فهرست مطالب mohsen asadi lari

Ensuring the comprehensive and accurate representation of data within cancer registries holds paramount significance across various facets of public health decision-making. This study delves into the evaluation of data completeness in breast cancer (BC) pathology reports within a population-based cancer registration system in Iran, spanning the period from 2016 to 2018.   

Employing a retrospective and descriptive analytical approach, we harnessed secondary data extracted from pathology reports encompassing breast cancer diagnoses, which were duly recorded in the Integrated Cancer Information Management System database during 2016-2018. A total of 4000 pathology reports were thoughtfully selected from each of the three years. The spectrum of pathology information encompassed tumor type, site grade, size (T), and involvement of lymph nodes (N).  Summary statistics were provided as percentages of categorical variables and mean with standard deviation of continuous variables.  A comparison of categorical variables was performed using the Chi-squared test.   

The participants' mean age was 51.8±12.5 years. Among the 12,000 studied patients, 5744 (47.9%) were ≤ 50 years old, 5233 (43.6%) were aged 50-69 years, and 1023 (8.5%) were >60 years old. The completeness of BC pathology reports varied for different variables. Interestingly, the completeness of these variables increased with older age groups. The proportion of specific tumor types differed significantly among age groups (P = 0.001). Notably, the prevalence of invasive ductal carcinoma was higher in the ≤ 50 years age group compared to the older cohorts. Likewise, notable variations in tumor sizes were observed (P = 0.009), with a higher prevalence of missing tumor size data noted in the age group ≤ 50 years. On the other hand, pathologic T stage also demonstrated age-dependent variations (P = 0.014), indicating a higher prevalence of missing stages in the ≤ 50 years age group. Finally, tumor grade exhibited a statistically significant difference (P < 0.001), with a higher proportion of grade 1 tumors observed in the 50-69 years age group.   

Tumor grade had the highest completeness rate, while tumor size, pathologic T stage, and pathologic N stage had the lowest. Therefore, a good understanding of completeness of pathology reports, as well as improvement in the registration of stage, integrated system at the national level for BC is warranted.

Talin-1 is a constituent of the multiprotein adhesion complexes that play  main role in the formation of tumors and migration in different types of malignancies. The present study aimed to assess  expression and prognostic significance of the talin-1 protein in ovarian serous carcinoma (OSC) patients.

The expression of talin-1 in mRNA and its protein levels were investigated for ovarian cancer (OC) by using bioinformatics tools, including Gene Expression Profiling Interactive Analysis 2 (GEPIA2), Gene Expression Database of Normal and Tumor Tissue 2 (GENT2), and The University of ALabama at Birmingham CANcer data analysis Portal (UALCAN) databases. Thereafter, immunohistochemical (IHC) staining was used to study the expression patterns of the talin-1 protein using 46 paraffin-embedded OSC tissue specimens, 25 benign tumors, and 20 normal tissues, which were assembled in tissue microarrays (TMAs). We also assessed the potential association between the expression of the talin-1 protein, various clinicopathological parameters, and survival outcomes.

Our IHC examination for talin-1 was significantly overexpressed in OSC tissues compared to benign tumors and normal tissues. The Kaplan-Meier survival analysis has also indicated statistically significant differences in terms of disease-specific survival (DSS) and progression-free survival (PFS) between the patients with high and low expression levels of talin-1, respectively.

The talin-1 protein was overexpressed in OSC tissues, and a high expression level of talin-1 was found to be significantly associated with tumor aggressiveness and poorer DSS or PFS. Therefore, talin-1 may serve as a molecular marker of cancer progression and a novel prognostic biomarker in these patients.

Women’s nutrition status includes significant effects on their children and household health. The purpose of this study was to assess energy and micronutrient intake adequacy in Iranian women.

This study was a part of the Urban HEART Study, which has jointly been developed by the World Health Organization (WHO) Centre for Health Development, Kobe, Japan. In total, anthropometric and dietary intake data were collected from 1125 women in southern Tehran municipality districts. A 24‑h recall questionnaire was completed by the expert nutritionists and the participants’ anthropometric statuses were assessed. Food intakes were calculated in grams per capita per day. Micronutrients and energy requirements were adapted from WHO/Food and Agriculture Organization (FAO) tables and Iran National Food Consumption Survey, respectively.

Nearly 71.5% of the women were overweight or obese [body mass index (BMI) ≥25 kg/m2 ]. Furthermore, 1.2% of the women were underweight (BMI <18.5 kg/m2 ), while 27.3% had normal weight (BMI = 18.5‑‑24.9 kg/m2 ). The mean bread/cereal and vegetable intakes were significantly higher in obese group, compared to that in normal/under/overweight group (375.6 g/day ± 151.4, P = 0.05; and 331.4 g/day ± 227.5, P = 0.02), respectively]. Women in the lean group significantly consumed higher quantities of cakes/pastries and had the lowest calcium and iron adequacy ratios, compared to other groups (p = 0.001, P = 0.03, and P = 0.05, respectively).

