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.

Self-Reported and Network Scale-Up Estimates of Substance Use Prevalence among University Students in Kerman, Iran.

BACKGROUND: This study aimed to estimate the prevalence of substance use among university students measured by direct and indirect methods, and to calculate the visibility factor (VF) defined as ratio of indirect to direct estimates of substance use prevalence. STUDY DESIGN: A cross-sectional study. METHODS: Using a multistage non-random sampling approach, we recruited 2157 students from three universities in Kerman, Iran, in 2016. We collected data on substance use by individual face-to-face interview using direct (i.e. self-report of their own behaviors) and indirect (NSU: Network scale up) methods. All estimates from direct and indirect methods were weighted based on inverse probability weight of sampling university. RESULTS: The response rate was 83.6%. The last year prevalence of water pipe, alcohol, and cigarettes indirect method was 44.6%, 18.1%, and 13.2% respectively. Corresponding figures in NSU analysis were 36.4%, 18.2%, and 16.5% respectively. In the female population, VF for all types of substance was less than male. CONCLUSIONS: Considerable numbers of university students used substances like a water pipe, alcohol, and cigarettes. NSU seems a promising method, especially among male students. Among female students, direct method provided more reliable results mainly due to transmission and prestige biases.