Prevalence of Gestational Diabetes in Iran: A Systematic Review and Meta-analysis.

Background: Pregnant women who have gestational diabetes mellitus (GDM) are more prone to adverse pregnancy outcomes. We estimated the prevalence of GDM in Iran. Methods: Web of Science, Scopus, PubMed, Google Scholar, and Persian databases (SID, Magiran, Irandoc, and) were searched using the MeSH and non-MeSH terms in abstract, title, or keywords of articles until June 2021, with no limitation in time. Random effects models were applied to summarize the GDM prevalence in Iran. The obtained data were quantitatively analyzed to determine an effect size for each paper. The pooled effect size was introduced as prevalence and 95% confidence interval. Sensitivity analyses and subgroup analyses were done to determine heterogeneity. Publication bias was assessed by the classic fail-safe N and Egger test. Results: A total of 53 papers were considered for meta-analysis, involving 56,521 Iranians. The total GDM prevalence in Iran was 7.6% (95% CI, 6.1%-9.4%). Conclusion: This meta-analysis was the newest to estimate the GDM prevalence among Iranian women. Our results suggest a high prevalence of GDM in Iran, showing that Iran might have many GDM patients.

Folic acid supplementation improved cognitive deficits associated with lithium administration during pregnancy in rat offspring.

INTRODUCTION: The present study aimed to analyse both neurobehavioural and biochemical results of neonates born of mothers exposed to different doses of lithium along with the groups that received lithium at the highest dose with folic acid as a preventive treatment. MATERIALS AND METHODS: Male and female rats were mated in separate cages, and pregnant rats were divided into eight first group as (1) vehicle; (2) propylthiouracil (PTU)-induced hypothyroidism; (3-4) received two different doses of lithium carbonate (15 and 30 mg/kg); (5-7) the highest doses of lithium (30 mg/kg) plus three different doses of folic acid (5, 10 and 15 mg/kg); and (8) received just folic acid (15 mg/kg). All treatments were dissolved in drinking water and continued until delivery, followed by returning to a regular diet without treatment. RESULTS: Lithium (30 mg/kg) disrupts both behavioural and biochemical markers, including TSH, T3 and T4 as measuring indicators to assess thyroid function, IL-10 and TNF-α as anti-inflammatory and inflammatory agents, respectively, malondialdehyde as an oxidative stress marker, alongside SOD, and catalase activity as antioxidant indicators. Besides, folic acid, almost at the highest dose (15 mg/kg), attenuated memory impairement and anxiety-like behaviour caused by lithium. Moreover, the groups treated with folic acid alone in comparison with vehicles demonstrated higher levels of antioxidant and anti-inflammatory indicators. CONCLUSION: According to the results, prenatal exposure to a high dose of lithium (30 mg/kg) leads to foetal neurodevelopmental disorder and growth restriction through various mechanisms more likely attributed to hypothyroidism, which means it should be either prohibited or prescribed cautiously during pregnancy.

Feeding crocin ameliorate cognitive dysfunction, oxidative stress and neuroinflammation induced by unpredictable chronic mild stress in rats.

INTRODUCTION: The aim of the current study was to investigate the probable mechanism and effect of crocin on brain oxidative damage and memory deficits induced by unpredictable chronic mild stress (UCMS). MATERIALS AND METHODS: Male Wistar rats were randomly divided into six groups consisting of one vehicle group (received normal saline), four groups included rats who received UCMS 4 weeks out of which three groups were pretreated with different doses of crocin (10, 20, and 30 mg/kg/day) concomitantly. To assess the pure effect of crocin, the last experimental group received a high dose of crocin (30 mg/kg/day) without exposure to the UCMS procedure. The behavioral tests including Morris water maze (MWM) and passive avoidance (PA) were performed and eventually they were sacrificed for the estimation of biochemical parameters. RESULTS: The increase in Malondialdehyde (MDA) as an oxidative stress indicator and nitrite levels in the hippocampus were observed in UCMS rats, along with memory deficits in behavioral tests including passive avoidance and Morris water maze (MWM) test. Moreover, treatment with crocin decreased MDA, nitrite, pro-inflammatory cytokine such as TNF-α, and pathological hallmark of Alzheimer's disease including amyloid-ß (Aß), and glial fibrillary acidic protein (GFAP) in the hippocampus, whereas antioxidant agents including total thiol content, SOD, and catalase activity were increased. Also behavioral test demonstrated a positive effect of crocin on memory deficit induced by UCMS. Interlukin-10 as an important anti-inflammatory agent was increased as well. Interestingly, in some behavioral and biochemical findings, treatment with 30 mg/kg of crocin has given better results compared to vehicle group, which means the administration of crocin could have preventive effects on learning and memory impairment. CONCLUSION: The present study strongly confirmed the positive effect of crocin and has the potential as an antioxidant and anti-inflammatory agent that could improve memory impairment induced by UCMS.

