Estimating the Completeness of Gastric Cancer Registration in Ardabil/Iran by a Capture-Recapture Method using Population-Based Cancer Registry Data

Khodadost, Mahmoud,Yavari, Parvin,Babaei, Masoud,Mosavi-Jarrahi, Alireza,Sarvi, Fatemeh,Mansori, Kamyar,Khodadost, Behnam Asian Pacific Journal of Cancer Prevention 2015 Asian Pacific journal of cancer prevention Vol.16 No.5

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.

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

Khodadost, Mahmoud,Mosavi-Jarrahi, Alireza,Hashemian, Seyed Sepehr,Sarvi, Fatemeh,Maajani, Khadije,Moradpour, Farhad,Khatibi, Seyed Reza,Amini, Hossein Asian Pacific Journal of Cancer Prevention 2016 Asian Pacific journal of cancer prevention Vol.17 No.no.sup3

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.

Relationships between Self-Efficacy and Pap Smear Screening in Iranian Women

Majdfar, Zahra,Khodadost, Mahmoud,Majlesi, Freshteh,Rahimi, Abbas,Shams, Mohsen,Mohammadi, Gohar Asian Pacific Journal of Cancer Prevention 2016 Asian Pacific journal of cancer prevention Vol.17 No.no.sup3

Cervical cancer is the fourth common cancer among women worldwide. Pap smear screening has resulted in deceasing incidence of cervical cancer in developed countries but low uptake of Pap smear screening among women in developing countries is still a public health challenge. The aim of this cross-sectional study was to assess the relationship between self-efficacy and timely uptake of Pap smear among Iranian women. A total of 580 married women referred to primary health care centers covered administratively by Shahid Beheshti University of Medical Sciences in Tehran were administered a questionnaire by trained staff. Data were analyzed with SPSS (version 16) software, using univariate and multivariate logistic regression. The mean age for participants was $33.1{\pm}8.8years$. There was a significant association between self-efficacy and Pap smear screening (P<0.01). There was also a positive correlation between duration of marriage and husband's education with Pap smear uptake (P<0.01). In univariate analysis, there was a significant association between Pap smear uptake and level of selfefficacy (OR = 15.3 for intermediate and OR=7.4 for good level), duration of marriage (OR = 5.7 for 5-14 years and OR=10.4 for more than 15), age (OR =2.7 for 27-34 years and OR=7.4 for more than 35 years) and husband education level (OR=2.3 for more than 12 years of education). In multivariate analysis, significant associations persisted between Pap smear uptake and self-efficacy (OR = 23.8; 95% CI: 8.7, 65.5), duration of marriage (OR = 5.9; 95% CI: 2.8, 12.2), age (OR = 3.9; 95% CI: 1.2, 12.9) and husband's education (OR = 2.5; 95% CI: 2.0, 10.3). Efforts are needed to increase women's knowledge about cervical cancer and improve their self-efficacy and perceptions of the Pap smear screening in order to reduce cervical cancer incidence and mortality rates.

Factors Associated With Failure of Health System Reform: A Systematic Review and Meta-synthesis

Bayat Mahboubeh,Kashkalani Tahereh,Khodadost Mahmoud,Shokri Azad,Fattahi Hamed,Ghasemi Seproo Faeze,Younesi Fatemeh,khalilnezhad Roghayeh 대한예방의학회 2023 예방의학회지 Vol.56 No.2

Objectives: The health system reform process is highly political and controversial, and in most cases, it fails to realize its intended goals. This study was conducted to synthesize factors underlying the failure of health system reforms.Methods: In this systematic review and meta-synthesis, we searched 9 international and regional databases to identify qualitative and mixed-methods studies published up to December 2019. Using thematic synthesis, we analyzed the data. We utilized the Standards for Reporting Qualitative Research checklist for quality assessment.Results: After application of the inclusion and exclusion criteria, 40 of 1837 articles were included in the content analysis. The identified factors were organized into 7 main themes and 32 sub-themes. The main themes included: (1) reforms initiators’ attitudes and knowledge; (2) weakness of political support; (3) lack of interest group support; (4) insufficient comprehensiveness of the reform; (5) problems related to the implementation of the reform; (6) harmful consequences of reform implementation; and (7) the political, economic, cultural, and social conditions of the society in which the reform takes place.Conclusions: Health system reform is a deep and extensive process, and shortcomings and weaknesses in each step have overcome health reform attempts in many countries. Awareness of these failure factors and appropriate responses to these issues can help policymakers properly plan and implement future reform programs and achieve the ultimate goals of reform: to improve the quantity and quality of health services and the health of society.

