On March 11th 2020, the coronavirus outbreak was declared a pandemic by the WHO. One of the groups that is considered high risk in this pandemic are cancer patients as they are treated with a variety of immune system suppressor treatment modalities and this puts them in a great risk for infectious disease (including COVID-19). Therefore, cancer patients require higher level measures for preventing and treating infectious diseases. furthermore, cancer patients may bear additional risk due to the restriction of access to the routine diagnostic and therapeutic services during such epidemic. Since most of the attention of health systems is towards patients affected with COVID-19, the need for structured and unified approaches to COVID-19 prevention and care specific to cancer patients and cancer centers is felt more than ever. This article provides the recommendations and possible actions that should be considered by patients, their caregivers and families, physician, nurses, managers and staff of medical centers involved in cancer diagnosis and treatment. We pursued two major goals in our recommendations: first, limiting the exposure of cancer patients to medical environments and second, modifying the treatment modalities in a manner that reduces the probability of myelosuppression such as delaying elective diagnostic and therapeutic services, shortening the treatment course, or prolonging the interval between treatment courses.
Background: Breast cancer is the most common cancer in women worldwide with a rising incidence rate in most countries. Considering the increase in life expectancy and change in lifestyle of Iranian women, this study investigated the age-adjusted trend of breast cancer incidence during 2000-2009 and predicted its incidence to 2020. Materials and Methods: The 1997 and 2006 census results were used for the projection of female population by age through the cohort-component method over the studied years. Data from the Iranian cancer registration system were used to calculate the annual incidence rate of breast cancer. The age-adjusted incidence rate was then calculated using the WHO standard population distribution. The five-year-age-specific incidence rates were also obtained for each year and future incidence was determined using the trend analysis method. Annual percentage change (APC) was calculated through the joinpoint regression method. Results: The bias adjusted incidence rate of breast cancer increased from 16.7 per 100,000 women in 2000 to 33.6 per 100,000 women in 2009. The incidence of breast cancer had a growing trend in almost all age groups above 30 years over the studied years. In this period, the age groups of 45-65 years had the highest incidence. Investigation into the joinpoint curve showed that the curve had a steep slope with an APC of 23.4% before the first joinpoint, but became milder after this. From 2005 to 2009, the APC was calculated as 2.7%, through which the incidence of breast cancer in 2020 was predicted as 63.0 per 100,000 women. Conclusions: The age-adjusted incidence rate of breast cancer continues to increas in Iranian women. It is predicted that this trend will continue until 2020. Therefore, it seems necessary to prioritize the prevention, control and care for breast cancer in Iran.
Background:There are important differences regarding cancer disclosure in various geographical populations (Europeans, Western Asia, Eastern Asia), depending on multiple sociocultural factors, and therefore, there is no standard protocol on this issue, especially in Iran.Objectives:To evaluate the amount of information that Iranian patients have and their preference for the disclosure of the cancer diagnosis.Patients and Methods:In this cross sectional descriptive research, patients admitted in the oncology departments of 3 referral medical centers, Imam Hussein, Shohada-e-Tajrish and Modarres, in Tehran, from March 2007 to April 2008, were questioned about their awareness and knowledge regarding their diagnosis. Two different structured questionnaires were designed for the people who know and who didn't know their diagnosis. For the former, the survey concerned their psychological reactions to their situations, whether they would prefer to know about their diagnosis and by whom they are preferred to be informed .For the latter, the questionnaire included their preference whether to know the diagnosis and their current emotional state. Descriptive statistics and chi square test was applied to analyze gathering Data, using SPSS version 14.Results:60.3% of the patients knew their diagnosis. Among the subjects who did not know their diagnosis, 88% preferred to be more informed about their diagnosis and 68% had some psychological reaction to their situations. Among the subjects who knew their diagnosis, 92.1 % preferred to know their diagnosis, 73.6% preferred to be informed directly by their physicians. Following the diagnostic disclosure, 81.5% reported that they had felt nervous, anxious and worried.Conclusions:The majority of Iranian patients with malignancy want to know the truth and they prefer to be informed directly by their doctors.
