Return to Work in Cancer Patients: A Systematic Review and Meta-analysis.

CONTEXT: Diseases and accidents bring about the disorder at someone's job insofar as one is not able to return to her/his previous work. These cases are related to the amount of occurred accidents, type of disease, and one's job. AIM: The aim of this study was to evaluate the factors that affect return to work (RTW) in cancer survivors using a systematic review and meta-analysis design. METHODS: This is a systematic review and meta-analysis study. We searched the PubMed, Scopus, SID, Google, Elsevier, Google Scholar and Web of Science databases using following keywords: Return to work, cancer patients, employment status, cancer survivors from 2002 to 2017. The rate of return to work in cancer patients based on age group and risk factors was calculated using subgroup analysis. Data were analyzed using STATA software (version 11.1). RESULTS: The total sample size was 4675 people with a mean of 668 in each study. The frequency of studies in the world consists mainly of five studies (71.5%) from Europe continent (the Netherlands and Denmark) and two studies (28.5%) from Asia continent (Iran and Japan). The overall rate of RTW estimated at 72% (68%-77%). The percentage of RTW in Asia and Europe was 57% (50%-65%) and 52% (43%-60%), respectively. Surgery had the highest percentage of treatment options in patients with cancer with 46% (25%-68%), followed by radiotherapy and chemotherapy with 37% (29%-46%) and 36% (23%-49%), respectively. Breast cancer and gastrointestinal cancer were the most and less common type of cancers with 36% (19%-54%) and 16% (7%-26%), respectively. CONCLUSION: The overall rate of RTW estimated at 57%. Nonetheless, the faster diagnosis and regular screening could improve the survival rate of cancer patients and the increase of RTW.

The relationship between smoking and dysmenorrhea: A meta-analysis.

Many studies have investigated the potential association between smoking and dysmenorrhea. However, results from such studies have been inconsistent. In this study, we assessed the association between smoking and dysmenorrhea by meta-analysis. We performed a systematic search of the international databases, including PubMed, Scopus, Web of Science, EBSCO and Google Scholar by the MeSH heading and/or additional terms to obtain relevant studies published from 1990 until 2017. I2 statistics were used to assess heterogeneity. Pooled effects size was obtained using a random effects model. Subgroup analyses were also conducted. Data were analyzed through Stata software version 12 (Stata Corp, College Station, TX, USA). A total of fourteen studies were included in meta-analysis. A significant positive association was observed between current smoking and dysmenorrhea in both the unadjusted (odds ratio [OR] = 1.60; 95 percent confidence interval [CI]: 1.35, 1.85) and adjusted models (AOR = 1.44; 95 percent CI: 1.18, 1.69). Also, the association between current smoking and primary dysmenorrhea was significant only in the unadjusted model (OR = 1.53; 95 percent CI: 1.21, 1.85). The pooled effects size showed a significant association between smoking and dysmenorrhea in the fourteen eligible studies. This provides a new approach for prevention from dysmenorrhea in females for policymakers.

Effect of prenatal smoking cessation interventions on birth weight: meta-analysis.

BACKGROUND: Smoking is preventable factor for pregnancy outcomes such as low birth weight (LBW). In this study, we assessed the effects of smoking cessation in pregnancy period on the birth weight in Randomized Controlled Trial studies (RCTs). METHODS: International databases of Pub Med, Scopus, and Web of Science, by the MeSH heading and/or additional terms, were searched to assess relevant studies in systematic possess. I2 statistics was used to assess of heterogeneity. Pooled effects size was obtained by random effects model. Meta-regression was used to explore of heterogeneity using Stata software version 12 (Stata Corp, College Station, TX). RESULTS: A total 16 RCTs, 6192 women were enrolled to assess of smoking cessation in pregnancy period on the birth weight. Relative risk (RR) of not smoking at the end of pregnancy in intervention group was 2.47 (95% CI: 1.73-3.20). The odds ratio (OR) for effect of smoking cessation on LBW was 0.65 (95% CI: 0.42-0.88) and standardized mean difference (SMD) was significantly increased in the intervention group, 0.28 (95% CI: 0.05-0.50). CONCLUSIONS: Results of this study approve results of previous RCTs that smoking cessation in pregnancy is a good practical action to prevention of LBW in infants.

5-year survival rates based on the type of leukemia in Iran, a Meta-analysis.

BACKGROUND: According to epidemiological studies, leukemia is among the five most common cancers in Iran. Keeping efforts to estimate survival is critical to monitoring and improving patients' quality of life with leukemia. The purpose of this study was to evaluate the 5-year survival rate of leukemia patients in Iran using meta-analysis method. METHODS: This meta-analysis was carried out according to studies that adhere to inclusion and exclusion criteria during enrolment. The valid Iranian databases included: Medex, Magiran, SID, and Medlib, along with international data bases, namely, Scopus, Pubmed, and ISI were searched to find relevant articles. After determining the heterogeneity between studies, the random effects models were used to estimate pooled survival in leukemia patients. RESULTS: In total, 18 studies involving 2517 participants were included in this meta-analysis. The pooled 5-year survival rate was 0.56 % (95% CI, 0.54 to 0.58). According to types AML and ALL, the 5-year survival rates in Iran were 35.0 % (95% CI: 32.0-38.0) and 57.0 % (95% CI: 54.0-60.0), respectively. CONCLUSION: Based on our findings, slightly less than 50% of leukemia deaths happened in the first 5 years after diagnosis, which is lower than the global average.

