Clear Cell Renal Cell Carcinoma: A Comprehensive in silico Study in Searching for Therapeutic Targets.

INTRODUCTION: Clear cell renal cell carcinoma (ccRCC) is recognized as one of the leading causes of illness and death worldwide. Understanding the molecular mechanisms in ccRCC pathogenesis is crucial for discovering novel therapeutic targets and developing efficient drugs. With the application of a comprehensive in silico analysis of the ccRCC-related array sets, the main objective of this study was to discover the top molecules and pathways in the pathogenesis of this cancer. METHODS: ccRCC microarray datasets were downloaded from the Gene Expression Omnibus database, and after quality checking, normalization, and analysis using the Limma algorithm, differentially expressed genes (DEGs) were identified, considering the adjusted p value <0.049. The intensity values of the identified DEGs were introduced to the Weighted Gene Co-Expression Network Analysis (WGCNA) algorithm to construct co-expression modules. Functional enrichment analyses were performed using the DEGs in the disease-correlated module, and hub genes were identified among the top genes in a protein-protein interaction network and the disease most correlated module. The expression analysis of hub genes was done by utilizing GEPIA, and the GSCA server was used to compare the expression patterns of hub genes in ccRCC and other cancers. DGIdb database was utilized to identify the hub gene-related drugs. RESULTS: Three datasets, including GSE11151, GSE12606, and GSE36897, were retrieved, merged, normalized, and analyzed. Using WGCNA, the DEGs were clustered into eight different modules. Translocation of ZAP-70 to immunological synapse, endosomal/vacuolar pathway, cell surface interactions at the vascular wall, and immune-related pathways were the topmost enriched terms for the ccRCC-correlated DEGs. Twelve genes including PTPRC, ITGAM, TLR2, CD86, PLEK, TYROBP, ITGB2, RAC2, CSF1R, CCR5, CCL5, and LCP2 were introduced as hub genes. All the 12 hub genes were upregulated in ccRCC samples and showed a positive correlation with the infiltration of different immune cells. According to the DGIdb database, 127 drugs, including tyrosine kinase inhibitors, glucocorticoids, and chemotaxis targeting molecules, were identified to interact with the hub genes. CONCLUSION: By utilizing an integrative bioinformatics approach, this experiment shed light on the underlying pathways in the pathogenesis of ccRCC and introduced several potential therapeutic targets for repurposing or developing novel drugs for an efficient treatment of this cancer. Our next step would be to assess the gene expression profiles of the identified hubs in different cell populations in the tumor microenvironment.

Estimation of heavy metal concentrations (Cd and Pb) in plant leaves using optimal spectral indicators and artificial neural networks.

The necessity of continuously monitoring the agricultural products in terms of their health has enforced the development of rapid, low-cost, and non-destructive monitoring solutions. Heavy metal contamination of the plants is known as a source of health threats that are made by their proximities with pollutant soil, water, and air. In this paper, a method was proposed to measure lead (Pb) and cadmium (Cd) contamination of plant leaves through field spectrometry as a low-cost solution for continuous monitoring. The study area was Mahneshan county of Zanjan province in Iran with rich heavy metal mines that have more potential for plant contamination. At first, we collected different plant samples throughout the study area and measured the Pb and Cd concentrations using ICP-AES, in which we observed that the concentrations of Pb and Cd are in the range of 1.4 ~ 282.6 and 0.3 ~ 66.7 µgg-1, respectively, and then we tried to find the optimum estimator model through a multi-objective version of genetic algorithm (GA) optimization that finds simultaneously the structure of an artificial neural network and its input features. The features extracted from the raw spectrums have been collimated to be compatible with the Sentinel-2 multispectral bands for the possibility of further developments. The results demonstrate the efficiency of the optimum estimator model in estimation of the leaves' Pb and Cd contamination, irrespective of the plant type, which has reached the R2 of 0.99 and 0.85 for Pb and Cd, respectively. Additionally, the results suggested that the 783-, 842-, and 865-nm spectral bands, which are similar to the 7, 8, and 8a sentinel-2 spectral bands, are more efficient for this purpose.

Development of HRM real-time PCR for assemblage characterization of Giardia lamblia.

