Increased Trend of Breast Cancer Mortality in Iran

Taghavi, Afsoon,Fazeli, Zeinab,Vahedi, Mohsen,Baghestani, Ahmad Reza,Pourhoseingholi, Asma,Barzegar, Farnoosh,Pourhoseingholi, Mohamad Amin Asian Pacific Journal of Cancer Prevention 2012 Asian Pacific journal of cancer prevention Vol.13 No.1

Background: Breast cancer is the most commonly diagnosed cancer in women worldwide In Iran, it ranks first among cancers diagnosed in women and is the fifth most common cause of death. The aim of this study was to present the mortality trends from breast cancer for Iranian women during a period of almost a decade, in order to provide update information regarding the likely future. Methods: We analyzed National death Statistic reported by the Iranian Ministry of Health and Medical Education from 1995 to 2004 to generate annual mortality rates/100,000, overall, by age group (<15, 15-49 and ${\geq}50$ years of age) and age standardized rate (ASR). Results: The age standardized mortality rate of breast cancer increased dramatically during these years from 1.40 to 3.52 per 100,000 and its mortality was increasing 151.4% for Iranian women, although it seemed that the rate leveled off from 2002 to 2004. Moreover the increasing rate was higher for those aged between 15-49 compared to age >50 years old. Conclusion: There is an increasing trend for breast cancer mortality in Iran. Thus, health education programs to rectify the lack of women awareness about breast cancer signs and effective screening are urgently needed.

Survival Rates for Breast Cancer in Iranian Patients: a Meta-Analysis

Rahimzadeh, Mitra,Pourhoseingholi, Mohamad Amin,Kavehie, Behrooz Asian Pacific Journal of Cancer Prevention 2016 Asian Pacific journal of cancer prevention Vol.17 No.4

Background: Breast cancer is the most common cancer among Iranian women. Since development of the disease in Iranian women occurs relatively early, the survival rate matters considerably. In different countries, survival of breast cancer patients varies considerably. Therefore, the one-year, three-year, five-year, and ten-year survival rates for breast cancer in Iran were assessed using a meta-analysis. Materials and Methods: This systematic review and meta-analysis was based on valid Iranian sources including SID, MAGIRAN and IRANMEDEX, along with reliable English databases, namely, PUBMED and SCOPUS. In domestic databases, a search was conducted based on key words of breast cancer and survival rate, and in international databases, with "breast cancer" and the equivalent of "neoplasm" of Mesh Word, "survival rate" and "Iran." Then all reviewed papers and theses which met the inclusion criteria were selected for investigation. To conduct the analysis STATA 11.2 software and random-effects models were used. Results: In 24 studies, 22,745 participants were included. The one-year, three-year, five-year and ten-year survival rates were 0.956, 0.808, 0.695 and 0.559, respectively. The minimum and maximum survival rates for 5-years were 0.48 and 0.87. The average age of the onset of the disease was 48.3. Conclusions: As in Iran, since the onset of the disease is at low age, in spite of the relatively high survival rate as compared to other cancers, prevention and screening programs at early age for early stage diagnosis seems necessary.

Ovarian Cancer in Iranian Women, a Trend Analysis of Mortality and Incidence

Sharifian, Abdolhamid,Pourhoseingholi, Mohamad Amin,Norouzinia, Mohsen,Vahedi, Mohsen Asian Pacific Journal of Cancer Prevention 2014 Asian Pacific journal of cancer prevention Vol.15 No.24

Background: Ovarian cancer is an important cause of mortality in women. The aim of this study was to evaluate the incidence and mortality rates and trends in the Iranian population and make predictions. Materials and Methods: National incidence from Iranian annual of National Cancer Registration report from 2003 to 2009 and National Death Statistics reported by the Ministry of Health and Medical Education from 1999 to 2004 were included in this study. A time series model (autoregressive) was used to predict the mortality for the years 2007, 2008, 2012 and 2013, with results expressed as annual mortality rates per 100,000. Results: The general mortality rate of ovarian cancer slightly increased during the years under study from 0.01 to 0.75 and reaching plateau according to the prediction model. Mortality was higher for older age. The incidence also increased during the period of the study. Conclusions: Our study indicated remarkable increasing trends in ovarian cancer mortality and incidence. Therefore, attention to high risk groups and setting awareness programs for women are needed to reduce the associated burden in the future.

