zahra ravankhah

The incidence of colorectal cancer (CRC) is rising in Iran, but reports vary across different regions due to diverse methods and data sources. This study aimed to conduct a systematic review and meta analysis to provide an overview of theincidence rate of CRC and its trend among Iranians in various provinces.

A comprehensive literature search based on the Preferred Reporting Items for Systematic Reviews and Meta Analyses checklist was performed using national and international databases for papers published up to December 2023. CRC incidence rates were extracted from the numbers, crude rates, and age standardized rates (ASRs). A meta analysis was conducted to calculate the incidence rate and 95% confidence intervals (CIs) in subgroups of sex and province.

The initial database search retrieved 1287 papers, with 47 studies meeting the inclusion criteria after further screening. Overall, the trend of CRC incidence has been increasing, although a different pattern was observed in 2008. The pooled incidence rate of CRC was 8.46 (95% CI: 7.16–9.86) per 100,000 population beforethe publication of the annual continuous reports of the Iranian National Cancer Registry. The latest national data (2014–2017) indicated an ASR of approximately 15 per 100,000 population.

The incidence of CRC in Iran is lower than the global average. However, inconsistent cancer registration policies and gaps in registration have hindered the ability to establish a reliable trend of CRC incidence over time.

 In Isfahan, the fecal immunochemical test (FIT) has been used since January 2016 as part of the Iran’s Package of Essential Non-communicable Diseases (IraPEN) program for colorectal cancer (CRC) screening. The test is recommended for people who are 50-70 years old. Then, those with positive results would be referred for colonoscopy. This study aims to describe the uptake of the program and its outcome.

 A retrospective observational study was performed by collecting data from Isfahan Vice-Chancellor for Health database for this study purpose. The number of participators, the number of positive FIT, and the number of detected polyps or cancers were determined.

 Between 2016 and 2019, the number of participants in the program reached 345 207 individuals (nearly 40% of the eligible population of 874 674). Totally, 21 264 participants (6.1%) had positive tests, of whom about 20% underwent the recommended colonoscopy with available reports, and 971 (24%) and 110 (3%) patients were diagnosed with polyps and CRC, respectively.

 Over four years of screening with FIT in Isfahan, 40% of the eligible population participated. Among those with positive FIT results, 20% underwent colonoscopy, and approximately 26% of these individuals were identified as having polyps or cancer. This study provides valuable insights into the uptake and outcomes of a population-based CRC screening program in Isfahan, Iran. The findings highlight the need for targeted interventions to increase participation rates and improve the detection of polyps and CRC cases.

Gastric cancer (GC) is a frequent and multifactorial malignancy worldwide. The aim of this study was to investigate the relationship between some risk factors of GC and the 1-year or 5-year survival rates in newly diagnosed patients in Isfahan in 2016.

We included 274 newly diagnosed patients in this survival analysis from a database of 484 GC cases. We used a checklist to collect information. To inform about missed data, we call the patients or their families in non-survived cases. We evaluated each patient’s age, sex, body mass index (BMI), education, salt, salty foods, and red meat consumption. In addition, we asked patients about the intake of fresh fruits and vegetables, tobacco smoking, opium usage, and alcohol consumption. We surveyed the patient’s job, physical activity, Helicobacter pylori infection, family history of GC, history of gastric surgery, and survival status after 1 or 5 years. Variables were evaluated between survived and dead patients and compared for means and frequencies using the independent samples t-test or Mann-Whitney, or chi-square test. The univariate relationship of each risk factor, with 1- and 5-year survival, was examined by the log-rank test and the Kaplan-Meyer method and their multivariate relationship with Cox regression.

1- and 5-year survived patients were younger than dead patients with GC (P < 0.001; HR for 1-year survival: 1.014, 95% CI: 0.997 to 1.030; HR for 5-year survival: 1.005, 95% CI: 0.994 to 1.017), and had more frequent higher educational levels (P < 0.05; HR for 1-year survival: 1.887, 95% CI: 1.046 to 3.406; HR for 5-year survival: 1.482, 95% CI: 0.987 to 2.223). The death rate after 5 years was higher in men than in women (P = 0.009; HR: 1.009, 95% CI: 0.593 to 1.717) and depended on the job status of the patients (P = 0.021). The other studied variables were not significantly different between 1- or 5-year survived and dead patients.

GC development depends on genomic changes, environmental factors, and lifestyle status. But all risk factors that play a role in its development are not notable for a patient’s survival. We suggest that risk factors for these patients’ survival become elucidated in future studies. It helps to gather the necessary pieces of evidence for the enhancement of survival in patients with GC.

Clinical and pathologic features of oral and maxillofacial malignant lesions are very important and useful in diagnostic and therapeutic planning. The aim of this study was to determine and compare the clinicopathologic features of different types of oral and maxillofacial cancers in Cancer Registry System at Isfahan-Iran.