These findings suggest that Iranian women, especially those who reside in the southern areas of Tehran, need to change their dietary habits to maintain their health. Moreover, being under/normal weight does not necessarily mean following healthy diets.

Vaccines are the most successful and cost-effective public health tools that have helped control, eliminate, or eradicate many infectious diseases, and are the key intervention to end the COVID-19 pandemic. Therefore, the World Health Organization recommends that to increase the acceptance of vaccination, each country should identify and provide appropriate strategies to increase the motivation and desire of people and also to solve the challenges created to receive the vaccine. The purpose of this qualitative study was to identify the motivations and challenges of the participants in the COVID-19 vaccination program, particularly with PastoCovac which was jointly developed by the Finlay Institute of Vaccines in Cuba (IFV) and Pasteur Institute of Iran (PII), and to achieve a better understanding of the challenges of vaccination in the Iranian society, and to find ways to increase and strengthen the motivations.

A purposeful sample of people who visited a major urban health center in Semnan were approached for this qualitative study to reach data saturation (30 people) with open questions in a 30-minute interview. Relatively, after conducting the interview, the audio file was listened to carefully and if necessary intermittently by the interviewer and transcribed. The overt and hidden content of data obtained from the statements were checked and then the traditional content analysis was used to develop meaningful clusters of themes.

The main themes of people's motivations identified in the current research include controlling disease and reducing mortality, protecting health and establishing collective safety, improving social and economic conditions, advancing medical knowledge, trust and credibility of the Pasteur Institute of Iran (PII), acceptable possible side effects and The high effectiveness, local production of the vaccine are the unique characteristics of the vaccine, while the obstacles identified are: false and ignorant beliefs, lack of trust in the vaccine, people's fear and worry of side effects, the unique characteristics of the vaccine, lack of universal acceptability, insufficient recognition of vaccine characteristics.

PastoCovac as one of the major vaccines against COVID-19 developed jointly by PII and IFV, was acceptable to the Iranian population in every aspect. PastoCovac, therefore, played an important role in achieving e acceptable levels of safety in the country during the pandemic.

 Breast cancer (BC) is a leading cause of cancer-related deaths among women worldwide, and its incidence has increased in Iran over recent years.

 In this study, we aimed at assessing the completeness of BC pathology reports in the population-based cancer registration system and perform a spatial analysis of the incidence of this cancer in Iran in 2016 to help policymakers develop targeted interventions.

 We conducted a retrospective descriptive analysis, using secondary data from the Integrated Cancer Information Management System, and obtained 13789 BC pathology reports from all provinces in Iran in 2016. Pathology data, including tumor type, tumor site, tumor size, pathologic T stage, pathologic N stage, and tumor grade were examined for completeness by age group.

 Pathology reports from 4000 women with BC in 2016 from across all provinces of Iran were selected for this study. The completeness of tumor type, tumor site, tumor size, pathologic T stage, pathologic N stage, and tumor grade increased with aging. In addition, the completeness of pathology reports varied across different variables. Accordingly, the tumor grade and pathologic T stage had the highest and lowest completeness rates (100 % versus 27.4%), respectively. Spatial analysis revealed significant high-risk areas for BC incidence, including Isfahan, Markazi, Chaharmahal and Bakhtiari, and Kohgiluyeh and Boyer-Ahmad provinces in central Iran. In contrast, North Khorasan was identified as a low-risk area.

 Considering the incompleteness of the pathology report in most of the tumor variables in the BC registry, we recognize the gaps to improve pathology data. To ensure effective interventions for BC control, tailored preventive measures are needed, particularly for high-risk areas. Continuous evaluation and data completion, including standard cellular pathology reports, are necessary for accurate BC control in Iran.

Cardiovascular diseases (CVDs) contribute to over 30% of deaths worldwide and more than 40% in Iran in 2019. Establishing a cost-effective program to control cardiovascular diseases is essential for any country. This study aimed to estimate the cost-effectiveness of the primary prevention program (IraPEN) for cardiovascular diseases in Iran.  

