CI; 1.79-3.31), comorbidities (OR = 2.15; 95% CI; 1.62-2.84), respiratory distress (OR = 1.74; 95% CI; 1.28-2.37), and headache (OR = 0.44 95% CI; 0.21-0.92). CONCLUSIONS: The 2019-nCoV infection caused collections of severe respiratory illness and was associated to a high ratio of hospitalization in ICU and high mortality. Older age and comorbidities were associated with more risk of death among patients with 2019-nCoV.
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COVID-19/epidemiologia , Hospitalização/estatística & dados numéricos , Pandemias , Síndrome do Desconforto Respiratório/complicações , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Comorbidade , Feminino , Mortalidade Hospitalar , Humanos , Irã (Geográfico)/epidemiologia , Masculino , Pessoa de Meia-Idade , Síndrome do Desconforto Respiratório/mortalidade , Síndrome do Desconforto Respiratório/virologia , Estudos Retrospectivos , Fatores de Risco , SARS-CoV-2 , Fatores SexuaisRESUMO
BACKGROUND: Cancer-related causes of death (cancer CoD) are the main etiologies of death in cancer patients. Recent increase in survival rates of cancer patients resulted in higher risk of dying from causes other than cancer, called competing causes of death (competing CoD). We aim to characterize competing CoD among cancer patients in Golestan province, Northern Iran. METHODS: Data on cancer incidence was obtained from the Golestan population-based cancer registry (GPCR) dataset. Data on causes of death was obtained from the Golestan death registry (GDR) dataset. Using a linkage method between the GPCR and GDR dataset, we prepared the study dataset including data on vital status and causes of death in our cancer patients. The proportions of cancer CoD and competing CoD were calculated. Multivariate logistic regression analysis was considered to assess the relationship between competing CoD and other variables. RESULTS: Overall, 4,184 cancer patients died in the study population, including 2,488 men (59.9%). Cause of death in 3,455 cases was cancer and 729 cases (17.4%) died due to competing CoD. Ischemic heart disease (40.7%) was the most common competing CoD in our population. Higher survival rate was the strongest variable related to the competing CoD (adjusted OR=1.91; 95%CI: 1.61-2.26). Residence area, age group and year of death were other indicators of competing CoD in our population. CONCLUSION: Our results suggest high rates of competing CoD in our cancer patients. Competing CoD should be mentioned in cancer control planning both in clinical practice as well as in public health policy making.
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Causas de Morte , Neoplasias/mortalidade , Idoso , Estudos Transversais , Feminino , Humanos , Incidência , Irã (Geográfico)/epidemiologia , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Isquemia Miocárdica/mortalidade , Neoplasias/epidemiologia , Sistema de Registros/estatística & dados numéricos , Risco , População Rural/estatística & dados numéricos , Taxa de Sobrevida , Fatores de Tempo , População Urbana/estatística & dados numéricosRESUMO
Esophageal squamous cell carcinoma (ESCC) shows remarkable variation in incidence that is not fully explained by known lifestyle and environmental risk factors. It has been speculated that an unknown exogenous exposure(s) could be responsible. Here we combine the fields of mutational signature analysis with cancer epidemiology to study 552 ESCC genomes from eight countries with varying incidence rates. Mutational profiles were similar across all countries studied. Associations between specific mutational signatures and ESCC risk factors were identified for tobacco, alcohol, opium and germline variants, with modest impacts on mutation burden. We find no evidence of a mutational signature indicative of an exogenous exposure capable of explaining differences in ESCC incidence. Apolipoprotein B mRNA-editing enzyme, catalytic polypeptide-like (APOBEC)-associated mutational signatures single-base substitution (SBS)2 and SBS13 were present in 88% and 91% of cases, respectively, and accounted for 25% of the mutation burden on average, indicating that APOBEC activation is a crucial step in ESCC tumor development.
