Trend Analysis of Gastrointestinal Cancer Incidences in Guilan Province: Comparing Rates over 15 Years

Atrkar-Roushan, Zahra,Kazemnejad, Anoshirvan,Mansour-Ghanaei, Fariborz,Zayeri, Farid Asian Pacific Journal of Cancer Prevention 2013 Asian Pacific journal of cancer prevention Vol.14 No.12

Background: Cancers of gastric and esophagus are the most frequent gastrointestinal (GI) tract cancers in Iran. This study aimed to analyze time trends of GI tract cancers in Guilan province by gender and age to provide solid scientific evidence for cancer prevention and control. Materials and Methods: The data were obtained from the Guilan Cancer Registry System and Guilan Provincial Health Center, over the 15 year period between 1997 and 2011. Crude incidence and age standardized (AS)incidence rates were calculated and annual percent change was estimated by Joinpoint software for long term trend analysis. Results: During the study period, 8,332 cases of GI malignances with a male to female ratio of 1:1.73 were registered in Guilan province. The AS rates for esophageal, gastric, colon and rectal cancers were 5.97, 14.5, 7.59 and 3.58 per 105 respectively. While the trend was declining and relatively constant for esophageal and gastric cancer, respectively, the incidence trend for colon and rectal cancers was of increase over the period of the study. Conclusions: The results indicated that the incidence of GI cancers was relatively low in Guilan province compared to neighboring provinces. An effective cancer control program including prevention measures, early detection and effective treatment needs to be implemented to reduce cancer morbidity and mortality.

The Investigation of Risk Factors Impacting Breast Cancer in Guilan Province

Joukar, Farahnaz,Ahmadnia, Zahra,Atrkar-Roushan, Zahra,Hasavari, Farideh,Rahimi, Abbas Asian Pacific Journal of Cancer Prevention 2016 Asian Pacific journal of cancer prevention Vol.17 No.10

Introduction: Breast cancer is multifactorial therefore more recognition of risk factors is important in its prevention. Objective: This study was conducted in order to determine the factors influencing breast cancer in women referred to health centers in Guilan province in 2015-2016. Method: In a case- control study, 225 women with breast cancer were investigated. The control group consisted of 225 healthy women of the relatives (third-rank) whose phone numbers were obtained from the patients. Data were collected through telephone interviews. Results: The risk of breast cancer raised in women who have a family history of other cancers (OR= 3.5; 95% CI= 1.96-6.6), exposure to X-Ray (OR= 2.5; 95% CI=1.1-5.5), having more than 4 children (OR= 2.695% CI=1.2-4.8), age more than 36 years at first pregnancy(OR=2.3; 95% CI=0.7-5.1),primary levelof education (OR= 5.4;95% CI=2.8-11.2) and inadequate intake of fruit (OR=1.5; 95% CI=1-2.2). Also, presence of the following factors reduced breast cancer risk: regular menstruation (OR= 0.66; CI=0.4-0.9), duration of breastfeeding more than 12 months, less than 6 months and 7-12 months (OR=0.23; 95% CI=0.09-0.59, OR=0.29; 95% CI=0.17-0.49 and OR=0.03; 95% CI=0.01-0.08) and parity (OR=0.4; 95% CI=0.27-0.83) In multiple linear regression analysis of higher education (OR=0.16; 95% CI=0.03-0.77), using contraceptives for more than 16 years (OR=2.3; 95% CI=1.4-3.9), family history of other cancers (OR=6.1; 95% CI=1.9-19.3) and a history of X-Ray exposure (OR=4.4; 95% CI=1.07-18.1) were considered as predictive factors. Conclusion: The results of this study emphasize the importance of informing women about breast cancer risk factors. So, identification of these risk factors is required as important means of prevention and treatment of breast cancer.

The Associations between Meat Group Consumption and Acute Myocardial Infarction Risks in an Iranian Population: a Case-Control Study

Zeinab Poursafar,Farahnaz Joukar,Farideh Hasavari,Zahra Atrkar Roushan 한국임상영양학회 2019 Clinical Nutrition Research Vol.8 No.2