This methodological cost-effectiveness study was performed to estimate the cost-effectiveness of the IraPEN program by modifying cardiovascular disease risk factors in the IraPEN program. We calculated the economic burden of CVDs risk factors from 2016 to 2018 in 4 pilot cities in Iran. We observed 160,833 individuals for 2 years to measure the economic burden of cardiovascular diseases. To estimate the variation of the 1-year risk of cardiovascular illnesses, and according to the study's goal of estimating the 1-year risk of cardiovascular disease, only 36,631 people remained in the study who compiled the program's instruction for 1 year. Propensity scores were used to consider the effect of those excluded from the study. The 10-year risk of CVDs was estimated by the laboratory tests and information registered in the population’s electronic records. To evaluate the effect of the IraPEN program in reducing the risk factors for cardiovascular diseases, major CVD risk factors were studied by the World Health Organization formula (whocvdrisk) and cardiovascular diseases risk scoring. We used the 10-year risk for CVDs to conduct a cost-effectiveness analysis in terms of cost per disability-adjusted life-year  (DALY) saved.  

According to estimates of the 1-year relative risk reduction in cardiovascular disease, the results showed that relative risk reductions for men and women were 0.74 and 0.65, respectively. Hence, about 174,088 annual acute CVDs events reduction would be expected; this decrease is predicted for men (93,034) more than women (81,054) for the total population of Iran. The total cost of treatment for people with cardiovascular diseases was 165 USD for coronary heart disease or stroke per individual. All risk factors were further reduced in women than men, except for smoking. DALYs averted was 1057.66 for samples who were in the study for a year (36631 samples). The total cost per averted DALY was 47.16.  

Estimating the costs associated with disease prevention programs is more important in developing countries. The most cost-effective strategies have been preventive therapies that target high-risk individuals. PEN risk reduction programs for primary prevention such as Ira-pen are highly cost-effective and efficient in low- and middle-income countries.

 Colorectal cancer (CRC) accounts for a large proportion of the global burden of cancer and is the fourth leading cause of cancer-related mortality worldwide. Fecal Immunochemical Testing (FIT) can be used for CRC screening programs due to its high accuracy and compliance. The present study reports the preliminary results of the CRC screening program in Iran among all people aged 50 to 69 years.  

 This cross-sectional study was carried out on 2,669,625 participants referred to health centers in Iran for CRC screening programs in 2018 and 2019. The data required for this study was taken from the CRC screening program.  Relevant information for all individuals aged 50 to 69 referred to the health system that was called for colorectal cancer screening was extracted from the Integrated Electronic Health Records (SIB) database. Finally, the standards indices were calculated for all provinces. Gender, history of inflammatory bowel disease (IBD) (Crohn's disease or ulcerative colitis), history of colon cancer or adenoma in a first-degree family (father, mother, siblings or children), history of colon cancer in a second-degree family if occurred under the age of fifty (aunt, uncle, grandparents), lower gastrointestinal bleeding in a prior month, constipation in the prior month (with or without diarrhea, abdominal pain and feeling of fullness in the colon after defecation), more than ten percent weight loss in the last six months and FIT were assessed.   

 Among a total number of over 2.6 million, 56.3% were female, and the number of people evaluated by health care providers for CRC screening programs in 2018 and 2019 were 1,365,248 (14.23%) and 1,304,377 (12.89%), respectively. The number of people with positive FIT evaluated for the CRC screening program in 2018 and 2019 was 33,299 (3.09%) and 33,583 (2.57%), respectively. Bushehr province (0.59%) and Isfahan province (7.35%) had the lowest and highest positive FIT rate in 2018, respectively. Also, the correlation between the above-mentioned variables and the number of people with a positive FIT across gender was statistically significant (p<0.05). The study of the relationship between the number of positive FIT cases and the variables examined by Behvarz and community health worker showed that the number of people with a family history of colon cancer in second-degree relatives under the age of 50 and also the number of people with an individual history of inflammatory bowel disease had a significant association with the number of positive FIT cases (p<0.05) (β=-0.718, 95% CI; -2.557-14.992, β=0.388, 95% CI; 0.322-16.737, respectively). The relationship between the number of positive FIT cases and effective variables was not statistically significant (p>0.05). 

 Positive cases should be referred for further evaluation and colonoscopy. Before performing a screening program, the conditions for performing colonoscopy for these people must be assessed and prepared. The FIT for CRC screening program can be easily promoted in Iran.

 Health systems must have functional and efficient preparedness and response plans to manage pandemics. Moreover, it is essential to adjust to changing circumstances and the dynamic character of pandemics. The World Health Organization (WHO) introduced the Strategic Preparedness and Response Plan (SPRP), emphasizing 144 measures across 10 pillars, helping governments prepare and respond to the coronavirus disease 2019 (COVID-19) pandemic. This study aimed to determine how the Iranian health system, based on the WHO—SPRP, addresses strategic preparedness and response plan in the COVID-19 pandemic at the national level.

 The WHO–SPRP was adopted and translated into Persian by 2 bilingual natives. The chief of the health office requested that authorized officers complete the SPRP. Then, a meeting was held by officers of related units involved in COVID-19 management to address the SPRP at regional and national levels. 

