Association between waterpipe smoking and lung cancer: a multicentre case-control study in Iran.

OBJECTIVES: This study investigated the association between lung cancer and waterpipe smoking, which is an emerging global public health concern. STUDY DESIGN: Multicentre case-control study. METHODS: This study included 627 cases and 3477 controls from the Iranian Study of Opium and Cancer (IROPICAN) study, which was conducted between 2017 and 2020. One frequency-matched control for each lung cancer patient was selected by age, gender and residential place; however, this study used controls of four cancer types in the analyses. The multivariable logistic regression model estimated the odds ratio (OR) and 95% confidence intervals (CIs). Additional analyses were performed among 181 lung cancer cases and 2141 controls who were not cigarette smokers or opium or nass/pipe users. RESULTS: The odds of lung cancer were higher among waterpipe smokers than never-smokers (OR = 1.3, 95% CI: 1.0-1.7). Results showed a higher OR of lung cancer for those who smoked the waterpipe daily (OR = 2.1, 95% CI: 1.4-3.0), smoked more than two heads per day (OR = 2.7, 95% CI: 1.8-4.0), had smoked for >20 years (OR = 1.9, 95% CI: 1.3-2.7), smoked more than 20 head-years (OR = 2.8, 95% CI: 1.9-4.1) and initiated smoking before the age of 30 years (OR = 1.7, 95% CI: 1.1-2.5). The association was only statistically significant for squamous cell carcinomas (OR = 1.8, 95% CI 1.2-2.7). Furthermore, this study observed a higher OR of lung cancer among exclusive waterpipe smokers (OR = 2.3, 95% CI: 1.6, 3.5). CONCLUSIONS: Waterpipe smoking was associated with an increased risk of lung cancer. The association was stronger with higher frequency, duration and intensity of exposure to waterpipe smoking. The association increases in exclusive waterpipe smokers, which is likely due to controlling for residual confounding by cigarette smoking and opium consumption, and higher exposure levels in this subpopulation.

Self-reported versus proxy reported quality of life for breast cancer patients in the Islamic Republic of Iran.

Since quality of life (QoL) is subjective, self-reported QoL is the main source of assessment; however, in some situations the patient cannot evaluate his/her own status. In this cross-sectional study, 148 patients with breast cancer referred to the Cancer Institute of the Islamic Republic of Iran and their caregivers were selected through the consecutive sampling method. Five oncologists from this centre also evaluated the QoL of these patients. The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire was completed by these 3 groups and the results compared. The patient-caregiver intra-class correlation coefficient (ICC) for all 15 QLQ.C30 domains was moderate to good (ICC = 0.41-0.76). Agreements between QoL scores of patients and those of oncologists were moderate to good, except in the 4 domains. In the patient-caregiver comparison there was 55% exact agreement, and for the patient-physician comparison agreement was 45%. The findings can be used in the patients' decision-making process and care planning when patients with breast cancer are unable to self-report the QoL.

Correction: The atypical ubiquitin ligase RNF31 stabilizes estrogen receptor α and modulates estrogen-stimulated breast cancer cell proliferation.

Since the publication of the above article, the authors have noted that the input data in Fig. 6E is incorrect. The correct data are included in the below Fig. 6E. The mistake does not affect the conclusions of the paper as the levels of input proteins remain similar between samples. We apologise for any inconvenience caused by this error.

Metabolic and clinical effects of Ramadan fasting in patients with type II diabetes.

OBJECTIVE: To evaluate the effects of fasting on anthropometric indices and carbohydrate and lipid metabolism in patients with type II diabetes. DESIGN: Observational non-interventional study. PLACE AND DURATION OF STUDY: : Diabetes clinic, Shariati Hospital, Tehran, Iran during Ramadan 1419 (winter 1998-99). PATIENTS AND METHODS: Fifty-seven volunteers with type II diabetes underwent anthropometric and biochemical evaluation before and on the 14th and 28th days of Ramadan. Biochemical markers were measured by standard laboratory methods and anthropometric indices by WHO criteria. Statistical analysis was done by ANOVA for repeated measurements and Friedman's two-way ANOVA using SPSSv6 software. RESULTS: Daily cholesterol intake increased in all subjects (p<0.03). Body mass index increased in women (p<0.03), but BMI and waist-hip ratio both decreased in men (p<0.01). Blood pressure, fasting blood glucose and serum fructosamine did not change during the study. Plasma insulin (p<0.05), C-peptide (p<0.01) and insulin resistance (p<0.01) decreased only in men. Total and LDL cholesterol increased significantly in all subjects during the study. CONCLUSION: Ramadan fasting does not alter carbohydrate metabolism or tissue insulin sensitivity in patients with type II diabetes given appropriate dietary education and rescheduling of oral hypoglycaemic medication. Lipid profile is unfavourably altered due to changes in both diet and biochemical response to starvation.

Esophageal cancer in Iran; a population-based study regarding adequacy of cancer surgery and overall survival.

AIMS: Prognosis of esophageal cancer (EC) is poor. Population-based studies regarding EC survival and adequacy of cancer surgery (ACS) from developing countries are lacking. We aimed to evaluate EC patients' survival and ACS in a population-based setting for the first time from Iran. METHODS: We randomly selected 409 cases from all 3048 newly diagnosed EC patients who were registered in the nationwide cancer registry in calendar year 2005-2006 and followed them until 2009. An expert panel in Cancer Institute of Iran reviewed adequacy of esophageal cancer surgery on a national basis. RESULTS: Overall three-year survival rate was 17%. The median (95% CI) survival time of all patients and cases who underwent surgery alone were 8.5 (6.9-10.1) and 6.0 (3.1-8.9) months, respectively. The hospital mortality was 27.8% among the operated patients. Only 6.8% of cases had documented free circumferential resection margin and merely 4.0% of patients experienced resection of more than 15 lymph nodes during surgery. CONCLUSIONS: In Iran, the overall survival of EC patients with different treatment modalities are slightly less than those reported from high-income countries, but cases with surgery alone as the main treatment had worse outcome compared with their counterparts in developed countries. Surgery with curative intent has not been performed in most cases in Iran. It seems current clinical outcome of EC patients could be improved with surgical quality improvement and/or more use of chemoradiation in Iran.