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Neoplasias Esofágicas/epidemiologia , Neoplasias Esofágicas/genética , Carcinoma de Células Escamosas do Esôfago/epidemiologia , Carcinoma de Células Escamosas do Esôfago/genética , Mutação , Desaminases APOBEC/genética , Adulto , Idoso , Idoso de 80 Anos ou mais , Aldeído-Desidrogenase Mitocondrial/genética , Brasil/epidemiologia , China/epidemiologia , Feminino , Humanos , Incidência , Irã (Geográfico)/epidemiologia , Masculino , Pessoa de Meia-Idade , Proteína Supressora de Tumor p53/genética , Reino Unido/epidemiologia , Sequenciamento Completo do GenomaRESUMO
BACKGROUND: We aim to present the development and the initial results of the Golestan Cancer Biobank (GoCB), in a low resource setting in northern Iran. METHODS: The GoCB protocol and its standard operation procedures (SOP) were developed according to internationally accepted standards and protocols with some modifications considering the limited resources in our setting. The main biological samples collected by the GoCB include blood sample, urine sample, fresh endoscopy tissue sample, fresh surgical tissue sample and formalin fixed paraffin embedded (FFPE) tissue sample. The GoCB collects patients' demographic data, tumor characteristics as well as data on risk factors. We developed a specific GoCB software for management of patient data and biological sample information. The GoCB dataset is annually linked with the Golestan cancer registry dataset to add complementary data (e.g., survival data). RESULTS: The GoCB started collection of data and biological samples in December 2016. By November 2020, a total number of 1217 cancer patients participated in the GoCB. The majority of the GoCB participants (n = 942, 77%) were those with gastrointestinal and breast cancers. Data on risk factors were successfully collected in 684 (56.2%) of the participants. Overall, 3563 samples were collected from the GoCB participants and 730 samples were used in 7 national and international research projects. CONCLUSION: We considered specific strategies to overcome major limitations, especially budget shortage, in the development and maintenance of a cancer-specific biological repositories in our setting. The GoCB may be considered as a model for the development of biobank in low- and middle-income countries (LMICs).
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Bancos de Espécimes Biológicos , Neoplasias da Mama , Feminino , Humanos , Irã (Geográfico)/epidemiologia , Sistema de Registros , Fatores de RiscoRESUMO
BACKGROUND: Iran is among countries with high opioid agonist therapy (OAT) coverage in prisons, which provides an infrastructure to increase feasibility of HCV programs. We aimed to evaluate the impact of an intervention to improve HCV screening, diagnosis, and treatment, including alongside the provision of OAT, in an Iranian prison. METHODS: During July-December 2018, in the Gorgan prison, all incarcerated adults (>18 years) received HCV antibody rapid testing and, if positive, provided a venepuncture sample for HCV RNA testing. Participants with positive RNA received direct-acting antiviral (DAA) therapy [(Sofosbuvir/Daclatasvir) for 24 or 12 weeks, respectively, for those with and without cirrhosis]. Response to treatment was measured by the sustained virological response at 12 weeks post-treatment (SVR12). RESULTS: Among 2015 incarcerated people with a median age of 35 years (IQR:29-41), the majority were male (97%), had not finished high school (68%), and had a history of drug use (71%), of whom 15% had ever injected drugs. A third of participants were receiving OAT, including 54% of those who had ever injected. HCV antibody prevalence was 6.7%, and RNA was detected in 4.6% of all participants; this prevalence was 32.6% and 24.7% among those with a history of injection, respectively. Treatment uptake was 82% (75/92) and was similar among people on OAT and those with a history of injection (81%). The majority completed treatment in prison and were available for SVR12 assessment (71%, 53/75). Achieved SVR12 was 100% (53/53) based on the available case analysis; those who did not have available SVR12 were released either prior to treatment initiation or completion (n = 39). CONCLUSION: The availability of OAT infrastructure should be considered as an opportunity for enhancing HCV care in prisons. Where resources are limited, the prison harm reduction network could be used to design targeted HCV programs among people who are at higher risk of infection.