 Our findings suggest that up to August 2020, effective risk communication and community engagement were not fully established. Our response plan lacked evidence-based information and educational messaging to consistently shape public opinion and impression of a respiratory pandemic.

 The Iranian health care system and services were almost able to address the SPRP and perform the major indicators that the WHO had proposed.  However, special attention should be paid to risk communication and community engagement to empower informed decision-making by individuals and communities.

Health inequalities can determine the risk of diseases and the measures employed to prevent and treat diseases when they occurs. The COVID-19 pandemic has played an important role in creating and reinforcing numerous health inequalities across the globe. This study aimed at investigating inequalities in access to health services in patients with COVID-19 and mortality caused by it at the provincial level of Iran.

This descriptive cross-sectional study assessed all provinces of Iran for a number of hospital measures, including total hospital beds, ICU beds, the number of CT scans, and the number of specialists and nurses. To determine the effect of hospital infrastructure and facilities on death and hospitalization, the Pearson correlation coefficient was used. Multivariate linear regression was employed to determine the relationship and significance of the variables, and the Gini coefficient and the Lorenz curve were used to measure inequalities in the distribution of facilities and infrastructures.

The results showed that on the basis of hospital facilities, the rate of hospitalization and death due to COVID-19 can be predicted by 96%. Increasing ICU beds increased hospitalization and death by 1.16 and 0.97 respectively. Also, for every increase in the number of doctors and nurses, the chance of hospitalization increased by 0.423 and decreased by 0.741 respectively. Isfahan, West Azerbaijan, Yazd, Kermanshah and Zanjan provinces had the lowest Gini coefficient in bed distribution.

The distribution of resources among provinces is not fair. Therefore, in order to achieve universal health coverage and comply with the leveling of service provision, it is necessary to make policies and plans according to the needs of the society and allocate resources based on the needs and burden of the disease.

The aging growth rate is more rapid in developing countries than in more developed countries. This rate is higher in Tehran metropolitan than in most of the other regions of Iran. This study aimed to indicate of disparity and inequity of levels of health related quality of life between different districts of the Tehran metropolitan.

This study analyzed the data of 1890 elderly aged ≥65 years who responded to questionnaires of the Urban-HEART survey. The Persian version of Short-Form Health Survey version 2 (SF 12 v2) was used for the assessment of the health-related quality of life. This instrument has two major components, including Physical Component Summary (PCS) and Mental Component Summary (MCS), and also has eight subscales. The mean of these scores was compared between genders and age groups and districts of the Tehran metropolitan using a one-way Analysis of Variance (ANOVA).

Mean±SD age of participants was 73.65±5.91 years. The Mean±SD age in men was 72.97±5.76 years. The Mean±SD PCS score in the participants was 33.36±10.48 and Mean±SD MCS score was 44.26±11.22. The Mean±SD PCS and MCS scores were lower in females than males. The highest Mean±SD PCS scores were observed in district 22 (37.25±11.51) and the lowest Mean±SD PCS scores were observed in district 16 (30.17±9.27).

The result of this study help health and urban policymakers could better diagnose and plan for decreasing these inequities in Tehran.

 Social network in older adults refers to interpersonal relationships and the perception of these relationships. Given the importance of the social network, the current study was conducted to answer three pivotal questions. First, do personal and regional factors affect the social network of the elderly? Second, how much share do the individual and regional factors have in the social network of the elderly? And third, which of these factors affect the social network of the elderly at each level of the personal and regional relationships.

 The study was conducted based on the second round of the Tehran city health equity and response tool (Urban-Heart 2). Thus, 5760 individuals (age <60 year) were selected from 22 urban regions in Tehran City. These data were then analyzed using the multilevel regression model.

The personal and regional levels explained about 89% and 11% of the social network of the elderlies, respectively. The individual factors explained 21% of the variance in the social network. Out of these parameters, age between 60 and 74, illiteracy, self-reported health, and mental health affected the social network significantly. At the regional level, the feeling of security, the control of corruption, the waiting time for bus arrival, and the sense of responsibility were the most influential factors explaining 19% of the variance in the social network.

 Not only is the social network of the elderlies affected by personal factors such as age, education level, and self-reported health and mental health, but it is also affected by regional factors (feeling of security, the control of corruption, the sense of responsibility, and waiting time for bus arrival). Although these regional factors are out of personal control, they can be improved for the elderly in society.

Determining the survival rate of cancer patients is a prerequisite for development of prevention and treatment services and implementation of cancer screening programs. The aim of this study was to determine the survival rate of breast cancer and to investigate the related factors.

