Cancer incidence in Golestan province: Report of an ongoing population-based cancer registry in Iran between 2004 and 2008

Background: Golestan Province, at the western end of the Asian esophageal cancer (EC) belt in northeastern Iran, was reported to have one of the highest worldwide rates of EC in the 1970s. We have previously shown a declining incidence of EC in Golestan during the last decades. This study reports additional new results from the Golestan Population-based Cancer Registry (GPCR). Methods: The GPCR collected data from newly diagnosed (incident) cancer cases from all 68 public and private diagnostic and therapeutic centers in Golestan Province. CanReg-4 software was used for data entry and analysis based on the guidelines of the International Agency for Research on Cancer (IARC). Age-standardized incidence rates (ASR) of cancers were calculated using the 2000 world standard population. Results: From 2004 through 2008, 9007 new cancer cases were reported to the GPCR. The mean (SD) age was 55.5 (18.6) years, and 54 were diagnosed in men. The ASRs of all cancers were 175.3 and 141.1 per 100,000 person-years for males and females, respectively. Cancers of the stomach (ASR:30.7), esophagus (24.3), and lung (15.4) were the most common cancers in males. In females, breast cancer (ASR:26.9) was followed by malignancies of the esophagus (19.1) and stomach (12.4). The diagnosis of cancer was based on histopatho- logical reports in 71 and on death certificate only in 9 ofcases. Conclusions: The EC incidence rate continues to decline in Golestan, while the incidence rates of stomach, colorectal, and breast cancers continue to increase

Five-year trend in hydrogenated vegetable oil consumption among Northern Iranian families

Background: The main aim of this study was to assess the trends in hydrogenated vegetable oil (HVO) consumption and some related factors among northern Iranian families from 2006 to 2010. Methods: A cross-sectional, population-based study was conducted with 6497 subjects, 15 to 65 years old, who were chosen by multistage cluster random sampling. The subjects were randomly chosen by 325 clusters with an equal size (n = 20 subjects). A multidimensional questionnaire including so-ciodemographic questions and type of cooking oil used were administered by interviewers. Results: The percentages of the sample reporting HVO consumption across the 5 years are as follows: 2006,85.2%; 2007, 79.7%; 2008, 75.9%; 2009, 59.3%; and 2010, 55.7%. Consumption decreased 29.5% during the 5 years of study and an average of 5.9% per year (P < .05). The estimated odds ratio of HVO consumption in rural areas verus urban areas was 2.59 (95% confidence interval [CI], 2.31-2.90); for poor compared with good economic level the odds ratio was 3.99 (95% CI, 3.13-5.10 for; for the uneducated versus college-educated sample it was 5.75 (95% CI, 4.10-8.17); and the odds ratio was 3.34(95% CI, 2.51-4.45) for Sisstani compared with Fars-native ethnic group. Conclusion: HVO consumption decreased during the 5-year study (2006 to 2010), but HVO is still used extensively in northern Iran. Preventive early intervention strategies are needed to target uneducated and poor families, with an emphasis on the Sisstanish ethnic group, to increase awareness about the negative consequences of HVO consumption

Healthcare utilization in patients with esophageal cancer in a high risk area in northeast of Iran

Introduction: Golestan, a province located north of Persian Gulf in northeastern part of Iran is a well known area for high risk of esophageal cancer (EC) in the world. There is no information about healthcare utilization in populations residing in the area. This study was conducted to assess utilization of healthcare and its associated factors among esophageal cancer patients in this region as well as to address ethical implication of this utilization. Methods: All new cases of EC in Golestan province during year of 2007 were recruited. Seven diagnostic and five therapeutic services were used to assess diagnostic utilization index (DUI), and therapeutic utilization index (TUI), respectively. Multivariate regression analysis was used to assess the relationship between variables and DUI or TUI. P-value of less than 0.05 was considered as statistically significant. Results: Tow hundred twenty three, patients were enrolled with mean (Standard Deviation) age of 64.3 (12.5) years with 57.8% male. We observed that occupation (P<0.01), ethnicity (P<0.01) and sex (P=0.03) were strongly associated with DUI. Insurance coverage (P<0.01), place of residency (P<0.01), and occupation (P=0.01) were associated with TUI. Conclusion: We concluded that several factors contribute to disparity in healthcare utilization in the studied population