A total of 90 stool samples were collected from dogs, referred to a dog shelter and a veterinary clinic. In addition, 395 stool samples obtained from pet dog owners and shelter keepers, as well as individuals referred to a medical laboratory as controls, were collected in Shahryar district, Tehran, Iran. Stool samples were parasitologically examined and the positive G. lamblia isolates were tested with Nested-PCR/sequencing for the tpi, gdh, and bg genes, and HRM real-time PCR. Microscopical examination revealed 20 (22.2%) and 34 (8.6%) Giardia-positive samples from dogs and humans, respectively. Regarding HRM real-time PCR, the prevalence of assemblages A and B in humans was 55.8% and 14.7%, respectively. In addition, 14.7% of samples were mix assemblages. HRM real-time PCR detected most of microscopically-positive samples in comparison to PCR/sequencing in both humans and dogs. The high prevalence of assemblages A and B in dogs signified the importance of a same source for infection between dogs and humans.

Urbanization Levels and Its Association with Prevalence of Risk Factors and Colorectal Cancer Incidence.

BACKGROUND: Colorectal cancer is one of the most common cancers in the world. This study aimed to determine the relationship between risk factors and the incidence of colorectal cancer in Urbanization levels in Iran. METHODS: This was a population-based study. Urbanization levels were determined using the census data of the Statistical Center in 2012. Data on risk factors for colorectal cancer were obtained from the information provided by the Iranian Non-Communicable Disease Control Center and the incidence of colorectal cancer from the data from the National Cancer Registry System. Negative binomial regression analysis was used to determine the relationship between colorectal cancer risk factors and urbanization levels with colorectal cancer incidence. For statistical analysis, SPSS and Stata software were used. A significant level of P≤0.05 was considered. RESULTS: The relationship between urbanization levels and risk factors with the incidence of colorectal cancer, nutrition Status, tobacco use, and body mass index were not significant. There was a significant relationship between physical activity and incidence at different levels and between levels of urbanization and incidence rate, indicating a lower incidence rate of colorectal cancer at lower levels of urbanization. CONCLUSION: Colorectal cancer incidence is higher at higher levels of urbanization than lower levels. The difference between regions in terms of urbanization can have in flounce on access to facilities, health service, and counseling opportunities to modify the risk factors and access to proper screening and follow-up care.

Association of socioeconomic risk factors with under 5-year mortality in Zabol, Iran, during 2011-2015.

Background: Under-5 mortality is an important health indicator of a country's development and every country is committed todecrease it. Children under-5 years are vulnerable to the imbalance of socioeconomic inequality and are dependent on the adults toremain healthy. The aim of this study was to determine the association of socioeconomic factors with under-5 mortality in Zabol. Methods: This descriptive cross sectional study was performed on 2001 children younger than 5 years who were under the coverageof Zabol University of Medical Sciences between 2011 and 2015. The data were collected using standard questionnaires on mortality ofinfant and children 1-59 months old, questionnaires determining socioeconomic condition, and health center data files. The analyseswere performed using SPSS software version 21, and significance level was set at 0.05 for all tests. Results: The most common causes of death under 5 years of age included immaturity, congenital defects, and respiratory diseases. Inthe logistic regression model, father's addiction, maternal literacy, socioeconomic level, and household family size were significantlyassociated with under-5 mortality (P<0.05). Moreover, there was a correlation between a congenital defect in the Zahak region andimmaturity in the Hamun region with under-5 mortality. Conclusion: Low socioeconomic status, parental addiction, and low education level were the most probable risk factors for under 5mortality.

Determining the Levels of Urbanization in Iran Using Hierarchical Clustering.

BACKGROUND: In this study, we used a variety of factors that affect urbanization in Iran to evaluate different provinces in Iran in terms of the level of urbanization. METHODS: Using information from census 2011, we collected data on 33 indicators related to urbanization in 31 provinces in Iran. To rank the provinces we used density-based hierarchical clustering scheme. To determine similarities or differences between the provinces, the square of the Euclidean distance dissimilarity coefficient; Ward's algorithm was used to merge the provinces to minimize intra-cluster variance. One-way analysis of variance (ANOVA) was used to determine the variance between the variables used to rank the provinces in terms of different levels of urbanization. Statistical analysis was performed using SPSS. RESULTS: The provinces in Iran were combined with each other in 30 stages and classified into four levels. Taking into account the variables used to rank the level of urbanization, Tehran, and Alborz provinces were at the highest level of urbanization. On the other hand, the provinces of Sistan and Baluchistan, Kerman, North Khorasan, South Khorasan, Hormozgan, and Bushehr were at the lowest level of urbanization. CONCLUSION: Identification of provinces at the same level of urbanization can help us to discover the strengths and weaknesses in the infrastructures of each of them. Given the differences between various levels of urbanization, the identification of factors that are effective in the process of urbanization can help to access more information required for designing plans for the years to come.