In the Cancer Registration Center of Hormozgan Health Department, 212 people with initial diagnosis of breast cancer had been registered. The Kaplan-Meyer method was used to determine the survival rate and determine the related risk factors using Cox proportional hazard regression model. For all tests, the error rate was considered 5%. Data analysis was performed by SPSS software (version 19).

The results showed that the five-year survival rate in patients with breast cancer is 80.2%. The risk of death is lower in people diagnosed in the early stages of cancer than in those diagnosed in the advanced stages (CI = 0.482-0.482: HR = 0.22). Risk of death in people with education of 8 classes and less was 0.267 (HR= 0.27, CI: 0.097-0.664) and in people with education of more than eight classes it was 0.254 (HR= 0.36, CI: 0.097-0.664).

According to the results of this study, implementation of screening program and early diagnosis of breast cancer in women with low levels of education, especially in the first level of the health system, is highly needed. In addition, prompt and timely referral of suspects is necessary.

Social capital (SC) is an essential concept of communities, and there is more SC inequality. In the current study, we studied SC Inequality concerning the explanatory socioeconomic factors.

In a cross-sectional observational study, the household data were retrieved from an Urban Health Equity Assessment and Response Tool survey in 2011. Over 5000 elderlies in Tehran (> 60 years old) consented to participate in the study and filled out 2 SC questionnaires (SCQ) and a household properties questionnaire (HPQ). Subsequently, the collected HPQ data were then statistically analyzed and used to measure the economic status of households. Besides, the statistical concentration index of the SC was applied to measure socioeconomic inequality and decomposed into its determinants using both SCQ and HPQ data collections. The concentration index and the decomposition analysis were used to analyze the study data.

The overall concentration index of the SC in Tehran senior citizens was 0.059 (95%CI,0.044-0.076). Among the SC dimensions, collective activity, social coherence, voluntary help, and social network were more concentrated in the poor older adults. Simultaneously, reciprocity was more focused on the wealthy class, and there was no inequality in trust. The decomposition of the concentration index showed that economic status made the most considerable contribution to the SC inequality among citizens (69.11%), followed by the level of education (12.695) and the elderlies'job type (9.58%).

Given that the economic status and level of education are the 2 main determinants of SC inequality, a holistic policy approach should be adopted to address the socioeconomic inequalities that are taken root in Tehran's senior communities.

High risk blood transfusions can cause a lot of financial and psychological burden to the community. The prevalence of Hepatitis B is useful for evaluating the blood products' safety and donor selection methods. We aimed to predict the prevalence of hepatitis B in Iranian blood donors from 2000-2016.

Positive cases of hepatitis B from 2006 to 2014 were collected from Iranian Blood Transfusion Organization. This database was classified according to the age, provinces, and type of donation. Data was not existed in all subnational levels and all years, therefore, for predicting the hepatitis B prevalence, two separate, Spatio-temporal and mixed model (GLMM) were developed.

At the national level, the hepatitis B prevalence declined from 0.69 (0.51 to 0.90) in 2000 to 0.27 (0.21 to 0.33) in 2016. In first-time, regular, and repeated donors, this prevalence declined from 2.31 (1.74 to 2.31), 0.26 (0.19 to 0.34), and 0.51 (0.38 to 0.68) in 2000 to 0.87 (0.69 to 1.09), 0.09 (0.07 to 0.12), and 0.19 (0.14 to 0.24) in 2016. At the provincial level, the highest and lowest prevalence in 2016 was observed in North Khorasan and Gilan. With increasing age, the average prevalence of hepatitis B, increased.

Prevalence of hepatitis B in Iranian blood donors has been reduced significantly over 17 years, but still new cases of hepatitis B are reported. By precise monitoring the donor selection process and implementing more sensitive laboratory screening, we can reduce the risk of new infectious agents.

Food insecurity is recognized as a serious public health problem worldwide. Since household food security may affect health-related quality of life, the present study was carried out to assess associations of household food security with health-related quality of life in various districts of Tehran, Iran.

Data of this cross-sectional study were collected from the Urban Health Equity Assessment and Response Tool (Urban HEART-2) Survey in Tehran Capital City, Iran, 2011, using multistage cluster random sampling method. From each household, one person was selected to participate. Data collection instruments included 6-item short-form to measure household food security status and SF-12V2 questionnaire to evaluate health-related quality of life. From 33252 people, 30521 people with ages of 18 years or greater were included in this study. Multiple linear regression model was used to assess independent effects of household food security on health-related quality of life.