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Hepatite C Crônica , Hepatite C , Abuso de Substâncias por Via Intravenosa , Adulto , Antivirais/uso terapêutico , Feminino , Hepacivirus/genética , Hepatite C/diagnóstico , Hepatite C/tratamento farmacológico , Hepatite C/epidemiologia , Hepatite C Crônica/tratamento farmacológico , Humanos , Irã (Geográfico)/epidemiologia , Masculino , Abuso de Substâncias por Via Intravenosa/tratamento farmacológicoRESUMO
BACKGROUND: Thyroid cancer is the most common type of endocrine cancer. We aimed to determine the incidence rates of thyroid cancer across a 10-year period (2004-2013) in Golestan, Iran. METHODS: We obtained the thyroid cancer data from Golestan Population-Based Cancer Registry (GPCR). Age-standardized incidence rates (ASR) were calculated and reported per 100000 person-years. The Joinpoint software was used to assess time trends, and average annual percent changes (AAPCs) and their corresponding 95% confidence intervals (CIs) were reported. RESULTS: Of 326 registered patients, 83 (25.5%) were men and 243 (74.5%) were women. The mean age was 51.3 and 42.6 years for males and females, respectively. Overall, the ASR of thyroid cancer was 2.2 per 100000 person-year (AAPC = 2.76; 95% CI: -3.68 to 9.64). The test of co-incidence showed a statistically significant difference in the incidence of thyroid cancer between men (1.3) and women (3.2) (P < 0.001). According to our results, the ASR of thyroid cancer in western parts of Golestan is higher, including Gorgan and Aliabad cities. CONCLUSION: Increasing trends in incidence rates of thyroid cancer were found in the Golestan province during the study period, especially in women. We found significantly higher rates of thyroid cancer in women. Geographical diversities were seen in incidence rates of thyroid cancer in the Golestan province. Our results may be helpful for designing further researches to investigate the epidemiological aspects of thyroid cancer in the Golestan province.
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Neoplasias da Glândula Tireoide/epidemiologia , Adulto , Idoso , Feminino , Humanos , Incidência , Irã (Geográfico)/epidemiologia , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Sistema de Registros , População Rural/estatística & dados numéricos , Distribuição por Sexo , Análise EspacialRESUMO
PURPOSE: Long non-coding RNAs (LncRNAs) are thought as tumorigenic factors in cancer progression. We investigated the clinical significance of arylsulfatase D (ARSD) and ARSD antisense in breast cancer patients. METHODS: Eighty breast cancer tumors were obtained from the Tumor Bank of Cancer Institute, Imam Khomeini Hospital. The expression level of ARSD and ARSD-AS1 were examined in breast tumors in comparison to the margin of normal tissues using quantitative real-time PCR. Demographic information and the clinicopathologic characteristics including tumor grade, presence of cell receptors, lymph node and vascular invasion were also evaluated. Bioinformatics databases were used for identification of ARSD and ARSD-AS1 molecular targets and their association with cancer. RESULTS: Significant up-regulation of ARSD was observed in tumor tissues in comparison with its antisense (p<0.05). Both ARSD and ARSD-AS1 expression in tumor specimens were notably lower than those in adjacent normal tissue. High expression of ARSD was associated to lower tumor grade (p<0.05). Bioinformatics results revealed the interaction of ARSD with STS and SUMF1 proteins was attributed to the inhibiting of sulfates activity. Also, ARSD co-expressed genes were associated with oncogenic transcription factors, MAF and GATA. TP53 transcription factor site was identified as a target of ARSD-AS1 mRNA. The interaction of this antisense with microRNA (miR-618) could explain its participation in tumor cell proliferation. CONCLUSION: Low expression of ARSD was associated with higher tumor grade. The evidence from this study enhance our understanding of ARSD and ARSD-AS1 function in cancer gene therapy. Accordingly, they could be introduced as great potential targets for breast cancer treatment.
