Cancer in Iran 2008 to 2025: Recent incidence trends and short-term predictions of the future burden.

Policymakers require estimates of the future number of cancer patients in order to allocate finite resources to cancer prevention, treatment and palliative care. We examine recent cancer incidence trends in Iran and present predicted incidence rates and new cases for the entire country for the year 2025. We developed a method for approximating population-based incidence from the pathology-based data series available nationally for the years 2008 to 2013, and augmented this with data from the Iranian National Population-based Cancer Registry (INPCR) for the years 2014 to 2016. We fitted time-linear age-period models to the recent incidence trends to quantify the future cancer incidence burden to the year 2025, delineating the contribution of changes due to risk and those due to demographic change. The number of new cancer cases is predicted to increase in Iran from 112 000 recorded cases in 2016 to an estimated 160 000 in 2025, a 42.6% increase, of which 13.9% and 28.7% were attributed to changes in risk and population structure, respectively. In terms of specific cancers, the greatest increases in cases are predicted for thyroid (113.8%), prostate (66.7%), female breast (63.0%) and colorectal cancer (54.1%). Breast, colorectal and stomach cancers were the most common cancers in Iran in 2016 and are predicted to remain the leading cancers nationally in 2025. The increasing trends in incidence of most common cancers in Iran reinforce the need for the tailored design and implementation of effective national cancer control programs across the country.

An updated systematic review and Meta-analysis of the prevalence of type 2 diabetes in Iran, 1996-2023.

Background: Diabetes mellitus (DM) poses a significant threat to public health, and the anticipated surge of over 100% in the age-standardized prevalence of type 2 diabetes in Iran between 2021 and 2050 underscores the pressing need for focused attention. The rationale for estimating the prevalence of type 2 diabetes in Iran becomes even more compelling when considering the potential cascading effects on the healthcare system, quality of life, and economic burden. The aim of this study was to estimate the prevalence and trends of DM from 1996 to 2023 in the Islamic Republic of Iran. Methods: Up to July 2023, without deadlines, the search for appropriate articles in Persian and English. Iranian sources including SID, Magiran, and Element were included in the databases, along with foreign ones like PubMed/MEDLINE, Web of Science, Science Direct, Embase, Scopus, ProQuest, and Google Scholar. Using the JBI quality checklist, the study's level of quality was evaluated. Version 14 of STATA was used to carry out the statistical analysis. The Dersimonian and Liard random-effects models were used because of heterogeneity. To investigate the causes of heterogeneity, subgroup analysis and univariate meta-regression were utilized. Sensitivity analysis was then carried out to see how each study's findings affected the final findings. The prevalence pattern over time was also followed using cumulative meta-analysis. Results: There were 53 studies in all, with a combined sample size of 1,244,896 people. Men were predicted to have a type 2 diabetes prevalence of 10.80% (95% CI: 9.1-12.4), while women were assessed to have a prevalence of 13.4% (95% CI: 11.6-15.3). Additionally, the prevalence of diabetes was much higher in the 55-64 age group, coming in at 21.7% (95% CI: 17.5-25.0). The anticipated prevalence of diabetes was 7.08% for 1988 to 2002, 9.05% for 2003 to 2007, 9.14% for 2008 to 2012, 15.0% for 2013 to 2017, and 13.40% for 2018 to 2023, among other time periods. Geographically, type 2 diabetes was most prevalent in Khuzestan (15.3%), followed by Razavi Khorasan (14.4%), Qazvin (14.3%), and Yazd (12.6%). Conclusion: The prevalence of type 2 diabetes was estimated at 10.8%, highlighting variations across gender, age groups, and geographic regions that underscore the necessity for specific interventions. These findings advocate for proactive measures, including tailored screening and lifestyle modification programs. The notable temporal increase from 2013 to 2017 signals the need for policymakers and healthcare practitioners to develop effective strategies, anticipating and addressing the potential future burden on the healthcare system. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023437506, identifier: CRD42023437506.

Epidemiology of cervical cancer in Iran in 2016: A nationwide study of incidence and regional variation.