Age range of the participants was 18–90 years with a mean age of 43.85 years ±16.2. Overall, 68.4% of the participants were female and 35.2% were male. Moreover, 62.2% of the participating households belonged to the food secure group. The mean score of the health-related quality of life was 60.5 ±19.4. The mean scores of health-related quality of life varied based on the household food security status in various districts of Tehran (p < 0.001). Multiple linear regression model showed significant relationships between health-related quality of life and household food security, adjusting age, gender, education, marital status, family size, body mass index and wealth and deprivation indices
(p < 0.001).

Results showed associations of the household food security with health-related quality of life in various districts of Tehran. Policy makers are recommended to provide efficient interventions to promote quality of life of urban households based on the social determinants in each district.

Since the beginning of the coronavirus disease 2019 (COVID-19) epidemic in Iran, the control and management of the epidemic were headed by the National Headquarter for the Control of COVID-19 Epidemic through setting up different scientific committees, including the COVID-19 National Epidemiology Committee. The present study reviews the missions, structures, achievements, and challenges of the Epidemiology Committee. Study design: A rapid review

All relevant reports, documents, guidelines, published literature, and surveillance data related to the establishment, visions, missions, roles, activities, and outputs of the COVID-19 Epidemiology Committee were critically reviewed in this study.

The efforts of the committee’s working groups may have impacted improvements in data registration/usage, provincial data quality at provincial levels, and perception of the epidemic situation in the provinces. The committees have also played role in informing the policies in different stages of the epidemic through routine or problem-based data/evidence analyses, epidemic investigations, and mathematical modeling.

The structure and experience gained by the committee can be used in similar situations within and outside the country. To further improve the impacts of our activities, it is essential to have effective interaction, collaboration, and data flow between the committee and a broad range of organizations within and outside the Ministry of Health and Medical Education.

Hepatitis B infection is the major risk factor for liver cancer in Iran. There is no comprehensive population-based study on the prevalence of hepatitis B by regional distribution. Moreover, systematic reviews of hepatitis B prevalence lack knowledge of some regions. We aimed to estimate the prevalence of hepatitis B and its temporal trends over 17 years by sex, age and geographical distribution.

We used the Iranian Blood Donors data in addition to systematic reviews on population-based studies at national and provincial levels and statistical methods (A two-stage spatio-temporal model and crosswalk approach) to address the missing points of hepatitis B prevalence among the general population. The direct age-standardized approach was applied using Iran’s national population in 2016.

At national level, age-standardized hepatitis B prevalence in Iran decreased from 3.02% (95% uncertainty interval; 2.26 to 3.96) in 2000 to 1.09% (95% uncertainty interval; 0.85 to 1.37) in 2016, with a total -64.84% change. Hepatitis B prevalence was more than 1.3 times greater in males than females in 2016. Overall, the prevalence of hepatitis B increased with increasing age. At provincial level, in 2016, the province with the highest prevalence had a nearly 11-time greater rate compared to the lowest prevalence. The declining annual percent change (APC) of the prevalence trend varied between -11.53% to -0.5% at provincial level from 2000 to 2016. Only one province did not witness a downward trend in which the APC was 0.5% (95% UI:0.47-0.54).

The downward trend in prevalence of hepatitis B infection indicates the effectiveness of strategies and preventive measures adapted in Iran. Nevertheless, we need to eradicate this infection. In this regard, re-evaluating preventive measures, especially in high-risk age groups of the population, is recommended

This study aimed to determine effective factors on geographic distribution of the Incidence of Colorectal Cancer (CRC) in Tehran, Iran using Geographically Weighted Poisson Regression Model.

This ecological study was carried out at neighborhood level of Tehran in 2017-2018. Data for CRC incidence was extracted from the population-based cancer registry data of Iran. The socioeconomic variables, risk factors and health costs were extracted from the Urban HEART Study in Tehran. Geographically weighted Poisson regression model was used for determination of the association between these variables with CRC incidence. GWR 4, Stata 14 and ArcGIS 10.3 software systems were used for statistical analysis

The total number of incident CRC cases were 2815 in Tehran from 2008 to 2011, of whom, 2491 cases were successfully geocoded to the neighborhood. The  median IRR for local variables were : unemployed people over 15 year old (median IRR: 1.17), women aged 17 years or older with university education (median IRR: 1.17), women head of household (median IRR: 1.06), people without insurance coverage (median IRR: 1.10), households without daily consumption of milk (median IRR: 0.85), smoking households (median IRR: 1.07), household’s health expenditure (median IRR: 1.39), disease diagnosis costs (median IRR: 1.03), medicines costs of households (median IRR: 1.05), cost of the hospital (median IRR: 1.09), cost of medical visits (median IRR: 1.27).

The spatial variability was observed for most socioeconomic variables, risk factors and health costs that had effects on CRC incidence in Tehran. Spatial variability is necessary when interpreting the results and utterly helpful for implementation of prevention programs.