The Relationship Between Human Development Index and Its Components with Thyroid Cancer Incidence and Mortality: Using the Decomposition Approach.

BACKGROUND: The link between age specific-rates of thyroid cancer (TC) and human development index (HDI) and also its components can be a new direction for planning by policy makers. OBJECTIVES: This study aimed at identifying the relationship between TC rates by gender, and HDI and its components in different regions of the world. METHODS: An ecological study was conducted; the data was obtained from the GLOBOCAN project in 2012. Inequality in TC estimates (age-specific incidence and mortality rates), according to the HDI and its components was calculated. Concentration index (CI) was used to estimate inequality and CI was decomposed to determine contribution of HDI and its components in inequality. RESULTS: The inequality index (CI) was 0.29 (95% CI: 0.21 - 0.38) and -0.15 (95% CI: -0.23 - 0.06) for incidence and mortality of TC by HDI, respectively. The important contributors in inequality for incidence rates of TC were life expectancy at birth (0.30), mean years of schooling (0.26), and expected years of schooling (0.18). The important contributors in inequality of mortality rates were mean years of schooling (0.19), expected years of schooling (0.17), and urbanization (0.17). CONCLUSIONS: According to the findings of this study, global inequalities exist in the TC incidence and mortality rates; incidence rates of TC are more concentrated in countries with high HDI, yet inequality index showed that deaths occurred more in disadvantaged countries.

Interventional study plan to investigate the training effects on physical and psychological outcomes awareness of smoking in teenagers.

BACKGROUND: Studies have found that nearly 90% of the first use of tobacco takes place before high school graduation (teenagers) and training discussion due to prevention can be useful, therefore, here, we aimed to determine the effects of training on awareness of cigarette outcomes (physical and psychological) in male teenagers. MATERIALS AND METHODS: We conducted an interventional study using Solomon's four-group plan, which used a two-stage cluster sampling in four groups (two experimental groups and two control groups). The three sessions of at least 2 h of education intervention including visual displaying using photo, film, and short scientific texts were held for the interventional group. After 1 month, all four groups took posttest, and research groups were followed up after 8 months of intervention. All data were analyzed using one-way analysis of variance and covariance in SPSS. RESULTS: According to the results, the mean of posttest scores had increased rather than pretest scores, and generally, a significant difference was observed (P ≤ 0.001). These results were significant in the aspect of both physical and psychological outcomes awareness. The difference between the mean of scores in follow-up period and posttest was not statistically significant, and it shows training retention after 8 months (P < 0.666). CONCLUSIONS: It can be concluded that through the training, it is possible to increase the awareness of teenagers about physical and psychological outcomes of cigarette smoking that this can have an important role in smoking prevention.

Survival rate of gastric cancer in Iran; a systematic review and meta-analysis.

AIM: In this study, we aimed to estimate one- to five-year survival rates in Iranian patients with gastric cancer (GC). In addition, we preformed subgroup analyses and meta-regression to explore possible sources of heterogeneity between studies. BACKGROUND: According to literatures, there has been increasing attention to the long-term survival rate in patients with GC in Iran. However, results have been inconsistent and remain controversial in overall survival rates. PATIENTS AND METHODS: Literature searches were conducted using PubMed, Scopus, and ISI, as well as Magiran, Medlib, SID, and Iran Medex databases. Studies were pooled and summary one to five survival rates were calculated. Univariate and multivariate regression analyses were used to explore possible sources of heterogeneity among studies. Subgroup analyses were also conducted. Analyses were conducted using the STATA statistical software package. RESULTS: Final analysis of 29361 patients from 26 eligible studies was performed. The overall survival rate (one to five years) in all studies, by meta-analysis of 24, 14, 23, 12 and 22 studies were 52%, 31%, 24%, 22%, and 15%, respectively. Meta-regression analysis showed an increase in one- and five-year survival rate over the time (Reg Coef = 0.016, p= 0.04) and (Reg Coef= 0.021, p= 0.049), respectively. Positive heterogeneity was observed between quality of papers and data sources (P<0.001). CONCLUSION: More than half of GC deaths happened in the first year at diagnosis, and another 30% plus they occurred during the second year after confirmed diagnosis. Our results admit lower survival rates in Iran, similar to other developing countries.

Survival Rate of Esophageal Carcinoma in Iran - A Systematic Review and Meta-analysis.