BACKGROUND: Cervical cancer is a common, and fatal cancer in women worldwide. This cancer is the fourth most common cancer in women after breast, colorectal, and lung cancer. AIMS: This study aims to investigate the age-standardized incidence rate (ASR) and the geographical distribution of Cervical Cancer in Iran. METHODS: This study was designed as a descriptive cross-sectional investigation. The study sample comprised all individuals registered as cervical cancer patients in the National Cancer Registry system in 2016. The crude rate and ASR for each province were computed independently. Furthermore, we employed ArcMap10.5 software and geographic information system to conduct an analysis of the gathered data. In order to ascertain the spatial distribution and clustering of cervical cancer incidence, we utilized Moran's I, which measures spatial autocorrelation. RESULTS: We studied a total of 808 cases of cervical cancer with a median age to be 52.19 years (IQR≈1.35). Among these cases, 685 (84.7%) were diagnosed based on the pathological reports with morphological verification, while 81 patients (10.1%) were clinically identified, and 42 cases (5.2%) were diagnosed using the death certificate-only method. Squamous cell carcinoma accounted for 61% of all cases (n = 497). The ASR of cervical cancer in Iran was 1.90 per 100 000 populations. The provincial ASR ranged from 0.29 to 5.03 per 100 000, with the highest rates observed in Golestan (5.03), East Azerbaijan (4.07), and Ilam (3.72). We found no clustering patterns in the distribution of provincial crude, age-specific, and age-standardized incidence rates (p > .05). CONCLUSION: The incidence of cervical cancer in Iran was lower than the global average, and we did not identify any significant disparities in the incidence rates among the provinces. Although there were differences in incidence rates among the areas, these were not clustered. It is crucial to remember that cervical cancer is still a major public health issue in Iran, and in order to lessen the disease's burden, national initiatives to enhance screening, early identification, and access to efficient treatment should continue to be top priorities.

Comparing the Frequency of Some Oral Lesions in Prediabetic and Healthy Individuals: Is There Any Difference?

BACKGROUND: Diagnosis of prediabetic stage is very important for prevention of diabetes and complications. This stage may be associated with some oral lesions. Only a few studies are available on the oral status of prediabetic patients and incidence of oral lesions in this population. This study aimed to compare some oral complications between prediabetic and healthy control groups. METHODS: The present two-group cross-sectional study was carried out on 302 prediabetic and non-diabetic (healthy) 20- to 60-year-old subjects. In this study, data on age, gender, educational level, medications use, smoking, and some other variables were extracted through history taking. In addition, orodental examination was carried out by an oral medicine specialist to diagnose oral lesions including candidiasis, lichen planus, periodontitis, gingivitis, xerostomia, delayed wound healing, geographic tongue, fissured tongue, and burning mouth sensation. Data entry and analysis was performed by SPSS version 22 software, and P value and odds ratio (OR) were calculated to show statistical relationship between variables. RESULTS: The most common oral lesion in prediabetic subjects was periodontitis (27.2%), followed by gingivitis (14.7%) and xerostomia (11.3%). In the control group, gingivitis (20.5%) followed by periodontitis (11.3%) are common oral lesions. Candidiasis (P = 0.036), periodontitis (P < 0.001), and xerostomia (P < 0.001) in prediabetic subjects were higher than control group that is statistically significant. Regression analysis showed that in the prediabetic group, periodontitis [OR = 2.91, confidence interval (CI): 1.54-5.49] and xerostomia (OR = 18.51, CI = 2.42-141.45) were significantly more prevalent than healthy subjects. CONCLUSION: Based on the results, glucose intolerance stage exhibited a significantly higher oral problems such as periodontitis and xerostomia than healthy euglycemic stage.

Cancer incidence in Iran in 2014: Results of the Iranian National Population-based Cancer Registry.

BACKGROUND: We aimed to report, for the first time, the results of the Iranian National Population-based Cancer Registry (INPCR) for the year 2014. METHODS: Total population of Iran in 2014 was 76,639,000. The INPCR covered 30 out of 31 provinces (98% of total population). It registered only cases diagnosed with malignant new primary tumors. The main sources for data collection included pathology center, hospitals as well as death registries. Quality assessment and analysis of data were performed by CanReg-5 software. Age standardized incidence rates (ASR) (per 100,000) were reported at national and subnational levels. RESULTS: Overall, 112,131 new cancer cases were registered in INPCR in 2014, of which 60,469 (53.9%) were male. The diagnosis of cancer was made by microscopic confirmation in 76,568 cases (68.28%). The ASRs of all cancers were 177.44 and 141.18 in male and female, respectively. Cancers of the stomach (ASR = 21.24), prostate (18.41) and colorectum (16.57) were the most common cancers in men and the top three cancers in women were malignancies of breast (34.53), colorectum (11.86) and stomach (9.44). The ASR of cervix uteri cancer in women was 1.78. Our findings suggested high incidence of cancers of the esophagus, stomach and lung in North/ North West of Iran. CONCLUSION: Our results showed that Iran is a medium-risk area for incidence of cancers. We found differences in the most common cancers in Iran comparing to those reported for the World. Our results also suggested geographical diversities in incidence rates of cancers in different subdivisions of Iran.