Food insecurity as a major public health problem has associations with a wide range of adverse consequences on health and quality of life. The aim of this study is to determine the prevalence of food insecurity among Iranian households, its key socio-economic risk factors and population attributable risk via a large-scale cross-sectional study in the capital of Iran.

This cross-sectional study was performed among 30,809 households with complete questionnaires of food security, during 2011. The univariate test was used to investigate the association between economic status and covariates with household food insecurity. Multiple logistic regression model was used to assess the independent effect of economic status on household food insecurity.

Totally, 37.8% (95% CI: 37.25, 38.34%) of the households were food insecure. There were significant associations between economic status and household food insecurity after adjustment for other variables (p-value<0.001). The extent of household food insecurity that could be attributed to the economic status in the 1st and 2nd quintiles (poorest and poor households), compared with the 5th quintile (richest households), was estimated to be 48.43% and 60.12%, respectively.

Food insecurity is relatively prevalent among households in Tehran. Economic status was identified as the most significant determinant of household food security, as 62.7% of poorest households were food insecure. Therefore, there is a crucial need to address food insecurity as a priority in food policies.

Gastric cancer is the fourth most common form of cancer and the second most common cause of death in the world. It is also one of the most common cancers leading to mortality in Iran. Therefore, this study aimed to determine the survival rate of patients with gastric cancer and its affecting factors in the south of Iran (Hormozgan province). 

In this study, all patients with gastric cancer (119 patients) that were diagnosed and registered during 2008 to 2013 in Hormozgan province, were studied. All patients were followed to the end of 2015. Kaplan-Meier method and Cox proportional hazards model were used to draw survival curves and to determine the effective factors on the survival rate of surveyed patients. Moreover, Log-rank test was used to evaluate whether or not survival curves for different groups are statistically equivalent (p<0.05).

The mean age of the study population was 58.9±14.91, and most of them were men (72.3% (86 persons)). After diagnosis, the survival rates for 1, 2, 3, 4, and 5 years were 62.2%, 49.4%, 43.7%, 39.7%, and 38% respectively. Survival in men were lower than women, but according to log-rank test this difference was not statistically significant (p=0.325). Also patients with advanced stage cancer had significantly lower survival in comparison to individuals with early stage disease (p<0.001). Based on multiple Cox proportional hazards model, job status of the patients and stage of cancer   were effective factors on patients’ survival.

Based on the findings of the present study, the survival rate was decreased over time after diagnosis. Stage of a cancer at the time of diagnosis is the most important factor affecting the survival of surveyed patients. This shows that there is a crucial need to diagnos the gastric cancer in early stages.

Various treatments are used to prolong survival and improve quality of life (QOL). The purpose of this study was to assess the change in QOL scores in patients with Oesophagogastric (OG) cancer undergoing curative intent and palliative therapy.

This was a mix-designed cohort study with a consecutive sampling of patients with OG cancer who underwent curative or palliative treatment regimens. The QOL, as a determinant of efficacy and impact of cancer care, was evaluated using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaires. QOL data were collected from the eligible subjects at three points of time. The repeated measurement test was used to compare the significance of change in scores.

Overall, 149 patients (54.4% male, 61.1% curative intent, 52.3% esophageal, 37.6 % gastric, 10.1% OG junction cancer; with mean age 62 year) with OG cancer were eligible for inclusion in the study. Compared to the palliative group, the curative group was more likely to have an esophageal tumor site, Squamous Cell Carcinoma, and stage 2 (versus stomach, Adenocarcinoma, and stage 4 in the palliative group). In comparing the patient's functional, global health status, and cancer symptom, considering time, group of treatment, and their mutual effect the result indicated significant difference between the intervention groups.

Most patients with Oesophagogastric cancer are diagnosed with an incurable form of the disease. Hence in absence of curative treatment, palliative therapy is the most effective therapy to maintain patient independency and relieve pain and symptom in order to improve their QOL. The present study has shown that palliative similar to curative intervention can improve the QOL in cancer patient especially in short term.