The atypical ubiquitin ligase RNF31 stabilizes estrogen receptor α and modulates estrogen-stimulated breast cancer cell proliferation.

Estrogen receptor α (ERα) is initially expressed in the majority of breast cancers and promotes estrogen-dependent cancer progression by regulating the transcription of genes linked to cell proliferation. ERα status is of clinical importance, as ERα-positive breast cancers can be successfully treated by adjuvant therapy with antiestrogens or aromatase inhibitors. Complications arise from the frequent development of drug resistance that might be caused by multiple alterations, including components of ERα signaling, during tumor progression and metastasis. Therefore, insights into the molecular mechanisms that control ERα expression and stability are of utmost importance to improve breast cancer diagnostics and therapeutics. Here we report that the atypical E3 ubiquitin ligase RNF31 stabilizes ERα and facilitates ERα-stimulated proliferation in breast cancer cell lines. We show that depletion of RNF31 decreases the number of cells in the S phase and reduces the levels of ERα and its downstream target genes, including cyclin D1 and c-myc. Analysis of data from clinical samples confirms correlation between RNF31 expression and the expression of ERα target genes. Immunoprecipitation indicates that RNF31 associates with ERα and increases its stability and mono-ubiquitination, dependent on the ubiquitin ligase activity of RNF31. Our data suggest that association of RNF31 and ERα occurs mainly in the cytosol, consistent with the lack of RNF31 recruitment to ERα-occupied promoters. In conclusion, our study establishes a non-genomic mechanism by which RNF31 via stabilizing ERα levels controls the transcription of estrogen-dependent genes linked to breast cancer cell proliferation.

Self-reported versus proxy reported quality of life for breast cancer patients in the Islamic Republic of Iran

Since quality of life [QoL] is subjective, self-reported QoL is the main source of assessment; however, in some situations the patient cannot evaluate his/her own status. In this cross-sectional study, 148 patients with breast cancer referred to the Cancer Institute of the Islamic Republic of Iran and their caregivers were selected through the consecutive sampling method. Five oncologists from this centre also evaluated the QoL of these patients. The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire was completed by these 3 groups and the results compared. The patient-caregiver intra-class correlation coefficient [ICC] for all 15 QLQ.C30 domains was moderate to good [ICC = 0.41-0.76]. Agreements between QoL scores of patients and those of oncologists were moderate to good, except in the 4 domains. In the patient-caregiver comparison there was 55% exact agreement, and for the patient-physician comparison agreement was 45%. The findings can be used in the patients' decision-making process and care planning when patients with breast cancer are unable to self-report the QoL

La qualité de vie étant de nature subjective, l'auto-évaluation constitue l'instrument de choix pour la mesure de celle-ci. Pour autant, dans certaines circonstances, le patient n'est pas capable d'évaluer sa situation. Au cours de cette étude transversale, 148 patients adressés à l'Institut du Cancer de République islamique d'Iran pour un cancer du sein ont été sélectionnés avec leurs aidants à l'aide d'une méthode d'échantillonnage consécutif. Cinq oncologues travaillant dans ce centre ont également évalué la qualité de vie de ces patients. Le questionnaire Qualité de vie [QLQ] de l'Organisation européenne pour la Recherche et le Traitement du Cancer a été rempli par ces trois groupes et les résultats ont fait l'objet d'une comparaison. Le coefficient intra-classe [CIC] patient-aidant pour les 15 domaines du QLQ-C30 allait de modéré à bon [CIC= 0,41-0,76]. La concordance entre les scores des patients portant sur la qualité de vie et ceux des oncologues étaient compris entre [ modéré ] et [ bon ], excepté dans quatre domaines. La comparaison patient-aidant donnait une concordance exacte dans 55%, et la comparaison patient-médecin une concordance de 45%. Les résultats peuvent être utilisés au cours du processus de décision clinique et de planification des soins quand les patients atteints d'un cancer du sein ne sont pas en mesure d'évaluer eux-mêmes leur niveau de qualité de vie

Parity and risk of stomach cancer by sub-site: a national Swedish study.

We investigated stomach cancer risk by anatomic sub-site in relation to parity, as a marker for higher exposure to sex hormones, in a case-control study, nested within a cohort of 2,406,439 Swedish women born in 1925 or later and followed from 1970 or age 30 until emigration, death, any cancer diagnosis, or through 2004, whichever occurred first. We identified 286 cardia and 2498 non-cardia stomach cancer cases with five matched controls for each case. Cross-linkage with the Multi-Generation Register provided information about reproductive history. Using conditional logistic regression models for estimating odds ratios (ORs) and corresponding 95% confidence intervals (CIs), adjusted for education level and occupation, we found no association between any aspect of parity and non-cardia stomach cancer (OR=1.01, 95% CI 0.89-1.15, comparing parous with nulliparous women). However, a 30% risk reduction for postmenopausal cardia cancer (OR=0.7, 95% CI 0.4-1.0) was noted among parous relative to nulliparous women and the risk for premenopausal cardia cancer fell with increasing number of children (P for trend=0.04). Our results indicate that exposure to female sex hormones does not protect against non-cardia stomach cancer and does not explain male predominance. The observed moderate inverse relationship between parity and cardia cancer may be mediated by non-hormonal factors and warrants further study.