Accuracy of Endoscopic Ultrasonography for Determination of Tumor Invasion Depth in Gastric Cancer

Razavi, Seyed Mohsen,Khodadost, Mahmoud,Sohrabi, Masoudreza,Keshavarzi, Azam,Zamani, Farhad,Rakhshani, Naser,Ameli, Mitra,Sadeghi, Reza,Hatami, Khadijeh,Ajdarkosh, Hossein,Golmahi, Zeynab,Ranjbaran, M Asian Pacific Journal of Cancer Prevention 2015 Asian Pacific journal of cancer prevention Vol.16 No.8

Background: Gastric cancer (GC) is one the common lethal cancers in Iran. Detection of GC in the early stages would assesses to improve the survival of patients. In this study, we attempt to evaluate the accuracy of EUS in detection depth of invasion of GC among Iranian Patients. Materials and Methods: This study is a retrospective study of patients with pathologically confirmed GC. They underwent EUS before initiating the treatment. The accuracy of EUS and agreement between the two methods was evaluated by comparing pre treatment EUS finding with post operative histopathological results. Results: The overall accuracy of EUS for T and N staging was 67.9% and 75.47, respectively. Underestimation and overestimation was seen in 22 (14.2%) and 40 (25.6%) respectively. The EUS was more accurate in large tumors and the tumors located in the middle and lower parts of the stomach. The EUS was more sensitive in T3 staging. The values of weighted Kappa from the T and N staging were 0.53 and 0.66, respectively. Conclusions: EUS is a useful modality for evaluating the depth of invasion of GC. The accuracy of EUS was higher if the tumor was located in the lower parts of the stomach and the size of the tumor was more than 3 cm. Therefore, judgments made upon other criteria evaluated in this study need to be reconsidered.

Relationship between Urbanization and Cancer Incidence in Iran Using Quantile Regression

Momenyan, Somayeh,Sadeghifar, Majid,Sarvi, Fatemeh,Khodadost, Mahmoud,Mosavi-Jarrahi, Alireza,Ghaffari, Mohammad Ebrahim,Sekhavati, Eghbal Asian Pacific Journal of Cancer Prevention 2016 Asian Pacific journal of cancer prevention Vol.17 No.no.sup3

Quantile regression is an efficient method for predicting and estimating the relationship between explanatory variables and percentile points of the response distribution, particularly for extreme percentiles of the distribution. To study the relationship between urbanization and cancer morbidity, we here applied quantile regression. This cross-sectional study was conducted for 9 cancers in 345 cities in 2007 in Iran. Data were obtained from the Ministry of Health and Medical Education and the relationship between urbanization and cancer morbidity was investigated using quantile regression and least square regression. Fitting models were compared using AIC criteria. R (3.0.1) software and the Quantreg package were used for statistical analysis. With the quantile regression model all percentiles for breast, colorectal, prostate, lung and pancreas cancers demonstrated increasing incidence rate with urbanization. The maximum increase for breast cancer was in the 90th percentile (${\beta}$=0.13, p-value<0.001), for colorectal cancer was in the 75th percentile (${\beta}$=0.048, p-value<0.001), for prostate cancer the 95th percentile (${\beta}$=0.55, p-value<0.001), for lung cancer was in 95th percentile (${\beta}$=0.52, p-value=0.006), for pancreas cancer was in 10th percentile (${\beta}$=0.011, p-value<0.001). For gastric, esophageal and skin cancers, with increasing urbanization, the incidence rate was decreased. The maximum decrease for gastric cancer was in the 90th percentile(${\beta}$=0.003, p-value<0.001), for esophageal cancer the 95th (${\beta}$=0.04, p-value=0.4) and for skin cancer also the 95th (${\beta}$=0.145, p-value=0.071). The AIC showed that for upper percentiles, the fitting of quantile regression was better than least square regression. According to the results of this study, the significant impact of urbanization on cancer morbidity requirs more effort and planning by policymakers and administrators in order to reduce risk factors such as pollution in urban areas and ensure proper nutrition recommendations are made.

Evaluation of Response to Preoperative Chemotherapy Versus Surgery Alone in Gastroesophageal Cancer: Tumor Resectability, Pathologic Results and Post-Operative Complications

Marandi, Aref Kashefi,Shojaiefard, Abolfazl,Soroush, Ahmadreza,Abdegah, Ali Ghorbani,Jafari, Mehdi,Khodadost, Mahmoud,Mahmoudzade, Hossein Asian Pacific Journal of Cancer Prevention 2016 Asian Pacific journal of cancer prevention Vol.17 No.no.sup3