Burden of Breast Cancer in Iranian Women is Increasing

Sharifian, Abdolhamid,Pourhoseingholi, Mohamad Amin,Emadedin, Majid,Nejad, Mohammad Rostami,Ashtari, Sara,Hajizadeh, Nastaran,Firouzei, Seyed Alireza,Hosseini, Seyed Jalil Asian Pacific Journal of Cancer Prevention 2015 Asian Pacific journal of cancer prevention Vol.16 No.12

Background: Breast cancer (BC) is the leading cause of oncological death for women, in both developed and developing countries. In Iran, breast cancer ranks first among cancers diagnosed in women. The aim of this study was to present the burden of this cancer including incidence, mortality and years life lost (YLL) due to breast cancer in Iranian women. Materials and Methods: National incidence data from the Iranian annual National Cancer Registration reports from 2003 to 2009 and national death statistics reported by the Ministry of Health and Medical Education from 1995 to 2010, stratified by age group, were included in this analysis. Also calculated YLLs provided by the Institute for Health Metrics and Evaluation (IHME) for the years 1990, 1995, 2000, 2005 and 2010 were employed to express the years lost due to BC for Iranian women. Results: The general mortality rate of breast cancer increased during these years from 0.96 to 4.33 per 100,000 and incidence increased from 16.0 to 28.3 per 100,000 for the years under study. YLLs calculated by IHME showed both increasing and decreasing patterns, with a tendency for stabilization. Conclusions: The burden of breast cancer for Iranian women is still increasing. Thus, health education programs to inform women regarding the signs and risk factors, and national screening to facilitate early diagnosis are needed for the female community in Iran.

Burden of Hepatocellular Carcinoma in Asia

Fazeli, Zeinab,Pourhoseingholi, Mohamad Amin,Vahedi, Mohsen,Zali, Mohammad Reza Asian Pacific Journal of Cancer Prevention 2012 Asian Pacific journal of cancer prevention Vol.13 No.12

Hepatocellular carcinoma (HCC), the sixth most prevalent cancer worldwide, continues to have high prevalence in many countries of Asia. The main challenge is the high prevalence of chronic hepatitis and aflatoxin, for example in China. HBV vaccination should be the major preventive tactic in Asian countries. The burden of HCC is low in Iran because most cases are due to HBV and this infection was less common. Although in Iran, a mass vaccination program started in 1993, its impact on decreasing the burden of HCC due to HBV can only be expected in future decades.

Evaluation of Endoscopic Characteristics of Upper Gastrointestinal Polyps in Patients with Familial Adenomatous Polyposis

Fatemi, Seyed Reza,Safaee, Azadeh,Pasha, Sara,Pourhoseingholi, Mohamad Amin,Bahrainei, Rasool,Molaei, Mahsa Asian Pacific Journal of Cancer Prevention 2014 Asian Pacific journal of cancer prevention Vol.15 No.16

Background: Familial adenomatous polyposis (FAP) is a disease inherited in an autosomal dominant fashion. Most FAP patients develop upper gastrointestinal polyps; especially those in the antrum and duodenum are usually neoplastic. The aim of this study was to evaluate the prevalence of gastroduodenal polyps in Iranian FAP patients. Materials and Methods: 28 patients affected by FAP underwent front-view and side-view endoscopy. Papillary biopsies were performed in all patients. Location of polyps, their number and size, pathology study, patient general information (gender, age, family history of FAP or colorectal cancer and gastroduodenal polyps) were analyzed. Results: Gastric polyps were seen in 39.3 % of patients. Some 72.7% of the affected individuals had fundic gland polyps and 36.36% had hyperplastic polyps. Duodenal adenoma was observed in 25% of patients. While 57% of patients had tubular adenoma with low grade dysplasia, 42.8% showed tubulovillous adenoma with low grade dysplasia. Conclusions: Findings of this study indicated that the prevalence of gastroduodenal polyps in FAP patients is high and dysplasia may be evident in duodenal polyps. Therefore, it appears that routine gastroduodenal endoscopy in FAP patients is necessary.

Survival of Colorectal Cancer Patients in the Presence of Competing-Risk

Baghestani, Ahmad Reza,Daneshvar, Tahoura,Pourhoseingholi, Mohamad Amin,Asadzade, Hamid Asian Pacific Journal of Cancer Prevention 2014 Asian Pacific journal of cancer prevention Vol.15 No.15

Background: Colorectal cancer (CRC) is considered to be a main cause of malignancy-related death in the world, being commonly diagnosed in both men and women. It is the third leading cause of cancer dependent death in the world and there are one million new cases diagnosed per year. In Iran the incidence of colorectal cancer has increased during the last 25 years and it is the fifth cause of cancer in men and the third in women. Materials and Methods: In this article we analyzed the survival of 475 colorectal patients of Taleghani hospital in Tehran with the semi-parametric competing-risks model. Results: There were 55% male cases and at the time of the diagnosis most of the patients were between 48 and 67years old. The probability of a patient death from colorectal cancer with survival of more than 25 years was about 0.4. Body mass index, height, tumour site and gender had no influence. Conclusions: According to these data and by using semi-parametric competing-risks method, we found out that only age at diagnosis has a significant effect on these patient survival time.