Using Routine Data to Categorize Poor Control Diabetic Patients: An Application of Cluster Analysis Technique.

BACKGROUND: Diabetes mellitus is one of the most important causes of morbidity and mortality all over the world. Chronic high blood glucose is the root cause of developing future micro and macro vascular complications. In current study, we analyzed poorly controlled patients' information by clustering method in order to find more homogenous sub-groups of patients for planning for further interventions. METHODS: This study was conducted based on medical records of diabetic patients admitted to 23 health care centers in four cities of Iran from 2010 to 2014. Demographic data and physical and biochemical measurements were extracted and analyzed using two-steps cluster analysis method. RESULTS: Three distinct clusters were derived from 2087 eligible cases. Cluster 1 totally consisted of men without any apparent risk factors. Members of clusters 2 and 3 were illiterate women with obesity. Dyslipidemia was a prominent characteristic in members of cluster 2. CONCLUSION: Masculinity would play the main role in diabetes control. Meanwhile, aggregation of obesity, illiteracy and/or dyslipidemia in diabetic women predispose them to poor control condition. Based on these findings, we will be able to plan interventions that are more appropriate for identified groups.

Population attributable fraction of modifiable risk factors for Alzheimer disease: A systematic review of systematic reviews.

BACKGROUND: Alzheimer's disease (AD) is the most common type of dementia. Demonstrating the modifiable risk factors of AD can help to plan for prevention of this disease. The aim of the current review was to characterize modifiable cardiovascular risk factors of AD using existing data and determine their contribution in AD development in Iran and the world. METHODS: The systematic search was done in Medline, Scopus, and Cochrane databases from inception to May 2014 to find systematic reviews or meta-analyses about association between AD and cardiovascular modifiable risk factors included diabetes, hypertension (HTN), physical inactivity, smoking, hypercholesterolemia, and overweight and obesity. The population attributable fraction (PAF) was calculated for these risk factors in Iran and the world. RESULTS: Of 2651 articles, 11 were eligible for data extraction after assessing relevancy and quality. Diabetes mellitus (DM) type 2, smoking, physical inactivity, overweight and obesity were significantly associated with increased risk of AD. Physical inactivity with 22.0% and smoking with 15.7% had the highest PAF for AD in Iran and the world, respectively. CONCLUSION: Our findings demonstrated that modifiable cardiovascular risk factors could increase the risk of AD. Moreover, about one-third of AD cases were attributed to five modifiable risk factors.

Perceived risk of exposure to indoor residential radon and its relationship to willingness to test among health care providers in Tehran.

BACKGROUND: Radon exposure is the second cause of lung cancer after exposure to tobacco smoke and the first cause in nonsmokers. The purpose of this study was to assess perceived risk of exposure to indoor residential radon among health care providers in urban and rural health centers affiliated to Tehran University of Medical Sciences. METHOD: In 2012-2013, a survey was carried out on 462 health care providers to assess their awareness and risk perception about exposure to indoor residential radon. Only subjects who had previously heard about radon were asked to answer knowledge-based and risk perception questions and report source of knowledge, willingness to test and willingness to pay for radon test kits. RESULTS: About 67% of responders had heard about radon before this study and of these, 83.5 % recognized it as being hazardous and 34.5 % identified lung cancer as the main health outcome of exposure to radon. Overall, 33% of 310 subjects had knowledgeable awareness. Seventy percent of responders who had previously heard about radon, had high perceived risk and they were more willing to test their houses and more willing to pay for radon test kits. CONCLUSION: Having knowledge about radon and perceiving it as a risk had a significant association with willing to take relevant health related behaviors. Furthermore, risk perception contributes to willing to spend more money when health is a concern. Education of health care providers seems to be a pre-requisite to public campaigns on radon awareness and testing.