Incidence pattern and spatial analysis of breast cancer in Iranian women: Geographical Information System applications.

BACKGROUND: Breast cancer is the leading cancer in Iranian women, but no studies have yet been conducted on the distribution and pattern of its incidence. AIM: To perform a spatial analysis and determine the incidence pattern of breast cancer in the Islamic Republic of Iran. METHODS: This was a cross-sectional, pathology-based study of all new female patients with breast cancer registered in the Islamic Republic of Iran in 2011 (n=10 233). Initially, crude incidence rates were calculated for each province and the whole country per 100 000 person-years. Then, a direct standardization method and World Health Organization standard population were used to adjust for age effects on a geographical scale. Stata and Arc GIS software were used to calculate incidence rates and conduct spatial analysis. RESULTS: The mean (standard deviation) age of the patients was 50.9 (12.6) years. The national age-standardized incidence rate for breast cancer in women was 29.88 per 100 000 person-years, with a range of 5-72 in different provinces. The clustering incidence pattern was observed in Mazandaran, Tehran, Alborz, Isfahan and Markazi Provinces (P < 0.01). There was a significant cluster of high incidence of breast cancer in Iranian women. CONCLUSION: These findings may help to establish etiological hypotheses of cancer causation and identify spatial anomalies in cancer incidence or registration in the Islamic Republic of Iran. Our findings may also aid further research on the possible explanations for these clusters and associations.

The Association between Adverse Events in the Last 5 Years and the Rate of Breast Cancer.

BACKGROUND: This study was conducted in Yazd Province, Central Iran aimed to investigate the relationship between adverse events and breast cancer during 2012-2014. METHODS: Hospital-based case-control study of 150 women with breast cancer and 150 healthy women (did not have breast cancer) was conducted. Sampling was performed in the form of accessibility. Data collection was conducted using questionnaire through interview. The collected data were entered into SPSS for statistical analysis. RESULTS: The mean age of participants was 51.58 yr. Eight percent of cases and 1.3% of the controls had experienced the sister's death over the past 5 yr, this difference was statistically significant (P=0.03). Factors such as disability due to illness, divorce, unemployment, the second marriage, addiction, ill spouse, child's problems (such as conflict, unemployment, addiction, legal troubles, illness), taking care of their own parents or their husband's parents, migration, change of habitat, loss of home, communication problems, job-relevant factors were not significantly different between the two groups (P>0.05). Mean of severity of adverse events in both groups was significantly different (8.92±8.29 in the case group, 5.72±5.6 in the control group) (P=0.000). CONCLUSION: There was no significant relationship between adverse events in the last 5 yr and the risk of breast cancer. Factors such as personality and ability to cope with problems may positively influence this relationship.

A Challenging Interaction of Chronic Kidney Disease With Other Metabolic Disorders: Paradoxes in Cardiometabolic Risk Factors.

INTRODUCTION: Controversial findings are reported on the risk of cardiovascular disease in chronic kidney disease (CKD). There are some interactions between CKD and other metabolic disorders including metabolic syndrome (MS) and obesity regarding coronary heart disease (CHD) outcomes. MATERIALS AND METHODS: A total of 2823 men and 3684 women aged 30 years and older, without cardiovascular disease, were followed for 10 years. Multivariable adjusted hazard ratio of CHD was estimated for those who developed CKD, MS or both by sex and body mass index levels below and above 27 kg/m2. The interaction term of CKD and MS and also CKD-MS components were assessed in the Cox proportional hazard models as well. RESULTS: Chronic kidney disease without MS, showed a significant effect on CHD only in participants with low body mass index (hazard ratio, 2.06; 95% confidence interval, 1.28 to 3.31 in the men and hazard ratio, 2.56; 95% confidence interval, 1.04 to 6.31 in the women). The joint effect of CKD and MS decreased to one-third of their multiplicative effect in this subgroup, indicating a negative interaction between CKD, MS, and Obesity. The same interaction was observed between CKD and hypertension in both sexes and CKD and type 2 diabetes mellitus in the men. CONCLUSIONS: Our results showed that CKD was an independent risk factor for CHD only in nonobese individuals; however, its risk was wiped out when joined to MS. Following the concept of "obesity paradox," the term of "risk factors paradox" also needs more attention.