Crocin, the main active saffron (Crocus sativus L.) constituent, as a potential candidate to prevent anxiety and depressive-like behaviors induced by unpredictable chronic mild stress.

INTRODUCTION: Saffron, the dried stigmas of Crocus sativus L. is a famous and high-value agricultural product of Iran exclusively used for cooking purpose and well known to treat mood and cognition disorder with antioxidant and anti-inflammatory activities. However, the majority of medicinal properties of saffron are associated with its main component named Crocin. Several evidence-based studies confirmed the strong positive correlation between stress hormones, and depression. The main aim of the present study is to determine the potential antidepressant effects of crocin, saffron's constitute, in unpredictable chronic mild stress (UCMS) induced anxiety and depression in rats. MATERIALS AND METHODS: The rats were treated as 1) Vehicle with saline, 2) UCMS, 3-5) UCMS- Crocin 10, 20, and 30 mg/kg by oral gavage, 6) Vehicle with Crocin 30 mg/kg by oral gavage. Male Wistar Rats were subjected to UCMS for a total of 4 weeks. During 4 weeks, they received seven training trials. After behavioral tests, the rat brain sections were collected to examine inflammation and oxidative stress damage criteria. RESULTS: Serum corticosterone levels, cortical malondialdehyde (MDA), tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) levels were increased in rats exposed to UCMS, while UCMS decreased IL-10 superoxide dismutase (SOD), Catalase (CAT, and thiol. In addition, UCMS decreased brain-derived neurotrophic factor (BDNF) level in cortical tissues. Crocin improved the behaviors of the UCMS rats in the open field (OF, elevated plus maze (EPM), and forced swimming (FS) tests and reversed the effects of UCMS in all measured parameters. CONCLUSION: Crocin improved UCMS -induced anxiety and depression through decreasing brain oxidative stress, inflammatory mediators, and corticosterone serum levels.

Geographic Distribution of Active Medical Specialists in Iran: A Three-Source Capture-Recapture Analysis.

BACKGROUND: Estimation of health workforce supply becomes problematic when there is no knowledge about the number of active specialists. The aim of this study is to estimate active specialists and their geographic accessibility in Iran. METHODS: We enrolled all medical specialists from the Iranian Ministry of Health database (14151), national hospitals survey (28898) and Continuing Medical Education registries (13159) in 2015. Duplicate records across the three registries were identified based on the similarity of national ID codes and medical council codes. The number of active medical specialists was estimated by three-source capture-recapture method using Stata 12 software. RESULTS: A total of 33,416 specialists were identified from three sources. We estimated the number of specialists at 39127 (95% CI: 38823.6-39448.4) in 2015. Of these, 45.4% pertained to the province of Tehran while only less than 1.8% of specialists were in the provinces of Ilam (0.50%), South Khorasan (0.56%) and Kohgiloye and Boyerahmad (0.59%). The estimated ratio for specialists was 4.9 per 10000 population and ranged from 9.2 per 10000 in Tehran to 1.5 per 10000 population in Sistan and Balochestan. The overall completeness of data registries by three sources was 85.4%. CONCLUSION: The current distribution of specialists appears to be imbalanced. It is suggested to adopt appropriate policies to improve the distribution and maintenance of medical specialists in different parts of Iran.

The burden of road traffic injuries in the northeast of Iran: the result of a population-based registry.

