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Selective IgA deficiency (IgAD) (serum IgA concentration of

Abstract Background Causes of the rapidly increasing incidence of breast cancer in Middle East and Asian countries are incompletely understood. We evaluated risk factors for postmenopausal breast cancer and estimated their attributable fraction in Iran. Methods We performed a hospital-based case–control study, including 493 women, diagnosed with breast cancer at 50 years or later between 2005–2008, and 493 controls. We used logistic regression models to estimate multivariable odds ratios (OR) and 95% confidence intervals (CI), and population attributable fractions (PAF) for significant risk factors. Results The risk of breast cancer decreased with increasing parity. Compared with nulliparous women, the adjusted OR (95% CI) was 0.53 (0.25-1.15) for parity 1–3, 0.47 (0.29-0.93) for parity 4–6 and 0.23 (0.11-0.50) for parity ≥7. The estimated PAF for parity (25) was approximately 25%. The family history was significantly associated with increased breast cancer risk, but not increasing height, early age at menarche, late age at first birth or short breastfeeding. Conclusions Decreasing parity and increasing obesity are determinants of increasing breast cancer incidence among Iranian women. These trends predict a continuing upward trend of postmenopausal breast cancer.

Abstract Background Sexual function in patients with breast cancer especially in younger patients is an important issue from clinical and psychosocial perspectives. This study aimed to assess sexual function among Iranian breast cancer patients. Methods This was a prospective study of sexual function in breast cancer patients attending the Cancer Institute of Iran. Sexual function was assessed using the Female Sexual Function Index (FSFI) at two points in time: baseline (pre-treatment) and after completion of cancer treatment at follow-up visits (post-treatment). Pre- and post-treatment data were compared. In addition logistic regression analysis was performed to find out factors that contributing to post-treatment sexual dysfunction. Results In all 277 breast cancer patients were approached. Of these, 231 patients (83%) were sexually active and data for 216 patients (93.5% of sexually active patients) were available at pre-and post-treatment. Overall pre- and post-treatment sexual dysfunction was found to be 52% and 84%, respectively indicating a significant deterioration in sexual function among breast cancer patients. The results obtained from multiple logistic regression analysis indicated that younger age [OR = 0.95, 95% CI = 0.93-0.98; P = 0.04], receiving endocrine therapy [OR = 3.34, 95% CI = 1.37-7.91; P = 0.007] and poor sexual function at pre-treatment [OR = 12.3, 95% CI = 3.93-39.0; P < 0.0001] were the most significant contributing factors to post-treatment sexual disorders. Conclusion A significant number of breast cancer patients experience deterioration in sexual function over time. The findings from this study indicated that younger age, receiving endocrine therapy, and poor sexual function at diagnosis were the most significant predicting factors for sexual disorders following treatment.

Study designDescriptive study.ObjectivesThe aim of this manuscript is to describe the development process of the data set for the National Spinal Cord Injury Registry of Iran (NSCIR-IR).SettingSCI community in Iran.MethodsThe NSCIR-IR data set was developed in 8 months, from March 2015 to October 2015. An expert panel of 14 members was formed. After a review of data sets of similar registries in developed countries, the selection and modification of the basic framework were performed over 16 meetings, based on the objectives and feasibility of the registry.ResultsThe final version of the data set was composed of 376 data elements including sociodemographic, hospital admission, injury incidence, prehospital procedures, emergency department visit, medical history, vertebral injury, spinal cord injury details, interventions, complications, and discharge data. It also includes 163 components of the International Standards for the Neurologic Classification of Spinal Cord Injury (ISNCSCI) and 65 data elements related to quality of life, pressure ulcers, pain, and spasticity.ConclusionThe NSCIR-IR data set was developed in order to meet the quality improvement objectives of the registry. The process was centered around choosing the data elements assessing care provided to individuals in the acute and chronic phases of SCI in hospital settings. The International Spinal Cord Injury Data Set was selected as a basic framework, helped by comparison with data from other countries. Expert panel modifications facilitated the implementation of the registry process with the current clinical workflow in hospitals.