Epidemiology of female reproductive cancers in Iran: Results of the gholestan population-based cancer registry

Background: Malignancies of the female reproductive tract are estimated to be the third most common group of cancers in women. Objectives: We here aimed to present their epidemiological features in Golestan provincelocated in Northeast of Iran. Materials and Methods: Data on primary female reproductive cancers diagnosed between 2004-2010 were obtained from Golestan Population-based Cancer Registry (GPCR). CanReg-4 and SPSS software were used for data entry and analysis. Age standardized incidence rates (ASR) (per 100,000 person-years) were calculated using the world standard population. Poisson regression analysis was used to compare incidence rates. P-values of less than 0.05 were considered as significant. Results: A total of 6,064 cancer cases were registered in Golestan females in the GPCR during 2004-2010, of which 652 cases (11%) were female reproductive cancers. Cancers of the ovary (ASR=6.03) and cervix (ASR=4.97) were the most common. We found significant higher rates in females living in cities than in villages. Our results showed a rapid increase in age specific incidence rates of female reproductive cancers at the age of 30 years. Conclusions: We found significant higher rates of female reproductive cancers among residents of cities than villages. Differences in the prevalence of risk factors including reproductive behavior between the two populations may partly explain such diversity. Our results also showed a rapid increase in incidence rates of these cancers in young age females. Further studies are warranted to determine risk factors of female reproductive cancers in our population

The trend of seat belt use among drivers in the north of Iran, 2007-2010: An epidemiologic study

Backgrounds and Objectives: Using seat belt has a considerable role in reducing human damage. The aim of this study was to compare trend of seat belt use rate during 4 years, from 2007 to 2010, in Golestan province (northern Iran). Materials and Methods: This was a population-based cross-sectional study that enrolled 3999 subjects aged 15-65 years during four years (2007 = 1000 cases, 2008 = 1000 cases, 2009 = 999 cases and 2010= 1000 cases) using stratified cluster sampling. Interviewers recorded the data using a multidimensional questionnaire including anthropometric indexes. Using seat belt in the case of sitting in the front seat of car (as a driver or passenger) of all samples was asked. SPSS 16.0 software was used for statistical data analysis. Results: The rate of seat belt use in the years 2007, 2008, 2009 and 2010 were 71%, 69.8%, 74.5 and 86.4%, respectively. Seat belt use during the four years increased up to 15.4%. Statistical differences among four years was significant (P<0.01). The increasing seat belt use rate was 19% and 14.9% in urban and rural areas, respectively. The seat belt use rate was higher in subjects with =35 years old people in proportion to 35= years old people (17.85% versus 14.3%). During the latest year of study, using seat belt was about 14.8% higher in men comparing with women (P<0.05). Conclusion: Using seat belt increased up to 3.9% per year and the trend in the rural areas was lower than in the urban areas. Seat belt used in men more than women. Using seat belt and its growing trend, will help in reducing mortality caused by accidents in Iran. © IDOSI Publications, 2012

The association of fasting blood glucose (FBG) and waist circumference in northern adults in Iran: A population based study