Completeness is an important indicator of data quality in cancer registry programs. This study aimed to estimate the completeness of registered cases in a population based cancer registry program implemented in five provinces of Iran. Capture-recapture methods were used to esti mate the number of cases that may have been missed and to estimate rates of completeness for different categories of age, year, and sex. The data used for this study were obtained from three sources: 1) National Pathology Database; 2) National Hospital Discharge Database; and 3) National Death Registry Database. The three sources were linked and duplicates were identified based on first name, last name, father's names, and date of birth, ICD code, and case's residency address using Microsoft Excel. Removing duplicates, the three sources reported a total of 35,643 cases from March 2008 to March 2011. Running many different multivariate models of capture-recapture and controlling for source dependencies revealed an overall under-reporting of 49% in all five registries combined. The estimated completeness differed based on age, sex, and year. The overall completeness was higher for males than females (71.2% for males and 59.9% for females). Younger age had lower rates of completeness compared to older age (38.1% for <40 years, 55.4% for 40-60 years, and 76.7 for >60 years). The results of this study indicated a moderate to severe (depending on the age, sex and year) degree of completeness in the population based cancer registration of Iran.
Background: Cancer is the first cause of death followed by ischemic heart disease (IHD) and stroke, worldwide, with increasing 19.5% years of life lost (YLL) due to cancer from 2007 to 2017. The cancer burden is steadily increased with decreasing 4.4% death rate from 2007-2017. The incidence rate of cancer is twice to 3 times higher in developed countries with low mortality due to care regarding developing countries. Objectives: Here, we report the 10 years' incidence and mortality of malignancies in Iran with different patterns compared to the other parts of the world. Methods: Data of national cancer registry system from 2005 to 2014 were analyzed in order to find out the trend of age standardized incidence rate (ASIR)/age standardized mortality rate (ASMR)/ mortality to incidence ratio (MIR) in both sexes in Iranian population. Results: Growing trend in ASIR for both sexes in all of the cancers were seen. ASMR decreased from 2005 to 2014 in both sexes with higher rate in males. MIR decreased by half in 2014 compared to 2005 regarding the increase of cancer in Iran. Conclusions: In Iran, the incidence of cancer is increasing due to aging people and death is decreasing due to the good care of patient. So, it is a good sample of developing country, which is comparable with the developed ones.
Introduction: Cancer Registry is one of the important components of health information systems in developing countries. Continuous monitoring of data quality can have a crucial role in controlling cancers. This study aimed to assess the quality of cancer registry data in terms of completeness of coverage and validity. Methods: Data were collected from three main sources, including Pathology registry, Hospital and national death registries in five provinces in Iran during March 2008-March 2011. We used two source capture-recapture method for estimate of cancer registry coverage and measures of validity were percentage of death certificate only (DCO%), histological verified cases (MV%); cancer incidence in childhood based on sex and age group, percentage of cancer in the elderly (80 years or above) and mortality-to-incidence ratio (M:I).We compared them to international standards. Results: The overall completeness was estimated at 54.2% and 32.4% under reporting for stomach cancer in a period of three years (2008 -2010). MV% and percentage of unknown primary site of the tumor were 68.7%, and 5% respectively. The mortality-to-incidence ratio for men and women was 37.6% and 28.2%, and percentage of cancer in the elderly was 10.9% in 2010 year. The age-specific rate in girls and boys in age groups of 5 -9 and 10 -14 years was lower than minimum of the recommended international standards. Conclusions:The results of this study showed data quality of cancer registry is relatively low in terms of the completeness and validity. Cancer registries should pay great attention to the quality of their data. In addition to technical measures in data processing, continuous evaluation of their quality in order to achieve the set goals is essential.
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