Objectives Previous studies assessed the link between plant based diet and breast cancer risk rather than healthy and unhealthy plant based diet. This study examined the relation between plant-based dietary pattern and risk of breast cancer among Iranian women. Methods This hospital-based case-control study was conducted among 412 women with pathologically confirmed breast cancer within the past year and 456 apparently healthy controls. Dietary data were collected using a validated and reliable 168-item FFQ. We created three patterns including overall plant-based diet index (PDI), a healthful plant-based diet index (hPDI), and an unhealthful plant-based diet index (uPDI). The risk of breast cancer was compared across quartiles of PDI, hPDI, and uPDI. Results we did not find significant association between adherence to PDI and uPDI score and odds of breast cancer among women. However, a greater score of hPDI was inversely associated to the risk of breast cancer (OR: 0.63; 95% CI: 0.43-0.93, P = 0.01), in the crude model. After adjustment for age and energy, we saw stronger association between breast cancer risk and higher hPDI score (OR: 0.55; 95% CI: 0.37-0.82, P = 0.002). After stratified by menopausal status, we did not find significant association between PDI and uPDI score and risk of breast cancer. However, pre- and postmenopausal women in the highest quartile of hPDI score had lower risk of breast cancer than those in the lowest quartile. Conclusions we found an inverse significant association between hPDI and odds of breast cancer in the whole population of study. After stratifying by menopausal status, this correlation was also seen both in pre and postmenopausal women., Author(s): Bahareh Sasanfar [sup.1] , Fatemeh Toorang [sup.2] [sup.3] , Zahra Booyani [sup.2] , Fatemeh Vassalami [sup.2] , Elham Mohebbi [sup.4] , Leila Azadbakht [sup.3] [sup.5] [sup.6] , Kazem Zendehdel [...]

Background: End-of-life care for patients with advanced cancer can impose a significant financial burden. However, data on the economic impact of end-of-life care in low- and middle-income countries are limited. Objective: This study aims to compare the costs associated with palliative care units (PCUs) and non-PCU settings for cancer patients in Iran. Design: We designed a retrospective study at the largest hospital in the country. Methods: We conducted a comprehensive evaluation of hospitalization costs and care service delivery for 150 patients in the final 5 days of life, who were admitted to the largest hospital complex in Iran. All costs were adjusted based on the 2018 USD exchange rate. Results: Among the 150 patients included in the study, 56 (37%) were admitted to the PCU. The average total treatment cost during the final 5 days of life was three times higher in general wards compared to PCUs. In non-PCU settings, the total cost of care during this period amounted to $2873, while in PCU settings, it was $909.63. Conclusion: The establishment of PCUs within tertiary hospitals and the provision of palliative consultation services to patients with advanced cancer can yield significant benefits, even when resources are limited. Plain language summary: An economic study about the cost of last five days of cancer patients in two different hospital ward, to show the importance of establishing palliative care in cancer hospitals in point of view of health economic An economic study about the cost of last five days of cancer patients in two different hospital ward, to show the importance of establishing palliative care in cancer hospitals in Iran, a low- and middle-income country in point of view of health economic. Why was the study done? There was only one hospital with palliative care setting in the country. Unfortunately in 2020 because of COVID-19 pandemic and the policy of hospital to use beds for COVID patients the PCU ward was closed and we tried to show the role of PCU and the importance of opening the ward again. What did the researchers do? The research team studied the cost of services that patients received during their last days of their life in PCU and non-PCU. What did the researchers find? Among the 150 patients included in the study, 56 (37%) were admitted to the PCU. The average total treatment cost during the final five days of life was three times higher in general wards compared to PCUs. In non-PCU settings, the total cost of care during this period amounted to $2873, while in PCU settings, it was $909.63. What do the findings mean? This study showed that having PCU in hospitals could save money and reduce the futile services. [ABSTRACT FROM AUTHOR]