Association Between Socioeconomic Status and Participation in Colonoscopy Screening Program in First Degree Relatives of Colorectal Cancer Patients.

BACKGROUND: Approximately 15% to 25% of colorectal cancer (CRC) cases have positive family history for disease. Colonoscopy screening test is the best way for prevention and early diagnosis. Studies have found that first degree relatives (FDRs) with low socioeconomic status are less likely to participate in colonoscopy screening program. OBJECTIVES: The aim of this study is to determine the association between socioeconomic status and participation in colonoscopy screening program in FDRs. PATIENTS AND METHODS: This descriptive cross-sectional, study has been conducted on 200 FDRs who were consulted for undergoing colonoscopy screening program between 2007 and 2013 in research institute for gastroenterology and liver disease of Shahid Beheshti University of Medical Sciences, Tehran, Iran. They were interviewed via phone by a valid questionnaire about socioeconomic status. For data analysis, chi-square, exact fisher and multiple logistic regression were executed by SPSS 19. RESULTS: The results indicated 58.5% participants underwent colonoscopy screening test at least once to the time of the interview. There was not an association between participation in colonoscopy screening program and socioeconomic status to the time of the interview in binomial analysis. But statistical significance between intention to participate and educational and income level were found. We found, in logistic regression analysis, that high educational level (Diploma and University degree in this survey) was a predictor to participate in colonoscopy screening program in FDRs. CONCLUSIONS: According to this survey low socioeconomic status is an important factor to hinder participation of FDRs in colonoscopy screening program. Therefore, planned interventions for elevation knowledge and attitude in FDRs with low educational level are necessary. Also, reducing colonoscopy test costs should be a major priority for policy makers.

Estimating the Esophagus Cancer Incidence Rate in Ardabil, Iran: A Capture-Recapture Method.

BACKGROUND: Accurate cancer registry and awareness of cancer incidence rate is essential in order to define strategies for cancer prevention and control programs. Capture-recapture methods have been recommended for reducing bias and increase the accuracy of cancer incidence estimation. OBJECTIVES: This study aimed to estimate the esophagus cancer incidence by capture-recapture method based on Ardabil population-based cancer registry data. PATIENTS AND METHODS: Total new cases of esophagus cancer reported by three sources of pathology reports, medical records, and death certificates to Ardabil province cancer registry center in 2006 and 2008 were enrolled in the study. All duplicated cases between three sources were identified and removed using Excel software. Some characteristics such as name, surname, father's name, date of birth and ICD codes related to their cancer type were used for data linkage and finding the common cases among three sources. The incidence rate per 100,000 was estimated based on capture-recapture method using the log-linear models. We used BIC, G(2) and AIC statistics to select the best-fit model. RESULTS: After removing duplicates, total 471 new cases of esophagus cancer were reported from three sources. The model with linkage between pathology reports, medical record sources and independence with the death certificates source was the best fitted model. The reported incidence rate for the years 2006 and 2008 was 18.77 and 18.51 per 100,000, respectively. In log-linear analysis, the estimated incidence rate for the years 2006 and 2008 was 49.71 and 53.87 per 100,000 populations, respectively. CONCLUSIONS: Based on the obtained results, it can be concluded that none of the sources of pathology reports, death certificates and medical records individually or collectively were fully covered the incidence cases of esophagus cancer and need to apply some changes in data abstracting and case finding.

Cost-Effectiveness of Three Rounds of Mammography Breast Cancer Screening in Iranian Women.