BACKGROUND: Road traffic injuries (RTIs) are an important public health problem around the world, with the majority of RTIs occurring in low- and middle-income countries. This study aimed to determine disability-adjusted life years (DALY) of RTIs in the northeast of Iran. METHODS: In this cross-sectional study, we used the death registration system to calculate years of life lost (YLL) due to RTIs. To determine the years lost due to disability (YLD), hospital records of all people injured in road accidents were used. To estimate DALY, we used YLD and YLL to calculate DALY according to the Global Burden of Disease (GBD) 2003 guideline and the age/sex composition of the population was taken from the Statistical Centre of Iran (SCI) in 2016. All collected data entered into Excel software and performed calculations. RESULTS: Our findings showed that a total of 3403 RTIs and 132 deaths were recorded in 2016. The DALY was 38 per 1,000 of which 26.9 per 1,000 were related to YLL and 11.1 per 1,000 were related to YLD. The highest YLL rate in both sexes was in the 15-29 and 30-44 age groups with 49.8 per 1,000 and 46.0 per 1,000, respectively. This reflects a sex ratio of DALY in males (57.7 per 1,000) to females (8.6 per 1,000) was 6.7. CONCLUSIONS: It seems to be necessary, appropriate effective intervention programs and periodic evaluations are required regarding prevention and reducing traffic accidents mostly in middle-aged men.

Gestational diabetes mellitus in association with macrosomia in Iran: a meta-analysis.

PURPOSE: This meta-analysis aimed to estimate the association between gestational diabetes mellitus (GDM) and occurrence of macrosomia for the first time among Iranian population. METHODS: A systematic review was done of national and international databases. Lists of relevant articles were checked to increase sensitivity of the search reference. Also, access to unpublished articles and documents were accessed by negotiation with related individuals and research centers. These published epidemiological studies (cross-sectional, case-control and cohort studies) were used for comparisons to determine whether GDM was associated with macrosomia. Finally, the Mantel-Haenszel method and the fixed and random-effect models based on heterogeneity of the primary studies were used according to pool results and estimate the odds ratio of macrosomia in women with GDM. RESULTS: Of 1870 articles, thirty relevant articles were eligible for the current meta-analysis. Our findings showed that 335 of 2524 women with GDM had macrosomia while only 775 of 26,592 women without GDM had macrosomia. Using random-effect model, the pooled odds ratio (OR) relation between GDM and occurrence of macrosomia was estimated as of 5.49 (95% CI: 4.27-7.04). Subgroup analysis showed no difference regarding different study designs and definitions of macrosomia. There was no evidence of publication bias based on the result of Egger's test (ß = 0.1, P = 0.70). CONCLUSIONS: This meta-analysis shows that GDM is directly associated with the risk of macrosomia in the Iranian population. This confirms the findings of previous studies in the wider scientific literature.

Lipid Profile and Risk of Bone Fracture: A Systematic Review and Meta-Analysis of Observational Studies.

Purpose: Earlier studies have linked lipid profile to osteoporotic fractures; however, to our knowledge, no study had summarized available data on this relationship. We aimed to summarize the current evidence on the association between lipid profile and bone fractures. Material and Methods: A systematic search of PubMed and Scopus was done to find relevant published studies until March 2018. To combine effect sizes, we applied fixed- or random-effects analysis, where appropriate. Cochran's Q test and I2 were used to assess between-study heterogeneity. Results: Overall, 11 studies (seven prospective, three cross-sectional and one case-control studies) were included in the current systematic review. Out of them, 10 studies with a total sample size of 60,484 individuals, aged 25 years or more, were used in the meta-analysis. The results showed that total cholesterol concentration was positively associated with risk of bone fracture; such that a 50-mg/dl increase in plasma level of TC was associated with 15% greater odds of bone fracture (combined effect size: 1.15, 95% CI: 1.02-1.30, P = .02). Furthermore, we found that individuals with a decreased level of HDL (<40 mg/dl) had a lower risk of bone fracture compared with those with a normal level (≥40 mg/dl) (combined effect size: 0.82, 95% CI: 0.71-0.96, P = .01). No significant association was found between plasma level of TG and LDL with the risk of bone fractures either in prospective or cross-sectional studies. Conclusions: We found that plasma levels of total cholesterol were positively associated with bone fractures. In addition, decreased levels of HDL were associated with an increased risk of osteoporotic fractures. Abbreviations: TG: triglycerides, TC: total cholesterol, HDL: high-density lipoprotein, LDL: low-density lipoprotein, OR: odds ratio, RR: relative risk, HR: hazard ratio, DXA: dual-energy X-ray absorptiometry, ICD: International Classification of Diseases, SD: standard deviation.