Gastroesophageal cancer is one of the most common types of cancer worldwide. Despite significant developments in management, 5-year survival in the developing world is less than 20 percent. Due to restricted research about the impact of preoperative chemotherapy (POC) on tumor resection, pathological response and postoperative complications in Iran, we designed and implemented the present retrospective cross- sectional study on 156 patients with gastroesophageal cancer (GEc) between 2013 and 2015 at Shariati Hospital of Tehran. Two groups were included, the first group had previously received preoperative chemotherapy and the second group had only undergone surgery. All patients were followed for at least one year after the operation in terms of tumor recurrence, relapse free survival and one-year survival. The two groups were eventually compared regarding tumor resection, pathological response, postoperative complications, recurrence rate and survival. The mean age was $66.5{\pm}7.3years$ and 78 percent were male. The tumor resectability, pathological response and postoperative complications in the group which received POC were 93.5%, 21.8% and 12.8%, respectively, and in the surgery alone group figures for tumor resection and postoperative complications were 76% and 29.5%, respectively. Also based on our study the 5-year survival in the POC group was better (79.5% vs. 66.5%). Using standard neoadjuvant regimens (preoperative chemotherapy/chemoradiotherapy) beforesurgery could increase tumor resectability, pathological response, and improve the general status of the patients. Therefore using POC may be recommended over surgery alone.

Factors associated with mortality from tuberculosis in Iran: an application of a generalized estimating equation-based zero-inflated negative binomial model to national registry data

Fatemeh Sarvi,Abbas Moghimbeigi,Hossein Mahjub,Mahshid Nasehi,Mahmoud Khodadost 한국역학회 2019 Epidemiology and Health Vol.41 No.-

OBJECTIVES: Tuberculosis (TB) is a global public health problem that causes morbidity and mortality in millions of people per year. The purpose of this study was to examine the relationship of potential risk factors with TB mortality in Iran. METHODS: This cross-sectional study was performed on 9,151 patients with TB from March 2017 to March 2018 in Iran. Data were gathered from all 429 counties of Iran by the Ministry of Health and Medical Education and Statistical Center of Iran. In this study, a generalized estimating equation-based zero-inflated negative binomial model was used to determine the effect of related factors on TB mortality at the community level. For data analysis, R version 3.4.2 was used with the relevant packages. RESULTS: The risk of mortality from TB was found to increase with the unemployment rate (βˆ=0.02), illiteracy (βˆ=0.04), household density per residential unit (βˆ=1.29), distance between the center of the county and the provincial capital (βˆ=0.03), and urbanization (βˆ=0.81). The following other risk factors for TB mortality were identified: diabetes (βˆ=0.02), human immunodeficiency virus infection (βˆ=0.04), infection with TB in the most recent 2 years (βˆ=0.07), injection drug use (βˆ=0.07), long-term corticosteroid use (βˆ=0.09), malignant diseases (βˆ=0.09), chronic kidney disease (βˆ=0.32), gastrectomy (βˆ=0.50), chronic malnutrition (βˆ=0.38), and a body mass index more than 10% under the ideal weight (βˆ=0.01). However, silicosis had no effect. CONCLUSIONS: The results of this study provide useful information on risk factors for mortality from TB.

Incidence, Prevalence, and Mortality Rate of Gastrointestinal Cancer in Isfahan, Iran: Application of the MIAMOD Method

Moradpour, Farhad,Gholami, Ali,Salehi, Mohammad,Mansori, Kamiar,Maracy, Mohammad Reza,Javanmardi, Setareh,Rajabi, Abdolhalim,Moradi, Yousef,Khodadost, Mahmod Asian Pacific Journal of Cancer Prevention 2016 Asian Pacific journal of cancer prevention Vol.17 No.no.sup3

Gastrointestinal cancers remain the most prevalent cancers in many developing countries such as Iran. The aim of this study was to estimate incidence, prevalence and mortality, as well as time trends for gastrointestinal cancers in Isfahan province of Iran for the period 2001 to 2010 and to project these estimates to the year 2020. Estimates were driven by applying the MIAMOD method (a backward calculation approach using mortality and relative survival rates). Mortality data were obtained from the Ministry of Health and the relative survival rate for all gastrointestinal cancers combined was derived from the Eurocare 3 study. Results indicated that there were clear upward trends in age adjusted incidence (males 22.9 to 74.2 and females 14.9 to 44.2), prevalence (males 52.6 to 177.7 and females 38.3 to 111.03), and mortality (males 14.6 to 47.2 and females 9.6 to 28.2) rates per 100,000 for the period of 2001 to 2010 and this upward state would persist for the projected period. For the entire period, the male to female ratio increased slightly for all parameters (incidence rate increased from 1.5 to 1.7, prevalence from 1.4 to 1.6, and mortality from 1.5 to 1.7). In males, totals of 2,179 incident cases, 5,097 prevalent cases and 1,398 mortality cases were predicated to occur during the study period. For females the predicted figures were 1,379, 3,190 and 891, respectively. It was concluded that the upward trend of incidence alongside increase in survival rates would induce a high burden on the health care infrastructure in the province of Isfahan in the future.