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Arilsulfatases/genética , Neoplasias da Mama/tratamento farmacológico , Neoplasias da Mama/genética , RNA Antissenso/genética , RNA Longo não Codificante/genética , Arilsulfatases/biossíntese , Arilsulfatases/metabolismo , Linhagem Celular Tumoral , Feminino , Humanos , Pessoa de Meia-Idade , Oncogenes , RNA Antissenso/biossíntese , RNA Antissenso/metabolismo , RNA Longo não Codificante/biossíntese , RNA Longo não Codificante/metabolismo , Transcrição GênicaRESUMO
BACKGROUND: Hepatitis C virus (HCV) is among the highest priority diseases in custodial settings; however, the diagnosis remains suboptimal among people in custody. This study aimed to validate a short survey for identifying people with HCV infection in a provincial prison in Iran. METHODS: Between July and December 2018, residents and newly admitted inmates of Gorgan central prison completed a questionnaire, including data on the history of HCV testing, drug use, injecting drug use, sharing injecting equipment, and imprisonment. Participants received rapid HCV antibody testing, followed by venipuncture for RNA testing (antibody-positive only). Each enrollment question (yes/no) was compared with the testing results (positive/negative). RESULTS: Overall, 1892 people completed the questionnaire, including 621 (34%) who were currently on opioid agonist therapy (OAT); 30% of participants had been tested for HCV previously. About 71% had a history of drug use, of whom 13% had ever injected drugs; 52% had ever shared injecting equipment. The prevalence of HCV antibody and RNA was 6.9% (n = 130) and 4.8% (n = 90), respectively. The antibody prevalence was higher among people on OAT compared to those with no history of OAT (11.4% vs. 4.0%). History of drug use was the most accurate predictor of having a positive HCV antibody (sensitivity: 95.2%, negative predictive value: 98.9%) and RNA testing (sensitivity: 96.7%, negative predictive value: 99.5%). The sensitivity of the drug use question was lowest among people with no OAT history and new inmates (87% and 89%, respectively). Among all participants, sensitivity and negative predictive value of the other questions were low and ranged from 34 to 54% and 94 to 97%, respectively. CONCLUSIONS: In resource-limited settings, HCV screening based on having a history of drug use could replace universal screening in prisons to reduce costs. Developing tailored screening strategies together with further cost studies are crucial to address the current HCV epidemic in low- to middle-income countries.
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Usuários de Drogas/estatística & dados numéricos , Hepatite C/complicações , Hepatite C/diagnóstico , Pobreza , Prisioneiros/estatística & dados numéricos , Abuso de Substâncias por Via Intravenosa/complicações , Adulto , Feminino , Humanos , Irã (Geográfico) , Masculino , Fatores de Risco , Inquéritos e QuestionáriosRESUMO
BACKGROUND We assessed dietary intakes in the high- and low-risk areas for esophageal cancer (EC) in Golestan province, Northern Iran. METHODS Considering the EC rates, Golestan province was divided into high- and low-risk regions. Data on households' food consumption were obtained from the Statistical Center of Iran. We used multivariable logistic regression to assess the relationships between consumption of main food and EC risk. Adjusted odds ratios (aOR) were calculated. Joint point program was used for time trend analysis and average annual percent changes (AAPC) were reported. RESULTS Overall, 11910 households were recruited during 2006-2015. 4710 (39.5%) households were enrolled from the high-risk region. There were significant positive relationships between high consumption of sweets (aOR = 1.62; 95% CI: 1.24-2.10), oil/fat (aOR = 1.36; 95% CI: 1.04-1.79), and red meat (aOR = 1.33; 95% CI: 1.07-1.65) with EC risk. We found significant negative relationships between high consumption of dairy products (aOR = 0.62; 95% CI: 0.46-0.82), vegetables (aOR = 0.66; 95% CI: 0.50-0.87) and fruit (aOR = 0.72; 95% CI: 0.55-0.95) with the risk of EC. Time trend analysis showed a significant increasing trend in the proportions of households with low consumption of vegetables (AAPC = 4.71, p = 0.01) and dairy products (AAPC = 5.26, p = 0.02) in the low-risk region for EC. CONCLUSION Dietary intakes may be important etiological factors for EC in Northern Iran. Further studies are warranted to assess the role of dietary factors in this high-risk population.