Dietary total antioxidant capacity and risk of cancer: a systematic review and meta-analysis on observational studies.

BACKGROUND: Recent studies have shown that dietary total antioxidant capacity (D-TAC) may affect risk of cancer; however, findings are conflicting. Hence, we aimed to summarize the current evidence on the association between D-TAC and risk of cancer. METHODS: We searched the online databases of PubMed, ISI Web of Science, Scopus, ProQuest, Science Direct and Embase until October 2018 using relevant keywords. To pool data, fixed- or random-effects models were used where appropriate. RESULTS: In total, 19 studies including 8 prospective and 11 case-control studies with 721429 individuals and 16159 cases of cancer were included in the current systematic review and meta-analysis. Combining 15 effect sizes from 6 prospective and 8 case-control studies revealed a significant inverse association between D-TAC (obtained from ferric reducing antioxidant power (FRAP)) and risk of cancer (combined effect size: 0.86, 95% CI: 0.81-0.92, P < 0.001). Such inverse association was also seen for D-TAC obtained from other methods including trolox equivalence antioxidant capacity (TEAC) (combined effect size: 0.80, 95% CI: 0.70-0.90, P < 0.001), total radical trapping antioxidant parameter (TRAP) (combined effect size: 0.69, 95% CI: 0.62-0.78, P < 0.001) and oxygen radical absorbance capacity (ORAC) (combined effect size: 0.72, 95% CI: 0.52-1.00, P = 0.04). In addition, a significant non-linear association was found between D-TAC (based on FRAP and TRAP) and cancer risk (P-nonlinearity<0.001). Based on linear dose-response meta-analysis, a-10 mmol/day increase in FRAP and a-5 mmol/day increase in TRAP and TEAC were associated with 9%, 17% and 14% reduction in risk of cancer, respectively. Furthermore, D-TAC was inversely associated with risk of colorectal (combined effect size: 0.82, 95% CI: 0.75-0.89, P < 0.001), gastric (combined effect size: 0.63, 95% CI: 0.53-0.73, P < 0.001), and endometrial cancer (combined effect size: 0.78, 95% CI: 0.69-0.89, P < 0.001). CONCLUSIONS: Diet with high antioxidant capacity might have protective effects against cancer.

Dietary total antioxidant capacity and mortality from all causes, cardiovascular disease and cancer: a systematic review and dose-response meta-analysis of prospective cohort studies.

PURPOSE: No conclusive information is available about the association between dietary total antioxidant capacity (DTAC) and risk of mortality. Current meta-analysis of prospective cohort studies was done to summarize available findings on the association between DTAC and risk of death from all-cause, cancer and cardiovascular diseases (CVDs). METHODS: Online databases were searched to detect relevant publications up to January 2018, using relevant keywords. To pool data, either fixed-effects or random-effects model was used. Furthermore, linear and non-linear dose-response analyses were also done. RESULTS: In total, five prospective studies were included in the current systematic review and meta-analysis. In a follow-up period of 4.3-16.5 years, there were 38,449 deaths from all-cause, 4470 from cancer and 2841 from CVDs among 226,297 individuals. A significant inverse association was found between DTAC and all-cause mortality (combined effect size: 0.62, 95% CI 0.60-0.64). Such finding was also seen for cancer (combined effect size: 0.81, 95% CI 0.75-0.88) and CVD (combined effect size: 0.71, 95% CI 0.63-0.82) mortality. Findings from linear dose-response meta-analysis revealed that a 5 mmol/day increment in DTAC based on ferric reducing antioxidant power (FRAP) and oxygen radical absorbance capacity (ORAC) was associated with 7% and 15% lower risk of all-cause mortality, respectively. Based on findings from non-linear dose-response meta-analysis, a significant reduction in risk of all-cause mortality was seen when increasing FRAP from 2 to 12 mmol/day (P-nonlinearity = 0.002) and ORAC from 5 to 11 mmol/day (P-nonlinearity < 0.001). CONCLUSIONS: Adherence to diet with high total antioxidant capacity was associated with decreased risk of death from all-cause, cancer and CVDs.