BACKGROUND: Breast cancer is the most common cancer in Iranian women as is worldwide. Mammography screening has been introduced as a beneficial method for reducing mortality and morbidity of this disease. OBJECTIVES: We developed an analytical model to assess the cost effectiveness of an organized mammography screening program in Iran for early detection of the breast cancer. PATIENTS AND METHODS: This study is an economic evaluation of mammography screening program among Iranian woman aged 40 - 70 years. A decision tree and Markov model were applied to estimate total quality adjusted life years (QALY) and lifetime costs. RESULTS: The results revealed that the incremental cost effectiveness ratio (ICER) of mammography screening in Iranian women in the first round was Int. $ 37,350 per QALY gained. The model showed that the ICER in the second and third rounds of screening program were Int. $ 141,641 and Int. $ 389,148 respectively. CONCLUSIONS: Study results identified that mammography screening program was cost-effective in 53% of the cases, but incremental cost per QALY in the second and third rounds of screening are much higher than the accepted payment threshold of Iranian health system. Thus, evaluation of other screening strategies would be useful to identify more cost-effective program. Future studies with new national data can improve the accuracy of our finding and provide better information for health policy makers for decision making.

Cervical Cancer Screening: Recommendations for Muslim Societies.

BACKGROUND: The overall cervical cancer incidence rate is low in Iran; however, because of a higher risk of death for cervical cancer, a disease that kills women in middle age, a cervical cancer control program is needed. The aim of this study was to provide consensus recommendation for cervical cancer prevention in Iran and other Muslim societies with low incidences of cervical cancer. MATERIALS AND METHODS: Through a practical guideline development cycle, we developed six questions that were relevant to produce the recommendation. We reviewed 190 full text records of cervical cancer in Iran (1971 to 2013) of which 13 articles were related to the data needed to answer the recommendation questions. We also reviewed World Health Organization, IARC, GLOBOCAN report, Iran Ministry of Health cancer registry report and 8 available foreign countries guidelines. Lastly, we also evaluated the Pap smear results of 825 women who participated in the Iranian HPV survey, of whom 328 were followed-up after a 5-year interval. RESULTS: The obtained data highlighted the burden of HPV and cervical cancer situation in Iran. Experts emphasized the necessity of a cervical cancer screening program for Iranian women, and recommended an organized screening program with a cytological evaluation (Pap smear) that would start at the age of 30 years, repeated every 5 years, and end at the age of 69 years. Meanwhile, there is no need for screening among women with a hysterectomy, and screening should be postponed to post-partum among pregnant women. CONCLUSIONS: An organized cervical cancer screening is a necessity for Iran as more than 500-900 women in middle age diagnosed with an invasive cervical cancer every year cannot be ignored. This recommendation should be taken into account by the National Health System of Iran and Muslim countries with shared culture and behavior patterns. CUBA HPV test could be consideration in countries Muslim country with appropriate budget, resources and facility.

Underestimating the Effect of Lipids on Cardiovascular Events: Regression Dilution Bias in the Population-Based Cohort of Tehran Lipid and Glucose Study.

BACKGROUND: Random errors in the measurement of risk factors lead to bias in the exposure-disease association. OBJECTIVES: This study aimed to examine the extent of underestimation in the association of total cholesterol (TC), high density lipoprotein cholesterol (HDL-C) and triglyceride (TG) with cardiovascular disease (CVDs) in the Tehran Lipid and Glucose Study. PATIENTS AND METHODS: Of 6327 eligible people in the original cohort followed for about 10 years to detect CVD events, 3063 (1224 men and 1839 women) had replicate measurements for blood lipids. Two regression dilution ratios were calculated by nonparametric and parametric methods, using replicate data from reexaminations three and six years after baseline. Adjusted and unadjusted hazard ratios (HR) were corrected for regression dilution bias. RESULTS: By parametric method, based on reexamination three years after baseline, the strength of real association of usual levels of TC, TG and HDL-C with cardiovascular disease, considering ß coefficients of related models, were underestimated about 42%, 51% and 81% in men and 40%, 43% and 62% in women, respectively. Underestimations were relatively independent of age, sex and body mass index. Correction for regression dilution bias led to more than 60% increase in estimated HR for TC adjusted for confounders. CONCLUSIONS: Using baseline measurements of lipids led to considerable underestimation in the association of these factors with CVD outcome in TLGS. The underestimation increased with time interval between baseline and follow-up measurements for TC and TG. TC had more attenuation on estimated HR due to stronger relation with CVD risk.

Inequality in Utilization of In-patients Health Services in Iran.