Acute myocardial infraction (AMI) is a highly frequent cause of mortality and disability around the world. The aim of the present study was to evaluate the associations between meat group intake levels and AMI risks in an adult Iranian population. This case-control study was conducted on 200 first AMI cases and 200 healthy individuals matched by age, sex, and body mass index. A Food Frequency Questionnaire validated for Iranian populations was used to assess usual dietary intake levels over the previous year. Data was extracted regarding the meat group—including meat (red and processed), fish, poultry, eggs, nuts, and legumes. The associations between meat group items and AMI were calculated by multivariable logistic regression. Red meat consumption was significantly positively associated with increased risk of AMI. After adjustment for potential confounders, a positive association was found between higher frequency of processed and red meat intake, and increased risk of AMI (processed meat consumption: odds ratio [OR], 1.71; 95% confidence interval [CI], 1.31–2.23 and red meat consumption: OR, 2.51; 95% CI, 1.84–5.11). In addition, the results indicated an inverse association between the frequency of nuts consumption and AMI (OR, 0.52; 95% CI, 0.31–0.92). There were no associations seen between poultry, fish, eggs and beans intake levels, and the odds of AMI. The current study suggested a direct association between the frequency of processed/red meat consumption and increased AMI risks. In addition, an inverse relation was observed between frequency of nuts consumption and the risks of AMI.

Dietary Patterns and Risk of Breast Cancer in Women in Guilan Province, Iran

Ahmadnia, Zahra,Joukar, Farahnaz,Hasavari, Farideh,Roushan, Zahra Atrkar,Khalili, Malahat Asian Pacific Journal of Cancer Prevention 2016 Asian Pacific journal of cancer prevention Vol.17 No.4

Background: Several studies have pointed to roles of dietary and food groups in the pathogenesis of breast cancer, but information on dietary patterns among women with breast cancer and their healthy counterparts in Iran is limited. Therefore the present investigation was conducted in Guilan province in 2014-2015. Materials and Methods: In a case-control study, 450 women with breast cancer and one of their relatives (third-rank) were investigated. At first the phone numbers of patients in Razi Hospital in radiotherapy and chemotherapy and oncology centers of Guilan were taken. Data were collected through telephone interviews by the researcher. The questionnaire had two parts comprising demographic clinical and food frequency data including a list of 40 food items. To analyze the variables, Chi-square test and univariate logistic regression models were used. Results: In each group, 225 subjects were investigated. The majority of samples in both groups of experiment and control were consumed than two glasses of milk and dairy products per day. Regarding consumption of meat and its products, 56% of the cancer group had more than three servings per day while 26.7% of the control group had less than 2 servings per day. The majority of subjects had less than six servings of cereal per day. Some 54. 7 % of the cancer and 62.2 % of the control group consumed less than two servings of fruit per day. Consumption of vegetables in experimental and control groups were 52.9% and 76.9% respectively, more than five servings per day. There was a meaningful difference between two groups regarding the consumption of milk and dairy items (OR=0.6,95%CI= 0.4-0.9), meat and its products (OR=0.49,95%CI=0.3-0.7), bread and cereals (OR=0.4,95%CI=0.2-0.8), vegetables (OR=0.5,95%CI= 0.3-0.9). (P-value<0.05). Conclusions: The results of this study emphasize the importance of informing women, particularly those at higher risk of breast cancer, in relation to dietary factors.

Strongyloides stercoralis and other intestinal parasites in patients receiving immunosuppressive drugs in northern Iran: a closer look at risk factors

Leila Mirzaei,Keyhan Ashrafi,Zahra Atrkar Roushan,Mohammad Reza Mahmoudi,Irandokht Shenavar Masooleh,Behnaz Rahmati,Farshid Saadat,Hamed Mirjalali,Meysam Sharifdini 한국역학회 2021 Epidemiology and Health Vol.43 No.-

OBJECTIVES: The objective of this study was to evaluate the prevalence of Strongyloides stercoralis and other intestinal parasites in patients receiving immunosuppressive drugs in northern Iran and to investigate related risk factors. METHODS: This cross-sectional study was conducted among 494 patients receiving immunosuppressive drugs, including cancer patients undergoing chemotherapy (n=188) and those treated with prolonged corticosteroid administration (n=306). All fresh fecal samples were examined using the direct wet-mount, formalin ethyl acetate concentration, and agar plate culture techniques. RESULTS: In total, 16.8% of patients were positive for at least 1 intestinal parasite; the helminthic and protozoan infection rates were 5.1% and 12.3%, respectively. The infection rate was significantly higher in corticosteroid-treated individuals (19.6%) than cancer patients (12.2%) (p<0.05). The prevalence rate of S. stercoralis among patients receiving chemotherapy and those treated with corticosteroids were 4.3% and 5.2%, respectively. The prevalence rate of S. stercoralis infection was significantly higher in older patients (p<0.05). CONCLUSIONS: Strongyloidiasis is one of the most common parasites among patients receiving immunosuppressive drugs in northern Iran. Early diagnosis and proper treatment of these patients are necessary to minimize the complications of severe strongyloidiasis.