Objectives: The aim of this study was to evaluate the association between Fasting Blood Glucose (FBG) level and Waist Circumference (WC) in men and women among 25-65 years old people in the north of Iran.Material and methods: This was a cross-sectional and analytical research gender that carried out on the 1797 subjects (941 males and 856 females) between 25-65 years old using multistage cluster sampling technique. FBG was measured in the morning after a 12-hour fast and was determined by using laboratory kits (enzymatic methods) and spectrophotometry technique. Central obesity was defined based on World Health Organization criteria: waist circumference ≥102 cm and ≥88 cm in men and women, respectively. The SPSS.16 software was used for statistical analysis.Results: As whole, the mean of FBG in women (98.3 ± 40.1 mg/dl) was higher than in men (94.6 ± 32.2 mg/dl). Also, the mean of WC in men 4.5 cm was lower than in women. In men, the mean of FBG statistically differs between normal and central obese subjects both in 35-45 year-age group (P = 0.001) and in 45-55 year-age group (P = 0.042). As whole, in men, the FBG level increased up 2.82 mg/dl in each 10 cm of WC with the highest rate in 35-45 year-age group. In totally, in women, the FBG level increased up 3.48 mg/dl in each 10 cm of WC and in 25-35 year-age group and it was higher than in other age groups. In men, the regression coefficients were constant with age increasing while in women it was decreased. Constant trend in men and decreasing trend in women with age was shown between FBG and WC. The cut-off point of WC for detecting of diabetes obtained 89 cm and 107 cm in men and women, respectively.Conclusion: The positive correlation was seen between WC and FBG level and it was declined with age in women. Cut-off point for detecting of diabetes in men was less than in women. WC is useable as a predictor of type 2 diabetes mellitus risk among adults in the north of Iran. © 2014 Veghari et al.; licensee BioMed Central Ltd

Esophagus cancer incidence among females in Golestan Province, Iran (2004)

The main aim of this study was to find and describe province-specific estimates of incidence in females by age groups for esophagus cancer. The data used in this study were collected in a cancer registry that was conducted by Health Deputy of Golestan province for a period of 1 year (2004). The age distribution was collected according to the following age strata: 0-4, 5-9, 10-14, 15-19, 20-24, 25-29, 30-34, 35-39, 40-44, 45-49, 50-54, 55-59, 60-64, 65-69, 70-74, 75-79, 80-84 and 85 above. Esophagus cancer data was identified and collected through the 18 Pathology Laboratory centers (where female populations referred to these centers) in Golestan province. A total of 348 primary cancer cases were captured. From these 32 cases was esophagus cancer. There were 26 squomous cell carcinoma (81.25%), 1 adenocarcinoma (3.12%). Esophagus cancer incidence among females in Golestan province was 7.62/100000. But esophagus cancer with the highest ASR: 127.91/100,000 was in age 75-79. The incidence of esophagus cancer in age over 75-79 has risen sharply and it was the lowest in age 30-34 (ASR: 1.68/100,000). For the present time it can be said that esophagus cancer in females appear to be one of the most prevalent and serious type of cancer (especially squomous cell carcinoma) in Golestan province and esophagus cancer is rising with ageing

Determinants of healthcare utilisation and predictors of outcome in colorectal cancer patients from Northern Iran

We aimed to assess healthcare utilisation (HU), its determinants, as well as its relationship with survival in colorectal cancer (CRC) patients. This study was conducted on incident CRC cases from Northern Iran. Information on HU was collected using a valid questionnaire, considering eight diagnostic and four therapeutic services. The results were categorised as good and poor HU. Multivariate logistic regression analysis was used to assess the relationship between HU and other variables. Cox regression analysis was performed to determine major predictors of survival. In total, 227 new cases of CRC were enrolled. HU could be assessed in 218 subjects (96). Living in rural areas was the strongest variable related to poor HU (adjusted OR, odds ratio=2.65; CI, confidence interval: 1.30-5.40). The median survival time was 40.5months. The 1-, 3- and 5-year survival rates were 71, 52 and 44 respectively. Cox regression analysis showed a significant lower survival rate in patients with poor HU (HR=2.3; CI: 1.46-3.64). HU was an independent predictor of survival in our CRC patients. Patients' place of residence was a significant determinant of HU. Regarding its effects on patients' outcome, HU and its determinants should be considered in designing CRC controlling programmes in our region and similar high-risk populations. © 2016 John Wiley & Sons Ltd