Background: We aimed to study age‐standardized incidence rates (ASRs) of different cancer sites in Isfahan province, an industrialized city in the central part of Iran. Method: We obtained cancer incidence data from 2014 to 2018 in the Isfahan population‐based cancer registry (PBCR). We studied quality indicators of PBCR and the validity of residential places for cancer patients. ASRs per 100,000 of common cancers were reported overall and at subprovincial levels. Results: Overall, 42,994 new cancer cases were registered in Isfahan PBCR in 2014–2018, and 51.4% were male. A high percentage of microscopic verification (MV%) (78.1%) and a low percentage of death certificate‐only (DCO%) cases (7%) indicate the acceptable validity and completeness of this registry. The ASRs per 100,000 for all cancers combined were 173.7 in men and 171.1 in women. The most common cancers were prostate (ASR = 26.1), bladder (ASR = 19.9), and colorectum (ASR = 19.6) cancers in men and breast (ASR = 49.9), thyroid (ASR = 11.5), and colorectal (ASR = 15.6) cancers in women. Compared to the national reports in Iran, Isfahan province had a higher ASR of leukemia (13.6 in men and 8.9 in women), non‐Hodgkin lymphoma (14 in men and 9 in women), and bladder (19.9 in men and 3.4 in women) cancer. The ASR of childhood cancers was 182.7. Notably, the most frequent cancer was leukemia (ASR = 73.4). We observed a wide geographic heterogeneity of cancer incidence in different counties for some cancers like breast, prostate, leukemia, and colorectal cancers. Conclusion: High incidence rates of hematological malignancies and bladder cancers in Isfahan province suggest further research to study the association between occupational and environmental exposures due to industrial pollution. [ABSTRACT FROM AUTHOR]

Head and neck squamous cell carcinomas (HNSCCs) are linked to tobacco smoking, opium use, and human papillomavirus (HPV) infection. However, little is known about the association of HPV infection with risk factors of HNSCCs, including opium and tobacco use. This cross‐sectional analysis of a national multi‐center case–control study in Iran included 498 HNSCC cases and 242 controls. We investigated the association of opium and tobacco use with α‐ (n = 21), β‐ (n = 46), and γ‐HPV (n = 52) types in saliva samples using type‐specific bead‐based multiplex genotyping assays (TS‐MPG). We found that α‐HPV positivity was significantly associated with tobacco smoking (OR = 10.35; 95% CI = 1.15, 93; p =.03), but not with opium use (OR = 1.06; 95% CI = 0.41, 2.76; p =.89). Additionally, tobacco smoking correlated with an elevated risk of β‐species 2 HPV infection (OR = 1.28; 95% CI = 1.04, 1.58; p =.020). Conversely, opium use showed a positive association with γ‐species 12 HPV infection (OR = 5.67; 95% CI = 1.43, 22.44; p =.013). These findings indicate that tobacco and opium use may influence the risk of HPV infection in different ways depending on the HPV genus and species. Further studies are needed to replicate these findings in other populations. [ABSTRACT FROM AUTHOR]

Numerous studies have reported lower overall cancer mortality rates among immigrants compared to native populations. However, limited information exists regarding cancer mortality among immigrants based on specific birth countries and cancer types. We used population‐based registries and followed 10 million individuals aged 20 years or older in Sweden between 1992 and 2016. The Cox proportional hazard model was used to explore the disparities in cancer mortality by country of birth and cancer type, stratified by gender. Age‐standardized mortality rates were also computed using the world standard population. Hazard ratio (HR) of all‐site cancer was slightly lower among immigrants (males: HRm = 0.97: 95% confidence interval: 0.95, 0.98; females: HRf = 0.93: 0.91, 0.94) than Swedish‐born population. However, the immigrants showed higher mortality for infection‐related cancers, including liver (HRf = 1.10: 1.01, 1.19; HRm = 1.10: 1.02, 1.17), stomach (HRf = 1.39: 1.31, 1.49; HRm = 1.33: 1.26, 1.41) cancers, and tobacco‐related cancers, including lung (HRm = 1.44: 1.40, 1.49), and laryngeal cancers (HRm = 1.47: 1.24, 1.75). The HR of mesothelioma was also significantly higher in immigrants (HRf = 1.44: 1.10, 1.90). Mortality from lung cancer was specifically higher in men from Nordic (HRm = 1.41: 1.27, 1.55) and non‐Nordic Europe (HRm = 1.49: 1.43, 1.55) countries and lower in Asian (HRm = 0.78: 0.66, 0.93) and South American men (HRm = 0.70: 0.57, 0.87). In conclusion, there are large variations in cancer mortality by country of birth, and cancer type and require regular surveillance. Our detailed analyses lead to some novel findings such as excess mortality rate of mesothelioma and laryngeal cancers in Immigrants in Sweden. A targeted cancer prevention program among immigrants in Sweden is needed. [ABSTRACT FROM AUTHOR]