Cancer is a major public health concern all over the world. The aim of the current study is to demonstrate changing trends of cancer incidence from 2006 to 2009 in Tehran (capital city of Iran) and evaluate the effect of living in different regions according to their median socioeconomic status (SES) on cancer cumulative incidence.
The incident cases were obtained from the population based cancer register of ministry of health and medicine in Iran; we examined the annual percent changes (APCs) and overall trends of total cancer incidence across regions in Tehran. The age and sex standardized incidence rates were computed by the direct method. Poisson regression and negative binominal regression model were used to assess the existence of trends across 4 consecutive years, as well as the effect of living in each region, literacy rate, and employment rate across regions on this trend. All the analyses were done by Stata 12.0 software.
The findings of this study showed downward and nonlinear trend during 4 years. The age-standardized incidence rate (ASR) was higher in men compared to women in this period. ASRs for overall 4 years were 114 and 101 per 10,0000 men and women, respectively. Average annual percent change based on ASR and regression model for each sex was the same and around -5% and -6%, respectively. Incidence rate also differed between districts so that north and center districts had higher incidence than southern parts in both sexes. The lowest rate ratio attributed to district 17 and 18 located in south of Tehran and the highest rate ratio attributed to district 6 for each sex compared to the baseline district 16. Results reported the sharp increase of 59% and 37% in district 6 compared to district 16 in men and women, respectively. Better regional social status increased the risk of cancer among women. Also, the results showed a partially significant interaction with higher decrease in annual trend of cancer rate in socially more deprived regions.
The results showed downward and nonlinear decreasing trend during 4 years, especially in regions with lower socioeconomic status. Incidence rate also differed between districts so that northern regions had higher incidence than southern regions. Spatio-temporal Analysis of these cancer rates with adjustment for more regional socio-economic characteristics may better explain the disparities in rate of cancer in different districts across time.

Liver cancer is a highly lethal cancer with 5 year survival rate of about 18%. This cancer is a leading cause of death in many countries. As there is not a comprehensive population base study on liver cancer mortality rates by cause in national and provincial level in Iran. We aimed to estimate the liver cancer mortality rate, its patterns, and temporal trends during 26 years by sex, age, geographical distribution, and cause.
We used the Iranian death registration system (DRS), in addition to demographic and statistical methods, to address the incompleteness and misclassification and uncertainty of death registration system to estimate annual liver cancer mortality rate. Direct age standardized approach was applied using Iran national population 2015 as a standard population to facilitate the comparison between the provinces.
Liver cancer age standardized mortality rate in Iran increased by more than four times from 1.18 (95% uncertainty interval; 0.86 to 1.61) deaths per 100,000 person in 1990 to 5.66 (95% uncertainty interval; 4.20 to 7.63) deaths per 100,000 person in 2015. Male to female age adjusted mortality ratio changed from 0.87 to 1.82 during the 26 years of the study. With increasing age, liver cancer mortality rate increased in both sex and all provinces. At provincial level, the province with highest mortality rate have 2.96 times greater rate compare to the lowest. Generally, about 71% of mortality at national level is due to hepatitis B and C infection.
In order to reduce liver cancer mortality rate, it is recommended to control main risk factors including chronic hepatitis infections. Because of the growing rate of mortality from liver cancer, augmenting life expectancy, and increasing number of the elderly in Iran, policy makers are more expected to adopt measures including hepatitis B vaccination or hepatitis C treatment.

The number of new cancer cases in the elderly is growing because of the aging population.
Cancer data of the elderly (65 years and older) were collected from Iran cancer registry in 2007. Local Moran’s I was used as a measure of spatial analysis to identify the cluster patterns.
The overall cancer incidence rates were 862.4 and 474.8 per 100,000 in men and women, respectively. Prostate cancer and breast cancer were the most common types of cancer in men and women, correspondingly. Using the Local Moran’s I tool, we identified more spatial clusters among men than women. Districts 1, 2, 3 and 6 in the north of Tehran were hot spots for prostate cancer and district 16 in the south of Tehran was the cool spot for this type of cancer, and districts 1 and 3 were the hot spots for breast cancer.
More cancer hot spots were located in the north of Tehran where districts are more privileged, and more cool spots were located in the south of the city where districts are more underprivileged.

Socioeconomic status (SES) is one of the main determinants of health-related quality of life (HRQoL), where people with lower SES experience more health problems, have a lower quality of life, and are exposed to have a greater number of health-related risk factors.
This study aimed to examine the relationships between HRQoL, SES, and several demographic factors among the residents of the city of Ilam (located at the West of Iran).
This cross sectional study was conducted on 400 households from 3 districts of the city of Ilam in 2015. The participants were selected on the basis of the multistage sampling method. The second version of the 12-item Short-Form Health Survey (SF-12v2) questionnaire and the Wealth Index were used to measure HRQoL and SES, respectively.
The mean scores of the physical component summary (PCS) and the mental component summary (MCS) were 46.32 ± 9.69 and 42.12 ± 9.11, respectively. The findings indicated that PCS (P = 0.01) and MCS (P = 0.01) were significantly related to SES (wealth index). The demographic variables of age, gender, education level, marital status, job status, and home ownership (P HRQoL is directly related to SES, in that HRQoL is higher in families with higher SES. Similarly, HRQL is higher in younger people, men, and those with a university degree. A decrease in socio-economic inequalities and the gap between the rich and the poor can enhance the individuals’ health status and HRQoL within a community.