Opium use and risk of lung cancer: A multicenter case-control study in Iran.

Opium use was recently classified as a human carcinogen for lung cancer by the International Agency for Research on Cancer. We conducted a large, multicenter case-control study evaluating the association between opium use and the risk of lung cancer. We recruited 627 cases and 3477 controls from May 2017 to July 2020. We used unconditional logistic regression analyses to estimate the odds ratios (OR) and 95% confidence intervals (CI) and measured the association between opium use and the risk of lung cancer. The ORs were adjusted for the residential place, age, gender, socioeconomic status, cigarettes, and water pipe smoking. We found a 3.6-fold risk of lung cancer for regular opium users compared to never users (95% CI: 2.9, 4.6). There was a strong dose-response association between a cumulative count of opium use and lung cancer risk. The OR for regular opium use was higher for small cell carcinoma than in other histology (8.3, 95% CI: 4.8, 14.4). The OR of developing lung cancer among opium users was higher in females (7.4, 95% CI: 3.8, 14.5) than in males (3.3, 95% CI: 2.6, 4.2). The OR for users of both opium and tobacco was 13.4 (95% CI: 10.2, 17.7) compared to nonusers of anything. The risk of developing lung cancer is higher in regular opium users, and these results strengthen the conclusions on the carcinogenicity of opium. The association is stronger for small cell carcinoma cases than in other histology.

Opium use and risk of bladder cancer: a multi-centre case-referent study in Iran.

BACKGROUND: Bladder cancer (BC) is the 10th most common type of cancer worldwide and the fourth most common type of cancer in Iran. Opium use is considered as one of the risk factors for BC. We aim to assess the association between various parameters of opium use, which in Iran is mainly ingested or smoked in various forms, and the risk of BC. METHOD: In this multi-centre case-referent study in Iran, 717 BC cases and 3477 referents were recruited to the study from May 2017 until July 2020. Detailed histories of opium use (duration, amount, frequency) and potential confounders were collected by trained interviewers. Multivariable unconditional logistic regression models were used to measure adjusted odds ratio (OR) and 95% confidence intervals (CI). The ORs were adjusted for age, gender, place of residence and pack-years of cigarette smoking. RESULTS: Regular opium consumption was associated with an increased risk of BC (OR 3.5, 95% CI: 2.8, 4.3) compared with subjects who never used opium. Compared with continuous users, the risk decreased to one-third for those who stopped opium more than 10 years ago. The adjusted OR for those who used both crude opium (teriak) and opium juice was 7.4 (95% CI: 4.1, 13.3). There was a joint effect of opium and tobacco (OR for users of both opium and tobacco 7.7, 95% CI: 6.0, 9.7). CONCLUSIONS: Regular opium use is associated with an approximately 4-fold risk for BC. The OR decreases along with the increasing time since stopping opium use.

An Overview of Oncology Researches in Iran: A Scientometric Approach (1974 - February 2019).

BACKGROUND: With the growing rate of tumors, cancer has become one of the most important health concerns in Iran. The urgency with which Iranian researchers and health professionals address this challenge leads to a load of scientific materials. METHODS: To reveal gaps in produced knowledge and suggest future research directions, applying well-validated scientometric tools, we assessed the trends of Iranian published scientific articles and citations in the field of oncology. The inclusion criteria consisted of all oncology-related articles that were data-based, and peer-reviewed; with at least an abstract published in English; and authored by at least one researcher affiliated with Iranian institutions. RESULTS: Amongst 5063525 oncology research records indexed in at least one of PubMed, Scopus, or Web of Science Core Collection (WoS) from the start to February 2019, Iranian researches accounted for about 24867 (0.49%). Published articles on all cancers by Iranian researchers had a sharp continuously ascending trend, with the same pattern for citations received. Some important topics such as complementary and alternative medicine (CAM) therapies have been missing and some such as diagnostic and pharmaceutical innovations have been less investigated. The most collaborative country was the United States, while no close collaboration was observed with China that was introduced as the most productive country in the field of oncology over the past decades. CONCLUSION: Despite the progressive trend in most oncology fields, some significant practical topics are still missing. Systematic reviews of produced theoretical innovations and translating them to functional knowledge can be of importance to fulfill the mentioned gaps.

Travel Burden and Clinical Profile of Cancer Patients Admitted to the Cancer Institute of Iran in 2012.

BACKGROUND: Burden of cancer is increasing in developing countries, where healthcare infrastructures and resources are limited. Evaluating the pattern of care would provide evidence for planning and improvement of the situation. MATERIALS AND METHODS: We studied the pattern of residential place and clinical information of cancer patients who were admitted to the Cancer Institute of Iran from January 1, to May 31, 2012. RESULTS: We studied 1,705 consecutive cancer patients admitted to the Cancer Institute in the study period. The most common cancers were breast (29.2%), colorectal (9.0%), stomach (8.3%), head & neck (8.0%) and esophageal (3.8%) cancers. Radiotherapy was the main treatment (52.1%) followed by chemotherapy (43.8%) and surgery (29.1%). We found that 60% of the patients presented in the loco-regional or advanced stages. About 35% of patients travelled from other provinces mainly from Mazandaran (13.4%), Lorestan (10.6%), Zanjan (7.8%) and Ghazvin (6.6%). On average, the cancer patients travelled about 455 kilometers to receive care in the cancer institute. We found more than 38% patients who were referred from other provinces had an early stage tumor. CONCLUSION: Establishment of comprehensive cancer centers in different geographical regions and implementation of a proper referral system for advanced cancer patients is needed to improve the patient outcomes and mitigate the burden of travel of patients for cancer care.

Encapsulation of curcumin in diblock copolymer micelles for cancer therapy.