Quetiapine versus Haloperidol in Controlling Conversion Disorder Symptoms; a Randomized Clinical Trial.

INTRODUCTION: About 5% of visits to emergency departments are made up of conversion disorder cases. This study was designed with the aim of comparing the effectiveness of quetiapine and haloperidol in controlling conversion disorder symptoms. METHODS: The present single-blind clinical trial has been performed on patients with conversion disorder (based on the DSM-IV definition) presenting to emergency department of 9-Day Hospital, Torbat Heydariyeh, Iran, from January 2017 until May 2018. RESULTS: 73 patients were allocated to haloperidol and 71 to quetiapine group. Mean age of these patients was 32.03 ± 12.80 years (62.50% female). Two groups were similar regarding the baseline characteristics. Within 30 minutes, 90.41% of haloperidol cases and 91.55% of quetiapine cases were relieved (p=0.812). The most common side effects after 30 minutes were extrapyramidal symptoms (9.59%) in the haloperidol group and fatigue and sleepiness (7.04%) in the quetiapine group. Extrapyramidal symptoms was significantly higher than the quetiapine group (p=0.013). CONCLUSION: The results of the present study showed that although quetiapine and haloperidol have a similar effect in relieving the patients from conversion disorder symptoms, the prevalence of extrapyramidal symptoms is significantly lower in the group under treatment with quetiapine. Therefore, it seems that quetiapine is a safer drug compared to haloperidol.

The effects of alpha-lipoic acid supplementation on glucose control and lipid profiles among patients with metabolic diseases: A systematic review and meta-analysis of randomized controlled trials.

OBJECTIVE: This systematic review and meta-analysis of randomized controlled trials (RCTs) was performed to summarize the effect of alpha-lipoic acid (ALA) supplementation on glycemic control and lipid profiles among patients with metabolic diseases. METHODS: We searched the following databases till October 2017: MEDLINE, EMBASE, Web of Science and Cochrane Central Register of Controlled Trials. The relevant data were extracted and assessed for quality of the studies according to the Cochrane risk of bias tool. Data were pooled using the inverse variance method and expressed as standardized mean difference (SMD) with 95% confidence intervals (95% CI). Heterogeneity between studies was assessed by the Cochran Q statistic and I-squared tests (I2). Twenty-four studies were included in the meta-analyses. RESULTS: The findings of this meta-analysis showed that ALA supplementation among patients with metabolic diseases significantly decreased fasting glucose (SMD -0.54; 95% CI, -0.89, -0.19; P = 0.003), insulin (SMD -1.01; 95% CI, -1.70, -0.31; P = 0.006), homeostasis model assessment of insulin resistance (SMD -0.76; 95% CI, -1.15, -0.36; P < 0.001) and hemoglobin A1c (SMD -1.22; 95% CI, -2.01, -0.44; P = 0.002), triglycerides (SMD -0.58; 95% CI, -1.00, -0.16; P = 0.006), total- (SMD -0.64; 95% CI, -1.01, -0.27; P = 0.001), low density lipoprotein-cholesterol (SMD -0.44; 95% CI, -0.76, -0.11; P = 0.008). We found no detrimental effect of ALA supplementation on high density lipoprotein-cholesterol (HDL-cholesterol) levels (SMD 0.57; 95% CI, -0.14, 1.29; P = 0.11). CONCLUSIONS: Overall, the current meta-analysis demonstrated that ALA administration may lead to an improvement in glucose homeostasis parameters and lipid profiles except HDL-cholesterol levels.

Risk-taking behaviors and subgrouping of suicide in Iran: A latent class analysis of national registries data.

Suicide is one the most important public health problem which is rapidly growing concerns. The aim of this study was to subgroup suicide using LCA method. This cross-sectional study was conducted in Iran based on 66990 records registered in Ministry of Health in 2014. A case report questionnaire in the form of software was used for case registries. Latent class analysis was used to achieve the research objectives. Four latent classes were identified; (a) Non-lethal attempters without a history of psychiatric disorders, (b) Non-lethal attempters with a history of psychiatric disorders, (c) Lethal attempters without a history of psychiatric disorders, (d) Lethal attempters with a history of psychiatric disorders. The probability of completed/an achieved suicide is high in lethal attempter classes. Being male increases the risk of inclusion in lethal attempters' classes (OR = 4.93). Also, being single (OR = 1.16), having an age lower than 25 years (OR = 1.14) and being a rural citizen (OR = 2.36) associate with lethal attempters classes. The males tend to use more violent methods and have more completed suicide. Majority of the individuals are non-lethal attempters who need to be addressed by implementing preventive interventions and mental support provision.