BACKGROUND: Health services for those in need. Inpatient care shows a more serious side of individual care and patients and their family members perceive a high level of stress and urge. We conducted this study to determine inequalities of in-patient health care utilization in Iranian people and to assess factors that influence utilization. METHODS: In each province, the sample was comprised of 380 urban and 380 rural households that were recruited by a systematic random sampling method. A total of 23,560 households, which included around 102,000 individuals were recruited. We used the questionnaire for data collection. Met admission need (MAN) was the main variable and was considered household assets for determining the economic status. We did all analyses using the STATA version 9.1. RESULTS: The rates of MAN for urban and rural areas were 83% and 81.3% respectively. The rate of MAN was significantly higher in patients with higher educational level. Patients with primary health insurance coverage had significantly higher rate of MAN. CONCLUSIONS: Meeting admission needs was estimated around 84% and it seems that modifying insurance coverage is the most feasible intervention for increasing utilization of health services.

Regression dilution bias in blood pressure and body mass index in a longitudinal population-based cohort study.

BACKGROUND: Use of single measurement of risk factors can distort their estimated effects, due to random error in measurements. The aim of this study was to examine the extent of underestimation in the estimated effect of common variables in physical exam i.e. systolic and diastolic blood pressure (SBP, DBP) and body mass index (BMI) on cardiovascular diseases in Tehran Lipid and Glucose Study (TLGS). METHODS: A subsample (1167 men and 1786 women) of the original cohort, who had replicate measures of the variables in triennial interval, was used to calculate the regression dilution ratios (RDRs) in men and women. RDRs were determined by parametric and nonparametric methods. Hazard ratios (HR) of risk factors, per one standard deviation change, were corrected for regression dilution bias. RESULTS: The estimated RDRs by parametric method in men and women were 45% and 35% for SBP and 54% and 64% for DBP respectively. There were 26% and 25% underestimation in HR of SBP and 23% and 33% in HR of DBP in men and women. The corresponding underestimation for BMI was about 8%. RDRs of men and women and in age groups by both methods were fairly similar. They were relatively constant during the 10-year follow-up for SBP and BMI. CONCLUSIONS: Using baseline measurements of blood pressure underestimate its real association with CVD events and the estimated HRs. The underestimations are independent of age and sex, and it can be fairly constant in short to moderate time intervals.

Calculating population attributable fraction for cardiovascular risk factors using different methods in a population based cohort study.

BACKGROUND: Population Attributable Fraction (PAF) is one of the most practical measures for estimating the burden of risk factors with some challenges in its calculation. Cardiovascular disease (CVD) is the first cause of death worldwide and the estimation of accurate PAFs for CVD risk factors is of great importance in conducting preventive strategies. Our aim was to estimate the PAFs of CVD risk factors via direct, i.e. based on regression models, and indirect, i.e. using related equations, methods. METHODS: Participants (3200 males and 4245 females aged ≥30 yr) without history of CVD were selected from the population-based cohort of Tehran Lipid and Glucose Study (TLGS). Hazard ratio (HR) and Odds ratio (OR) of conventional risk factors were calculated for CVD events after ten yr of follow-up. Levin's and Miettinen's equations were applied to indirectly estimate the PAFs and average PAF was directly derived from logistic regression model. RESULTS: The sum of PAFs resulted from indirect estimations reached to more than 100% (around 200% and 150% based on Levin's and Miettinen's formula respectively). The direct estimation attributed 80% and 86% of burden of CVD events to conventional risk factors in men and women respectively. The rank and pattern of PAFs of risk factors was somehow different among different methods. CONCLUSIONS: Estimating priorities of risk factors may differ in different methods for calculating PAF. This study provides evidence on the more expediency of direct method over indirect ways when individual data is available through a population-based cohort.

Associations of demographic and socioeconomic factors with stage at diagnosis of breast cancer.