Application of nanoparticles has recently promising results for water insoluble agents like curcumin. In this study, we synthesized polymeric nanoparticle-curcumin (PNPC) and then showed its efficiency, drug loading, stability, and safety. Therapeutic effects of PNPC were also assessed on two cell lines and in an animal model of breast cancer. PNPC remarkably suppressed mammary and hepatocellular carcinoma cells proliferation (P < 0.05). Under the dosing procedure, PNPC was safe at 31.25 mg/kg and lower doses. Higher doses demonstrated minimal hepatocellular and renal toxicity in paraclinical and histopathological examinations. Tumor take rate in PNPC-treated group was 37.5% compared with 87.5% in control (P < 0.05). Average tumor size and weight were significantly lower in PNPC group than control (P < 0.05). PNPC increased proapoptotic Bax protein expression (P < 0.05). Antiapoptotic Bcl-2 protein expression, however, was lower in PNPC-treated animals than the control ones (P < 0.05). In addition, proliferative and angiogenic parameters were statistically decreased in PNPC-treated animals (P < 0.05). These results highlight the suppressing role for PNPC in in vitro and in vivo tumor growth models. Our findings provide credible evidence for superior biocompatibility of the polymeric nanocarrier in pharmacological arena together with an excellent tumor-suppressing response.

Situation analysis of the National Comprehensive Cancer Control Program (2013) in the I. R. of Iran; assessment and recommendations based on the IAEA imPACT mission.

INTRODUCTION: Iran was engaged in the Program of Action for Cancer Therapy (PACT) in 2012, and delegates from the International Atomic Energy Agency (IAEA), and the World Health Organization (WHO) evaluated the National Cancer Control Program (NCCP) status (the imPACT mission), based on which they provided recommendations for improvements of NCCP in the I.R. of Iran. We reported the results of this situational analysis and discussed the recommendations and their implication in the promotion of NCCP in the I.R. of Iran.  METHODS: International delegates visited the I.R. of Iran and evaluated different aspects and capacities of NCCP in Iran. In addition, a Farsi version of the WHO/IAEA self-assessment tool was completed by local experts and stakeholders, including experts from different departments of the Ministry of Health and Medical Education (MOHME) and representatives from the National Cancer Research Network (NCRN). Following these evaluations, the PACT office provided recommendations for improving the NCCP in Iran. Almost all the recommendations were endorsed by MOHME. RESULTS: The PACT program provided 31 recommendations for improvement of NCCP in Iran in six categories, including planning, cancer registration and information, prevention, early detection, diagnosis and treatment, and palliative care. The most important recommendation was to establish a strong, multi-sectoral NCCP committee and develop an updated national cancer control program. CONCLUSION: The imPACT mission report provided a comprehensive view about the NCCP status in Iran. An appropriate response to these recommendations and filing the observed gaps will improve the NCCP status in the I.R. of Iran.

Setting research priorities to reduce burden of cancer in Iran: an institutional experience.

OBJECTIVE: The aim of this study was to draw a set of priority areas of cancer research in order to utilize these priorities as broader policy for decision-making on a comprehensive cancer control program at the national level in Iran. MATERIALS AND METHODS: A steering committee consisting of scientists from the three major areas of clinical, basic research and public health sciences recommended a qualitative study of ranking an exhaustive outlines of cancer science topics by cancer scientists throughout country. Scientists were identified through Medline search and contacting cancer research centers all over the country. An exhausting outline of cancer science topics was modified and posed to Iranian cancer scientists. Doing research on each outlined topic was judged based on its state of being necessary, appropriate, practical or yielding in the Iranian societal context. An electronic system of communication was developed and all scientists were asked to rank each topic based in order of 1 to 5. As the areas of expertise of scientists were diverse, the participants had the option to rank the outlined topics that they think suitable to their areas. RESULTS: Out of 135 identified scientists, 108 participated of whom 56 were clinicians (M.D's with university appointment), 35 basic scientists and 17 epidemiologists and public health scientists. As the top first five areas of research priorities, the overall assessment indicated as research topics: 1) cancer surveillance and registration as the first priority; followed by 2) exogenous factors in the origin and cause of cancer; 3) surveillance--patient care and survivorship issues; 4) issues of end-of-life care; and 5) cost analyses and health care delivery of cancer services. CONCLUSION: The study concluded that research on infrastructure of cancer control programs, cancer registration, service delivery and patient quality of life bears higher priority in Iran.

HESA-A: new treatment for breast cancer and choroidal metastasis.

BACKGROUND: Breast cancer is one of the main causes of mortality among women worldwide. This type of cancer metastasizes to different body tissues, giving rise to many problems. The effect of HESA-A, a drug of herbal-marine origin, on vision, quality of life, and survival of end-stage breast cancer patients was investigated in this study. MATERIAL/METHODS: In a double-blind study, 24 breast cancer patients with choroidal metastasis, aged between 41 and 49 years, were divided into case and control groups, treated with 50 mg/kg/day of HESA-A and placebo, respectively. The patients were evaluated in respect to the intensity of experienced pain, by assessing their rate of narcotic analgesic use. The patients' vision scale was also evaluated. RESULTS: Notable improvement was seen in the vision of patients treated with HESA-A. Patients receiving HESA-A used narcotics at lower doses, owing to reduced experience of pain. No changes were observed in the vision of control group patients, or their pain experience. CONCLUSIONS: The effects of natural compounds with antioxidant and anticancer properties have been emphasized by different studies. HESA-A is a compound of natural origin, consisting of rare elements and organic materials, which in several animal and cellular studies has shown powerful anticancer effects and less toxicity on normal cells. The results of this study showed considerable improvement in the vision of breast cancer patients treated with HESA-A.