A comparative study of metal artifacts from common metal orthodontic brackets in magnetic resonance imaging

Kajan, Zahra Dalili,Khademi, Jalil,Alizadeh, Ahmad,Hemmaty, Yasamin Babaei,Roushan, Zahra Atrkar Korean Academy of Oral and Maxillofacial Radiology 2015 Imaging Science in Dentistry Vol.46 No.1

Purpose: This study was performed to compare the metal artifacts from common metal orthodontic brackets in magnetic resonance imaging. Material and Methods: A dry mandible with 12 intact premolars was prepared, and was scanned ten times with various types of brackets: American, 3M, Dentaurum, and Masel orthodontic brackets were used, together with either stainless steel (SS) or nickel titanium (NiTi) wires. Subsequently, three different sequences of coronal and axial images were obtained: spin-echo $T_1$-weighted images, fast spin-echo $T_2$-weighted images, and fluid-attenuated inversion recovery images. In each sequence, the two sequential axial and coronal images with the largest signal-void area were selected. The largest diameters of the signal voids in the direction of the X-, Y-, and Z-axes were then measured twice. Finally, the mean linear values associated with different orthodontic brackets were analyzed using one-way analysis of variation, and the results were compared using the independent t-test to assess whether the use of SS or NiTi wires had a significant effect on the images. Results: Statistically significant differences were only observed along the Z-axis among the four different brands of orthodontic brackets with SS wires. A statistically significant difference was observed along all axes among the brackets with NiTi wires. A statistically significant difference was found only along the Z-axis between nickel-free and nickel-containing brackets. Conclusion: With respect to all axes, the 3M bracket was associated with smaller signal-void areas. Overall, the 3M and Dentaurum brackets with NiTi wires induced smaller artifacts along all axes than those with SS wires.

Neoadjuvant Chemoradiotherapy in Non-cardia Gastric Cancer Patients - Does it Improve Survival?

Saedi, Hamid Saeidi,Mansour-Ghanaei, Fariborz,Joukar, Farahnaz,Shafaghi, Afshin,Shahidsales, Soodabeh,Atrkar-Roushan, Zahra Asian Pacific Journal of Cancer Prevention 2014 Asian Pacific journal of cancer prevention Vol.15 No.20

Background: Survival rates after resection of advanced gastric cancer are extremely poor. An increasing number of patients with gastric carcinomas (GC) are therefore being treated with preoperative chemotherapy. We evaluated 36 month survival rate of GC patients that were treated by adding a neoadjuvant chemoradiotherapy before gastrostomy.Materials and Methods: Patients with stage II or III gastric adenocarcinomas were enrolled. The patients divided into two groups: (A) Neoadjuvant group that received concurrent chemoradiation before surgery (4500cGy of radiation at 180cGy per day plus chemotherapy with cisplatin and 5-fluorouracil, in the first and the end four days of radiotherapy). Resection was attempted 5 to 6 weeks after end of chemoradiotherapy. (B) Adjuvant group that received concurrent chemo-radiation after surgical resection. Results: Two (16.7%) patients out of 12 patients treated with neoadjuvant chemo-radiotherapy and 5 (38.5%) out of 13 in the surgery group survived after 36 months. These rates were not significantly different with per protocol and intention-to-treat analysis. The median survival time of patients in group A and B were 13.4 and 21.6 months, respectively, again not significantly different. Survival was significantly greater in patients with well differentiated adenocarcinoma in group B than in group A (p<0.004). Conclusions: According to this study we suggest surgery then chemoradiotherapy for patients with well differentiated gastric adenocarcinoma rather than other approaches. Additional studies with greater sample size and accurate matching relying on cancer molecular behavior are recommended.

Outcome of Intestinal Metaplasia in Gastric Biopsy of Patients with Dyspepsia in Guilan Province, North Iran

Mansour-Ghanaei, Fariborz,Joukar, Farahnaz,Soati, Fatemeh,Mansour-Ghanaei, Alireza,Atrkar-Roushan, Zahra Asian Pacific Journal of Cancer Prevention 2013 Asian Pacific journal of cancer prevention Vol.14 No.6