BACKGROUND: Stage at diagnosis is one of the most important prognostic factors of breast cancer survival. Because in the breast cancer case this may vary with socioeconomic characteristics, this study was performed to recognize the relationship between demographic and socioeconomic factors with stage at diagnosis in Iran. MATERIALS AND METHODS: This cross-sectional, descriptive study conducted on 526 patients suffering from breast cancer and registered in Cancer Research Center of Shahid Beheshti University of Medical Sciences from 2008 to 2013. A reliable and valid questionnaire about family levels of socioeconomic status filled in by interviewing the patients via phone. For analyzing the data, Multinomial logistic regression, Kendal tau-b correlation coefficient and Contingency Coefficient tests were executed by SPSS22. Economic status, educational attainment of patient and household head and/or a combination of these were considered as parameters for socioeconomic status. First, the relationship between stage at diagnosis and demographic and socioeconomic status was assessed in univariate analysis then these relationships assessed in two different models of multinomial logistic regression. RESULTS: The mean age of the patients was 48.3 (SD=11.4). According to the results of this study, there were significant relationships between stage at diagnosis of breast cancer with patient education (p=0.011), living place (p=0.044) and combined socioeconomic status (p=0.024). These relationships persisted in multiple multinomial logistic regressions. Other variables, however, had no significant correlation. CONCLUSIONS: Patient education, combined socioeconomic status and living place are important variables in stage at diagnosis of breast cancer in Iranian women. Interventions have to be applied with the aim of raising women's accessibility to diagnostic and medical facilities and also awareness in order to reducing delay in referring. In addition, covering breast cancer screening services by insurance is recommended.

Estimating the completeness of gastric cancer registration in Ardabil/Iran by a capture-recapture method using population-based cancer registry data.

BACKGROUND: Knowledge of cancer incidences is essential for cancer prevention and control programs. Capture-recapture methods have been recommended for reducing bias and increasing the accuracy of cancer incidence estimations. This study aimed to estimate the completeness of gastric cancer registration by the capture-recapture method based on Ardabil population-based cancer registry data. MATERIALS AND METHODS: All new cases of gastric cancer reported by three sources, pathology reports, death certificates and medical records that reported to Ardabil population-based cancer registry in 2006 and 2008 were enrolled in the study. The duplicate cases based on the similarity of first name, surname and fathers names were identified between sources. The estimated number of gastric cancers was calculated by the log-linear method using Stata 12 software. RESULTS: A total of 857 new cases of gastric cancer were reported from three sources. After removing duplicates, the reported incidence rates for the years 2006 and 2008 were 35.3 and 32.5 per 100,000 population, respectively. The estimated completeness calculated by log-linear method for these years was 36.7 and 36.0, respectively. CONCLUSIONS: These results indicate that none of the sources of pathology reports, death certificates and medical records individually or collectively fully cover the incident cases of gastric cancer. We can obtain more accurate estimates of incidence rates using the capture-recapture method.

Relationships between Family Levels of Socioeconomic Status and Distribution of Breast Cancer Risk Factors.

BACKGROUND: Not only the expand development of knowledge for reducing risk factors, but also the improvement in early diagnosis and treatment of cancer, and socioeconomic inequalities could affect cancer incidence, diagnosis stage, and mortality. The aim of this study was investigation the relationships between family levels of socioeconomic status and distribution of breast cancer risk factors. METHODS: This descriptive cross-sectional study has conducted on 526 patients who were suffering from breast cancer, and have registered in Cancer Research Center of Shahid Beheshti University of Medical Sciences from March 2008 to December 2013. A reliable and valid questionnaire about family levels of socioeconomic status has filled by interviewing the patients via phone. For analyzing the data, Multinomial logistic regression, Kendal tau-b correlation coefficient and Contingency Coefficient tests have executed by SPSS19. RESULTS: The mean age of the patients was 48.30 (SD=11.41). According to the results of this study, there was a significant relationship between family socioeconomic status and patient's age at diagnosis of breast cancer (p value<0.001). Also, the relationships between socioeconomic status and number of pregnancies, and duration of breast feeding were significant (p value> 0.001). In the multiple logistic regressions, the relationship between excellent socioeconomic status and number of abortions was significant (p value> 0.007). Furthermore, the relationships between moderate and good socioeconomic statuses and smoking were significant (p value=0.05 and p value=0.02, respectively). CONCLUSION: The results have indicated that among those patients having better socioeconomic status, age at cancer diagnosis, number of pregnancies and duration of breast feeding was lower, and then number of abortions was more than the others. According to the results of this study, it was really important to focus on family socioeconomic status as a critical and effective variable on breast cancer risk factors among the Iranian women.