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BACKGROUND: Three billion people burn nonclean fuels for household purposes. Limited evidence suggests a link between household fuel use and gastrointestinal (GI) cancers. OBJECTIVES: We investigated the relationship between indoor burning of biomass, kerosene, and natural gas with the subsequent risk of GI cancers. METHODS: During the period 2004-2008, a total of 50,045 Iranian individuals 40-75 years of age were recruited to this prospective population-based cohort. Upon enrollment, validated data were collected on demographics, lifestyle, and exposures, including detailed data on lifetime household use of different fuels and stoves. The participants were followed through August 2018 with <1% loss. RESULTS: During the follow-up, 962 participants developed GI cancers. In comparison with using predominantly gas in the recent 20-y period, using predominantly biomass was associated with higher risks of esophageal [hazard ratio (HR): 1.89; 95% confidence interval (CI): 1.02, 3.50], and gastric HR: 1.83; 95% CI: 1.01, 3.31) cancers, whereas using predominantly kerosene was associated with higher risk of esophageal cancer (HR: 1.84; 95% CI: 1.10, 3.10). Lifetime duration of biomass burning for both cooking and house heating (exclusive biomass usage) using heating-stoves without chimney was associated with higher risk of GI cancers combined (10-y HR: 1.14; 95% CI: 1.07, 1.21), esophageal (10-y HR: 1.19; 95% CI: 1.08, 1.30), gastric (10-y HR: 1.11; 95% CI: 1.00, 1.23), and colon (10-y HR: 1.26; 95% CI: 1.03, 1.54) cancers. The risks of GI cancers combined, esophageal cancer, and gastric cancer were lower when biomass was burned using chimney-equipped heating-stoves (strata difference p-values=0.001, 0.003, and 0.094, respectively). Duration of exclusive kerosene burning using heating-stoves without chimney was associated with higher risk of GI cancers combined (10-y HR: 1.05; 95% CI: 1.00, 1.11), and esophageal cancer (10-y HR: 1.14; 95% CI: 1.04, 1.26). DISCUSSION: Household burning of biomass or kerosene, especially without a chimney, was associated with higher risk of some digestive cancers. Using chimney-equipped stoves and replacing these fuels with natural gas may be useful interventions to reduce the burden of GI cancers worldwide. https://doi.org/10.1289/EHP5907.
Assuntos
Culinária , Exposição Ambiental/estatística & dados numéricos , Características da Família , Neoplasias Gastrointestinais/epidemiologia , Utensílios Domésticos , Adulto , Idoso , Poluição do Ar em Ambientes Fechados/estatística & dados numéricos , Biomassa , Estudos de Coortes , Feminino , Calefação , Humanos , Irã (Geográfico)/epidemiologia , Querosene , Masculino , Pessoa de Meia-Idade , Gás Natural , Estudos Prospectivos , Fatores de Risco , MadeiraRESUMO
BACKGROUND: We aimed to present the temporal and geographical trends in the incidence of stomach cancer in the Golestan province, a high-risk area in Northern Iran. METHODS: This study was conducted on stomach cancer cases registered in the Golestan Population-based Cancer Registry (GPCR) during 2004-2016. Age-standardized incidence rates (ASRs) per 100000 person-years were calculated. The Joinpoint regression analysis was used to calculate the average annual percent changes (AAPC). We also calculated the contribution of population aging, population size and risk to the overall changes in incidence rates. RESULTS: Overall, 2964 stomach cancer patients were registered. The ASR of stomach cancer was significantly higher in men (26.9) than women (12.2) (P<0.01). There was a significant decreasing trend in incidence of stomach cancer in men (AAPC=-1.80, 95% CI: -3.30 to-0.28; P=0.02). We found a higher ASR of stomach cancer in the rural (21.4) than urban (18.1) (P=0.04) population, as well as a significant decreasing trend in its rates (AAPC=-2.14, 95% CI: -3.10to-1.17; P<0.01). The number of new cases of stomach cancer increased by 22.33% (from 215 in 2004 to 263 in 2016), of which 18.1%, 25.1% and -20.9% were due to population size, population aging and risk, respectively. Our findings suggest a higher rate for stomach cancer in eastern areas. CONCLUSION: We found high incidence rates as well as temporal and geographical diversities in ASR of stomach cancer in Golestan, Iran. Our results showed an increase in the number of new cases, mainly due to population size and aging. Further studies are warranted to determine the risk factors of this cancer in this high-risk population.
Assuntos
Neoplasias Gástricas/epidemiologia , Adolescente , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Feminino , Humanos , Incidência , Lactente , Recém-Nascido , Irã (Geográfico)/epidemiologia , Masculino , Pessoa de Meia-Idade , Sistema de Registros , Fatores de Risco , População Rural , Distribuição por Sexo , População Urbana , Adulto JovemRESUMO
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.