Background: It is generally accepted that gastric carcinomas are preceded by a sequential multistage process that includes chronic gastritis, gastric atrophy, usually with intestinal metaplasia (IM), and dysplasia. This series of changes in gastric carcinogenesis is often initiated by Helicobacter pylori (H pylori) infection. The aim of the present study was determination of gastric histopathologic changes in IM patients after at least one year in Guilan province, Iran. Materials and Methods: This case-series study was conducted in Guilan Gastrointestinal and Liver Disease Research Center (GLDRC) during 2010 to 2011. Gastric biopsy was performed for all 71 known cases of IM and precanceric lesions including gastric atrophy, IM, dysplasia and H pylori infection were determined after at least one year. Results: Of the total of 71 patients with established IM who were enrolled, 50 had complete-type IM and 21 had incomplete-type IM. Fifty two people had H pylori infection. H pylori eradication was achieved in 39 patients (75%). Secondary pathology findings of patients with IM were complete metaplasia (39.4%), incomplete metaplasia (32.4%), dysplasia (23.9%) and other precanceric lesions (4.2%). Dysplasia (20%vs 33%) occurred in patients who had complete and incomplete IM at baseline respectively (p>0.05). Age, gender, family history of gastric cancer(GC); smoking habits and NSAIDs use were not associated with gastric premalignant lesions in initial and secondary pathologies (p>0.05). The difference became statistically significant between H pylori infection in patients with more than 3 years diagnostic intervals (p<0.05). Statistical difference between eradicators and non-eradicators was not significant. Conclusions: We found that incomplete IM increased the risk of subsequent dysplasia in this study.

A comparative study of metal artifacts from common metal orthodontic brackets in magnetic resonance imaging

Zahra Dalili Kajan,Jalil Khademi,Ahmad Alizadeh,Yasamin Babaei Hemmaty,Zahra Atrkar Roushan 대한영상치의학회 2015 Imaging Science in Dentistry Vol.45 No.3

Purpose: This study was performed to compare the metal artifacts from common metal orthodontic brackets in magnetic resonance imaging. Material and Methods: A dry mandible with 12 intact premolars was prepared, and was scanned ten times with various types of brackets: American, 3M, Dentaurum, and Masel orthodontic brackets were used, together with either stainless steel (SS) or nickel titanium (NiTi) wires. Subsequently, three different sequences of coronal and axial images were obtained: spin-echo T1-weighted images, fast spin-echo T2-weighted images, and fluid-attenuated inversion recovery images. In each sequence, the two sequential axial and coronal images with the largest signalvoid area were selected. The largest diameters of the signal voids in the direction of the X-, Y-, and Z-axes were then measured twice. Finally, the mean linear values associated with different orthodontic brackets were analyzed using one-way analysis of variation, and the results were compared using the independent t-test to assess whether the use of SS or NiTi wires had a significant effect on the images. Results: Statistically significant differences were only observed along the Z-axis among the four different brands of orthodontic brackets with SS wires. A statistically significant difference was observed along all axes among the brackets with NiTi wires. A statistically significant difference was found only along the Z-axis between nickel-free and nickel-containing brackets. Conclusion: With respect to all axes, the 3M bracket was associated with smaller signal-void areas. Overall, the 3M and Dentaurum brackets with NiTi wires induced smaller artifacts along all axes than those with SS wires.

Gastric Precancerous Lesions in First Degree Relatives of Patients with Known Gastric Cancer: a Cross-Sectional Prospective Study in Guilan Province, North of Iran

Mansour-Ghanaei, Fariborz,Joukar, Farahnaz,Baghaei, Seyed Mohammad,Yousefi-Mashhoor, Mahmood,Naghipour, Mohammad Reza,Sanaei, Omid,Naghdipour, Misa,Shafighnia, Shora,Atrkar-Roushan, Zahra Asian Pacific Journal of Cancer Prevention 2012 Asian Pacific journal of cancer prevention Vol.13 No.5

Background & Objectives: In patients with gastric cancer, the most frequently reported family history of cancer also involves the stomach. The aim of this study was to assess the presence of gastric precancerous lesions in first-degree relatives of patients with gastric cancer and to compare the obtained results with those of individuals with no such family history. Methods: Between 2007 and 2009, 503 consecutive persons more than 30 years old were enrolled in the study covering siblings, parents or children of patients with confirmed adenocarcinoma of stomach. The control group was made up of 592 patients who were synchronously undergoing upper gastrointestinal endoscopy for evaluation of dyspepsia without gastric cancer or any family history. All subjects were endoscopically examined. Results: The overall prevalence of Helicobacter pylori was 77.7% in the cancer relatives and in 75.7% in the control group. Chronic gastritis was found in 90.4% vs. 81.1% (P<0.001). Regarding histological findings, 37(7.4%) of the study group had atrophy vs. 12(1.7%) in the control group (P<0.001), while no difference was observed for intestinal metaplasia (20.3%vs. 21.6%, P=0.58). Dysplasia were shown in 4% of cancer relatives but only 0.4% of the control group (P<0.001). There was no gender specificity. Conclusions: Findings of our study point to great importance of screening in relatives of gastric cancer patients in Iran.