Mortality Determinants in Colorectal Cancer Patients at Different Grades: a Prospective, Cohort Study in Iran

Ahmadi, Ali,Mosavi-Jarrahi, Alireza,Pourhoseingholi, Mohamad Amin Asian Pacific Journal of Cancer Prevention 2015 Asian Pacific journal of cancer prevention Vol.16 No.3

Background: Colorectal cancer (CRC) is an important cause of mortality and morbidity in many communities worldwide. This population based study was conducted to assess determinants of colorectal mortality in Iranian patients. Materials and Methods: A cohort of 1,127 cases of confirmed colorectal cancer registered in a population based registry covering 10 referral hospital in Tehran, Iran, were followed for five years. Information about tumor characteristics, smoking status and family history were collected at base line and survival status were followed every six months by contacting patient or next of kin (if patients died during the follow-up). The cause of death for each case was validated by verbal autopsy and referring to patient medical records at the time of death. The data were analyzed by Stata software using univariate and multivariate analysis (Cox regression). In building the model a p value of less than 5% was considered as significant. Results: The age at diagnosis was $53.5{\pm}14$ years. Sixty one percent were male. Colorectal mortality among the patients was 96.9 person-years among men and 83 person-years among women. Seventy five percent of patients lived for 2.72 years, 50% for 5.83, and 25% for 13 years after the diagnosis of colorectal cancer. The age at diagnosis was significantly different between men and women (p<0.03). Higher tumor grade predicted higher death rate; the adjusted hazard ratios were 1.79 (95%CI, 0.88-3.61), 2.16 (95%CI, 1.07-4.37), and 3.1 (95%CI, 1.51-6.34) for grades II, III, and IV respectively when they were compared with grade I as reference. Ethnicity, marital status, family history of cancer, and smoking were related to survival with different degrees of magnitude. Conclusions: Among many factors related to survival among the colorectal patients, tumor grade and smoking showed the highest magnitudes of association.

Survival of Colorectal Cancer in the Presence of Competing-Risks - Modeling by Weibull Distribution

Baghestani, Ahmad Reza,Daneshvar, Tahoura,Pourhoseingholi, Mohamad Amin,Asadzadeh, Hamid Asian Pacific Journal of Cancer Prevention 2016 Asian Pacific journal of cancer prevention Vol.17 No.3

Background: Colorectal cancer (CRC) is the commonest malignancy in the lower gastrointestinal tract in both men and women. It is the third leading cause of cancer-dependent death in the world. In Iran the incidence of colorectal cancer has increased during the last 25 years. Materials and Methods: In this article we analyzed the survival of 447 colorectal patients of Taleghani hospital in Tehran using parametric competing-risks models. The cancers of these patients were diagnosed during 1985 - 2012 and followed up to 2013. The purpose was to assess the association between survival of patients with colorectal cancer in the presence of competing-risks and prognostic factors using parametric models. The analysis was carried out using R software version 3.0.2. Results: The prognostic variables included in the model were age at diagnosis, tumour site, body mass index and sex. The effect of age at diagnosis and body mass index on survival time was statistically significant. The median survival for Iranian patients with colorectal cancer is about 20 years. Conclusions: Survival function based on Weibull model compared with Kaplan-Meier survival function is smooth. Iranian data suggest a younger age distribution compared to Western reports for CRC.

Evaluation of Insulin Like Growth Facror-1 Genetic Polymorphism with Gastric Cancer Susceptibility and Clinicopathological Features

Farahani, Roya Kishani,Azimzadeh, Pedram,Rostami, Elham,Malekpour, Habib,Aghdae, Hamid Asadzadeh,Pourhoseingholi, Mohamad Amin,Mojarad, Ehsan Nazemalhosseini,Zali, Mohammad Reza Asian Pacific Journal of Cancer Prevention 2015 Asian Pacific journal of cancer prevention Vol.16 No.10

Gastric cancer (GC) is one of the most common malignancies in the world. It is the first cause of cancer deaths in both sexes In Iranian population. Circulating insulin-like growth factor-one (IGF-1) levels have been associated for gastric cancer. IGF-1 protein has central roles involved in the regulation of epithelial cell growth, proliferation, transformation, apoptosis and metastasis. Single nucleotide polymorphism in IGF-1 regulatory elements may lead to alter in IGF-1expression level and GC susceptibility. The aim of this study was to investigate the influence of IGF-1 gene polymorphism (rs5742612) on risk of GC and clinicopathological features for the first time in Iranian population. In total, 241 subjects including 100 patients with GC and 141 healthy controls were recruited in our study. Genotypes were analyzed using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) assay with DNA from peripheral blood. The polymorphism was statistically analyzed to investigate the relationship with the risk of GC and clinicopathological properties. Logistic regression analysis revealed that there was no significant association between rs5742612 and the risk of GC. In addition, no significant association between genotypes and clinicopathological features was observed (p value>0.05). The frequencies of the CC, CT, and TT genotypes were 97%, 3%, and 0%, respectively, among the cases, and 97.9%, 2.1%, and 0%, respectively, among the controls. CC genotype was more frequent in cases and controls. The frequencies of C and T alleles were 98.9% and 1.1% in controls and 98.5% and 1.5% in patient respectively. Our results provide the first evidence that this variant is rare in Iranian population and it may not be a powerful genetic predisposing biomarker for prediction GC clinicopathological features in an Iranian population.