BACKGROUND: Esophageal cancer is often diagnosed in the last stages where the chance of patient's survival is very low. The aim of this systematic review was presentation of valid estimation of survival in patients with esophageal cancer in different regions of Iran. METHODS: A SYSTEMATIC REVIEW WAS CARRIED OUT BASED ON THE RELIABLE DOMESTIC MEDICAL DATABASES INCLUDING: SID, Magiran, Irandoc and Iranmedex as well as reliable foreign databases like PubMed and Scopus using "Cancer", "Esophagus", "survival" "Neoplasms" and "Longevity" as keywords. Then all the reviewed articles and dissertations which met the entry criteria were analyzed. The data were analyzed by using meta-analysis method (random model) and by means of STATA software application version 11.1. RESULTS: In 18 studies the total numbers of 2932 people were analyzed. The one year survival rate in Iran is estimated at 47 percent (95% CI: 34-61) and the five year survival rate is estimated at 12% (95% CI: 8-16). The two, three and four year survival rates were 31% (95% CI: 18-44), 22% (95% CI: 13-31) and 21% (95% CI: 4-38), respectively. CONCLUSION: According to the findings one year survival rate for esophageal cancer in Iran is almost four times higher than its five year survival rate. Moreover the five year survival rate in Iran is less than many other countries.

Esophageal carcinoma: long-term survival in consecutive series of patients through a retrospective cohort study.

AIM: The present study aimed to investigate the influence of histological factors on survival of patients with esophageal cancer. BACKGROUND: Esophageal cancer is almost the common form of malignancy in the eastern world. PATIENTS AND METHODS: Through a retrospective cohort study a consecutive series of 134 patients with definite diagnosis of esophageal cancer who had been hospitalized at the Towhid hospital, Sanandaj city, Kurdistan province western Iran during a five-year period from 2006 onward were recruited. The survival time of patients stratified by this grouping method were analyzed by Kaplan-Meier analysis and Cox regression. RESULTS: Overall, 127 males (55.1%), with a mean age of 65.38 ±11.62 years were included. Based on histological type of tumor, 23 patients (18.1%) had adenocarcinoma (AC) and 94 patients (74.0%) had squamous cell carcinoma (SCC). Gender was not significantly associated with survival (Log rank =0.480). Location of tumor (log rank =0.014), histological type (log rank ≤0.001) and grade of tumor (log rank =0.008) had significantly influenced the survival rates variation. For patients at initial stages of the disease, the overall one-year, two years and five years survival rates were 73.2%, 52.8% and 31.2% respectively. For advanced stages, the survival ranged from 46.3% in the first year to 8.2% in the five years. The five-year survival rates (by year) were estimated to be 49%, 27%, 24%, 22% and 19% respectively. CONCLUSION: Tumor grade, tumor deferential, clinical staging and location of the tumor were the prognostic factors for survival in patients with esophageal cancer.

Effects of nutrition education on levels of nutritional awareness of pregnant women in Western iran.

BACKGROUND: Maternal nutritional health, before and during pregnancy, influences the health status of herself and her developing fetus. Pregnancy is an important condition for improving nutritional knowledge. OBJECTIVES: The present study aimed at determining effects of nutrition education on levels of nutritional awareness of a representative group of pregnant women in Western Iran. PATIENTS AND METHODS: A quasi-experimental intervention was undertaken on a random sample of pregnant women (n = 100) attending urban health centers in Ilam city (western Iran) during the year 2011 for prenatal care. A nutritional education program containing two to four lessons was undertaken for small groups of between six to ten women. Nutritional knowledge was assessed before intervention (pretest) and followed by two posttests within three weeks interval. RESULTS: The awareness level of pregnant women about healthy nutrition was significantly increased from 3% before intervention to 31% after the nutritional education intervention (P < 0.001). This significant difference was independent from maternal characteristics of age and levels of literacy and in obese mothers in particular. CONCLUSIONS: A nutritional education intervention will have a positive effect on nutritional awareness of pregnant women.

Demographic and histological predictors of survival in patients with gastric and esophageal carcinoma.

BACKGROUND: Little is known about the possible influence of demographic and histological risk factors on the survival of patients with esophageal and gastric cancer. OBJECTIVES: Based on the available registry and follow-up information, this study compares 1-5 year survival rate of gastric and esophageal cancer. PATIENTS AND METHODS: Through a concurrent (prospective) cohort study, all 366 patients with definite diagnosis of esophageal and gastric cancer who had been hospitalized at the Towhid Hospital, Sanandaj city, Kurdistan province, western Iran during a five-year period from 2006 onwards were recruited. The survival time of patients stratified by this grouping method were analyzed by Kaplan-Meier analysis and Cox regression. RESULTS: Amongst the 366 patients, 23 had esophageal adenocarcinoma, 94 esophageal squamous-cell carcinoma and 239 had gastric adenocarcinoma. Age at diagnosis (P = < 0.001), tumor grade (P = 0.008) and practice treatment (P = < 0.001) had significant associations with the variation of survival rates in patients with esophageal but not with gastric cancer. The five-year survival rates (by year) for esophageal cancer were 49%, 27%, 24%, 22% and 19%, respectively and for gastric cancer were 41%, 17%, 13%, 10% and 5.4%, respectively. CONCLUSIONS: Major differences between these cancers were seen in the survival rates of patients and their incidence classified by sex. Age at diagnosis and histological types were prognostic factors for survival of patients with esophageal cancer but this wasn't the case for gastric cancer.