In this cross-sectional descriptive analytic study, required data (tumor type, tumor location, age, sex, and grade of malignancy) of 1081 patients from Isfahan Cancer Registry collected.

In this study, the mean age of the patients was 59.9±18.5years old. Most of the patients were male (56.43%). In this study, squamous cell carcinoma was the most common malignancy (61.9%) followed by non-Hodgkin's lymphoma (7%). The most common site was tongue (38.7%) and then the nasopharynx (13%). Also nasopharynx tumors in men were more common than women (P <0.001).

Squamous cell carcinoma, as the most common oral and maxillofacial cancer, requires considerable attention and rapid and appropriate diagnosis and treatment. Knowing the clinical and pathological features of this cancer and risk factors can improve the prognosis of patients.

This study was designed to investigate the results of the non-communicable diseases prevention and control program in Isfahan province under the supervision of the Vice Chancellor for Health of the University of Medical Sciences during the years 2017 to March 2021.

In this cross-sectional study, the target group was all the population over 30 years of age in Isfahan province who had referred to health centers for screening programs for non-communicable diseases and risk factors (cardiovascular and diabetes). Breast cancer screening has been performed in women aged 30 to 70 years and colorectal cancer screening has been performed in men and women aged 50 to 70 years.

The number of people diagnosed with diabetes at the end of March 2021 was 148,250 and its prevalence was 11.59%. Also, the number of patients with high blood pressure registered in electronic patient record from 2017 to the end of March 2021 was 249294 (prevalence 19.74%). In colorectal cancer screening, 1593 cases of polyps were detected from 5367 colonoscopy during 4 years of program. Also, by screening 46.9% of the target population, 513 cases of breast cancer were detected.

In the evaluation of the process of diagnosis and patient care, an increase is evident during the years 2017 to 2019, but the decrease in the number of risk assessments and patient care in 2020-2021 is due to the COVID19 pandemic.

Figures from Iranian cancer registries indicate that Isfahan ranks first in female breast cancer incidence. Although few previous studies have examined whether the breast cancer incidence trend in Isfahan province has increased over a given period of time, this study employed a joint point regression analysis to answer the same question. Moreover, it compared the data of Isfahan province, from a developing country, with those of England, as a representative of developed countries, and tried to explain the causes of the differences observed between the trends.

This repeated cross‑sectional study was conducted on the data of 6057 women in Isfahan province and of 141,011 women in England with breast cancer over the years 2001–2013. The incidence rates were calculated using direct standardization method and based on the 2013 standard European population. For an analysis of the trends in breast cancer incidence rates, Joint Point Regression program, version 4.3.1.0, released in April 2016, was employed.

The mean age‑standardized incidence rate (ASR) was calculated to be 34.7 per100,000 population over the years 2001 to 2013, which indicated an increase from 22 to 68 in Isfahan province. The corresponding mean ASR for England has also risen from 147.5 to 170.1 per 100,000 women during the same time period. The average annual percentage changes (AAPCs) for Isfahan and England were also calculated to be 9.6 and 1.1, respectively. This indicated an increasing trend in breast cancer incidence rates for Isfahan province over the period in question.

The drastic discrepancy in breast cancer incidence rates between these two regions may be attributed to differences in an improved cancer registry system in Iran and women’s developing awareness of the cancer over time.

The incidence of leukemia in the north-west and central provinces of Iran, including Isfahan province, is more than other areas. Since this cancer is a multifactorial disease, and in 90% of cases its etiology is unknown, this study intended to analyse the distribution of leukemia in all kinds of climate in Isfahan province during 2006-2010 period. This was a comparative study of disease distribution and climate situations and its presentation in map.
Information of patients with leukemia in Isfahan province during 2006-2010 was collected from Isfahan Province Health Center. After data filtration, the calculation of the ratio of patients by age, sex, years of developing and county was done. In addition, by using Arc Geographical information system (ArcGIS), the distribution of leukemia in different types of climate was determined.
Findings: Semirom, Fereydoon Shahr and Borkhar were the counties with the highest prevalence of leukemia in Isfahan province. The year 2009 was the peak of leukemia incidence.
The highest and the lowest leukemia incidence occurred in regions with middle semi-arid climate with 0.03762 persons per squared kilometre and sever dry climate region, respectively.

Skin cancer is the most common cancer in Iran and Isfahan. Behaviors taken to prevent skin cancer, especially in childhood and adolescence, have an effective role in prevention of skin cancer in the future. This study aimed to assess the knowledge, attitude and function of high school students in Isfahan Province. This was a cross-sectional study in 2012 over 1139 high school students in Isfahan Province. Data collected using a valid and reliable researcher-made questionnaires. Cluster random sampling method was used and data were analyzed using descriptive statistics. Overall, subjects had good knowledge (52.9%), poor attitude (28.3%) and poor function (27.5%) about skin cancer and protection against the sun rays. Conducting an intervention based on protection motivation theory to improve student's attitudes and behaviors is recommended to prevent skin cancer.