Opium as a Risk Factor for Bladder Cancer: A Population-based Case-control Study in Iran.

BACKGROUND: Bladder cancer (BC) is the most common genitourinary system malignancy in humans. Consumption of opium and its derivatives, maybe a risk factor possibly in Iran. The aim of this study was to investigate the relationship between consumption of opium and its derivatives and the incidence of BC. METHODS: In an individually matched case-control study in Shiraz (located in the south of Iran), 198 patients with BC and 396 healthy individuals (matched in age, sex and residence (urban/rural)) were investigated. Data about consumption of opium and its derivatives, tobacco, alcohol and diet were collected using a structured valid and reliable questionnaire. Crude and adjusted odds ratios (ORs) were computed using conditional logistic regression models. RESULTS: Opium consumption was associated with an increased risk of BC with an adjusted OR = 3.9 (95% CI: 1.2 - 12.0). Moreover, a considerable dose-response relationship was observed between the opium consumption and its derivatives and the incidence of BC; comparing to no users, the odds ratios of low and high consumptions were 3.3 (95% CI: 0.5 - 23.1) and 4.9 (95% CI: 1.1 - 21.9) respectively. CONCLUSION: Opium consumption can be a potential strong risk factor for BC in Iran.

The diminishing trend of ß-thalassemia in Southern Iran from 1997 to 2011: the impact of preventive strategies.

The marginal zones of the Caspian Sea and the Persian Gulf have a higher prevalence of thalassemia compared to other regions of Iran. This disease has disabled many people and resulted in increasing health care costs. The aim of this study was to assess the incidence of ß-thalassemia (ß-thal) and to evaluate the outcome of applied preventive strategies over a 14-year period in Fars Province, Southern Iran. This cross-sectional study comprised all new cases of ß-thal recorded during 1997-2011. The data were obtained from the Non-Communicable Diseases Surveillance Department of Shiraz University of Medical Sciences, Shiraz, Iran, and are presented as mean ± standard deviation (SD). The Fars Health Network System screened 840 686 males and females applying for marriage certificates. Among the carriers, 50.5% cancelled their marriages, 42.5% married, and 7.0% did not show up at the clinics. The rate of cancelled marriages has reduced since 2000, when marriage candidates were given the option of prenatal diagnosis. From 2000 to 2011, a total of 3539 married couples were referred for prenatal diagnosis. Of these, 806 fetuses were found to carry thalassemia and 800 aborted. It is impressive to note that while 101 cases of thalassemia were recorded in 1997, this figure was reduced to two cases by 2011. This study has established that an integrated primary health care approach, with good infrastructure for implementing successful strategies, can significantly reduce the incidence of ß-thal.

Data coverage of a cancer registry in southern Iran before and after implementation of a population-based reporting system: a 10-year trend study.

BACKGROUND: Cancer registries help to decrease the burden of cancers by collecting accurate and complete data. We aimed to measure the completeness of coverage of information recorded between 2000 and 2009 in a cancer registry program in Fars province, southern Iran. METHODS: The cancer registry program run by Shiraz University of Medical Sciences was investigated in two periods: pathology-based data from 2000 to 2007 and population-based data from 2007 to 2009. Completeness of yearly coverage was measured as the number of reported cases of cancer in each year divided by estimated cases based on 107.3 new cases per 100 000 individuals. The percentage of complete data registration (patient's name, age, gender, address, phone number and father's name) and correct cancer encoding was calculated for each year and compared to the maximum acceptable error rate for each item. RESULTS: A total of 29 277 non-duplicate cancer records were studied. Completeness of coverage varied from 22.68% in 2000 to 118.7% in 2008. Deficiencies in patients' demographic data were highest for name in 2002 (0.09%), age in 2006 (2.36%), gender in 2001 (0.06%) and father's name in 2001 (52.5%). Incomplete address (99.7%) and missing phone number (100%) were most frequent in 2000, and deficiencies in encoding information were highest in 2008 (6.36%). CONCLUSIONS: The cancer registry program in Fars province (southern Iran) was considered satisfactory in terms of completeness of coverage and information about age. However, it was deficient in recording patients' phone number and address, and father's name. The error level for cancer encoding was unacceptably high. Enhancing hardware and software resources, education and motivation in all public and private sectors involved in the cancer registry program, and greater attention to epidemiological research are needed to increase the quality of the cancer registry program, including its completeness.