Estimation of iron deficiency anemia in Iranian children and adolescents: a systematic review and meta-analysis.

OBJECTIVES: Iron deficiency anemia (IDA) is a major health issue in those aged less than 18 years old with high impact on their development. There are several reports from Iran with variable results. Systematic review and met analysis of these data would reveal a more realistic view of the prevalence of iron deficiency (ID). METHODS: We conducted a systematic search of national and international databases from December 1990 to 31 January 2016 for population-based studies providing estimates on the prevalence of IDA in Iran. From the extracted crude prevalence rates, the heterogenic index of the studies was determined using the Cochran's test (Q) and I2. Then, based on the heterogenetic results, a random effects model for estimate pooled prevalence of IDA was used. Meta-regression was applied to determine heterogeneity suspected factors. RESULTS: The overall prevalence of IDA in Iranian population with age less than 18 years was estimated to be 13.9% (95% CI: 10.8-17.1) and the overall prevalence of ID was 26.9% (95% CI: 19.7-34.1). The prevalence of IDA was 7.9% (95% CI: 4.1-11.7) in males and 8.5% (95% CI: 6.1-10.8) among females aged under than 18 years. DISCUSSION: Despite the efforts of ministry of health and medical education of Iran in implementing free iron supplements for infants and for girls, the prevalence of ID and resultant anemia is considerable. Further interventions to increase use of supplements when they are provided and special programs for non-covered groups including boys under six are in great need.

Family history of diabetes and the risk of gestational diabetes mellitus in Iran: A systematic review and meta-analysis.

OBJECTIVE: Gestational diabetes is the most prevalent metabolic disorder being firstly diagnosed during pregnancy. The relationship between the family history of diabetes and the gestational diabetes mellitus (GDM) has been investigated in several primary studies with a number of contradictions in the results. Hence, the purpose of the present study is to determine the relationship between the GDM and the family history of diabetes using the meta-analysis method. METHOD: All published papers in main national and international databases were systematically searched with some specific keywords to find the related studies between 2000 and 2016. We calculated the odds ratio (OR) with 95% confidence interval (CI) in analysis for each study using a random-effect and Mantel-Haenzel method. We also determined heterogeneity among these 33 articles and their publication bias. RESULTS: We entered 33 relevant studies of 2516 articles into the meta-analysis process including 2697 women with family history of diabetes mellitus as well as 29134 women without. Of them, 954 and 4372 subjects developed GDM respectively. Combining the results of the primary studies using the meta-analysis method, the overall odds ratio of family history for developing GDM was estimated as of 3.46 (95% CI: 2.80-4.27). CONCLUSION: This meta-analysis study revealed that the family history of diabetes is an important risk factor for the gestational diabetes mellitus.

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.

Estimating the Completeness of Lung Cancer Registry in Ardabil, Iran with a Three-Source Capture-Recapture Method.

Cancer registration is an important component of a comprehensive cancer control program, providing timely data and information for research and administrative use. Capture-recapture methods have been used as tools to investigate completeness of cancer registry data. This study aimed to estimate the completeness of lung cancer cases registered in Ardabil Population Based Cancer Registry (APBCR) with a three-source capture-recapture method. Data for all new cases of lung cancer reported by three sources (pathology reports, death certificates, and medical records) to APBCR for 2006 and 2008 were obtained. Duplicate cases shared among the three sources were identified based on similarity of first name, last name and father's names. A log-linear model was used to estimate number of missed cases and to control for dependency among sources. A total of 218 new cases of lung cancer was reported by three sources after removing duplicates. The estimated completeness calculated by log-linear method was 26.4 for 2006 and 27.1 for 2008. The completeness differed according to gender. In men, the completeness was 26.0% for 2006 and 28.1 for 2008. In women, the completeness was 36.5% for 2006 and 46.9 for 2008. In conclusion, none of the three sources can be considered as a reliable source for accurate cancer incidence estimation.