Objective: Despite the implementation of the WHO Framework Convention on Tobacco Control (FCTC) program in Iran, the regulation of second-hand smoke (SHS) exposure—an often-overlooked hazard—, still requires improvement. We employed a multi-center case-control study to investigate the association between exposure to secondhand smoke (SHS) from various tobacco products (cigarettes, water-pipes, pipes, and chopogh), opium use, and the risk of lung cancer. Method: We included 627 lung cancer cases and 3477 controls. Exposure to SHS tobacco and SHS opium was collected through a questionnaire. We used mixed-model logistic regressions to estimate odds ratios (ORs) and 95% confidence intervals (CI). Result: Among the overall population exposed to second-hand tobacco smoke (SHTS), the odds ratio (OR) compared to those never exposed was 1.35 (95% CI: 1.08–1.71). Never smokers who were ever exposed to second-hand tobacco smoke (SHTS) had 1.69-fold risk of lung cancer compared to those who were never exposed (95% CI: 1.13–2.52). Exposure to SHTS between 2–3 per day (OR = 2.27, 95% CI: 1.13–4.53) and more than three hours per day (OR = 2.29, 95% CI: 1.20–4.37) can increase the risk of lung cancer compared with the no exposure group (P-trend <0.01). We did not observe any association between exposure to second-hand opium smoke (SHOS) and the risk of lung cancer, either in the overall population or among never-smokers. Conclusion: Our study estimates the impact of second-hand tobacco smoke (SHTS) on lung cancer risk in both the overall population and never-smokers. Additional studies are required to evaluate the association between exposure to second-hand smoke from opium and other type of tobacco, including water-pipe and the risk of lung cancer. [ABSTRACT FROM AUTHOR]

Background: The inflammatory potential of diet may affect carcinogenesis. This study aimed to determine the association between dietary inflammatory index (DII) and the risk of head and neck cancer (HNC), as well as the interaction between DII and cigarette smoking in HNC development within the Iranian population. Study Design: This is a case-control study. Methods: In this multicenter case-control study, participants' dietary intake was assessed using a validated 130-item food frequency questionnaire, from which DII was computed. The study recruited 876 new cases from referral hospitals across 10 provinces and 3409 healthy controls who were frequency-matched based on age, gender, and residential place. Logistic regression was used to obtain odds ratios (ORs) for HNC across tertiles of DII, which were adjusted for confounding variables. Results: A higher pro-inflammatory diet was associated with an increased risk of all HNC (OR T3 vs. T1 [95% CI]: 1.31 [1.06, 1.62]; P-trend = 0.013). There was a significant association between lip and oral cavity cancers and DII (OR T3 vs. T1 [95% CI]: 1.56 [1.16, 1.66]; P-trend = 0.004). Furthermore, an inflammatory diet was associated with an increased risk of pharynx cancer (OR T3 vs. T1 [95% CI]: 2.08 [1.14, 3.79]; P-trend = 0.02). Additionally, no significant association was observed between DII and larynx cancer, while an interaction was found between DII and tobacco use on the risk of HNC (OR T3 vs. T1 [95% CI]: 2.52 [1.78, 3.57]; P-interaction = 0.03). Conclusion: DII was positively associated with HNC risk. There was a significant association between DII and the risk of lip, oral cavity, and pharynx cancers. Additionally, there was an interaction between tobacco use and DII in determining the risk of HNC. [ABSTRACT FROM AUTHOR]