OBJECTIVESThe main purpose of this study was to evaluate changes in the time trends of stomach, colorectal, and esophageal cancer during the past decade in Iran.METHODSCancer incidence data for the years 2001 to 2010 were obtained from the cancer registration of the Ministry of Health. All incidence rates were directly age-standardized to the world standard population. In order to identified significant changes in time trends, we performed a joinpoint analysis. The annual percent change (APC) for each segment of the trends was then calculated.RESULTSThe incidence of stomach cancer increased from 4.18 and 2.41 per 100,000 population in men and women, respectively, in 2001 to 17.06 (APC, 16.7%) and 8.85 (APC, 16.2%) per 100,000 population in 2010 for men and women, respectively. The corresponding values for colorectal cancer were 2.12 and 2.00 per 100,000 population for men and women, respectively, in 2001 and 11.28 (APC, 20.0%) and 10.33 (APC, 20.0%) per 100,000 in 2010. For esophageal cancer, the corresponding increase was from 3.25 and 2.10 per 100,000 population in 2001 to 5.57 (APC, 12.0%) and 5.62 (APC, 11.2%) per 100,000 population among men and women, respectively. The incidence increased most rapidly for stomach cancer in men and women aged 80 years and older (APC, 23.7% for men; APC, 18.6% for women), for colorectal cancer in men aged 60 to 69 years (APC, 24.2%) and in women aged 50 to 59 years (APC, 25.1%), and for esophageal cancer in men and women aged 80 years and older (APC, 17.5% for men; APC,15.3% for women) over the period of the study.CONCLUSIONSThe incidence of gastrointestinal cancer significantly increased during the past decade. Therefore, monitoring the trends of cancer incidence can assist efforts for cancer prevention and control.

Introduction Colorectal cancer (CRC) is a significant health problem with an increasing incidence worldwide. Screening is one of the ways, in which cases and deaths of CRC can be prevented. The objective of this systematic review was to evaluate the cost-effectiveness of the different CRC screening techniques and to specify the efficient technique from a cost-effectiveness perspective. Methods The economic studies of CRC screening in general populations (average risk), aged 50 years and above were reviewed. Two reviewers independently reviewed the titles, abstracts, and full-texts of the studies in five databases: Cochrane, Embase, Scopus, Web of Science and PubMed. The disagreements between reviewers were resolved through the authors’ consensus. The main outcome measures in this systematic review were the incremental cost-effectiveness ratio (ICER) of screening versus no-screening and then in comparison with other screening techniques. The ICER is defined by the difference in cost between two possible interventions, divided by the difference in their effect. Results Eight studies were identified and retained for the final analysis. In this study, when screening techniques were compared to no-screening, all CRC screening techniques showed to be cost-effective. The lowest ICER calculated was $PPP −16265/quality-adjusted life-year (QALY) (the negative ICERs were between purchasing power parity in US dollar ($PPP) −16265/QALY to $PPP −1988/QALY, whereas the positive ICERs were between $PPP 1257/QALY to $PPP 55987/QALY). For studies comparing various screening techniques, there was great heterogeneity in terms of the structures of the analyses, leading to diverse conclusions about their incremental cost-effectiveness. Conclusion All CRC screening techniques were cost-effective, compared with the no-screening methods. The cost-effectiveness of the various screening techniques mainly was dependent on the context-specific parameters and highly affected by the framework of the cost-effectiveness analysis. In order to make the studies comparable, it is important to adopt a reference-based methodology for economic evaluation studies.

Background: Breast cancer is the most common cancer among women in Iran. The aim of this study was to explore the spatial autocorrelation and the estimation incidence rates variance among Iranian provinces. Methods:In this cross-sectional exploratory study, age-standardized incidence rates from 2004 to 2010 were analyzed in order to detect hot and cold spots map and estimate the rates using ordinary kriging Conclusions:There are relatively large differences between the geographic distribution of the breast cancer clusters in the East and North East regions of the country in comparison to other areas. Policy makers are advised to consider such provincial diversity for better understanding of factors affecting the incidence of breast cancer.

Cancer patients are at risk for severe complications or death from COVID-19 infection. Therefore, the need for routine COVID-19 testing in this population was evaluated. Between 1st August and 30th October 2020, 150 cancer patients were included. Symptoms of COVID-19 infection were evaluated. All eligible individuals went through RT-PCR and serological tests for COVID-19. At the same time, 920 non-cancer patients were recruited from a random sample of individuals who were subject to routine molecular and anti-body screening tests. Of 150 cancer patients, 7 (4.7%) were RT-PCR positive. Comorbidity made a significant difference in the RT-PCR positivity of cancer patients, 71.4% positive versus 25.8% negative (P-value = 0.02). The average age for negative and positive groups was 53.3 and 58.2 respectively (P-value = 0.01). No significant difference was observed between cancer and non-cancer patients regarding COVID-19 antibody tests. However, cancer patients were 3 times less likely to have a positive RT-PCR test result OR = 0.33 (CI: 0.15–0.73). The probability of cancer patients having a positive routine test was significantly lower than non-cancer patients, and the concept that all cancer patients should be routinely tested for COVID-19 may be incorrect. Nevertheless, there may be a subgroup of patients with comorbidities or older age who may benefit from routine COVID-19 testing. Importantly, these results could not be subjected to multivariate analysis.

BackgroundConsidering the hygiene facilities and sharing the data of diseases, considerable attempts to promote the public awareness have been made by various media; however, most of the provided information is based on numerical and verbal statistics, and may not provide suitable understanding for people in regard with the situation of diseases.ObjectivesThe main aim of this study is to design an interactive WebGIS system in which people could simply produce and observe their favorite maps of different cancers and environmental parameters. They can use this tools to produce their personalized maps and explore various aspects of the cancer.Materials and MethodsA system has been developed by using WebGIS for convenience of ordinary users without any knowledge about geospatial information system (GIS) to observe the situation of the diseases and environmental conditions in terms of static and user-produced interactive maps. It has also provided the possibility of spatial comparison of the arbitrary parameters in the framework of bar and pie diagrams. This system has been designed and launched on cancer database of Iran where information of meteorological stations has been embedded as environmental parameters.ResultsThe innovative idea in this study has received less attention in previous works including possibility of producing web-based Choropleth map so that users could easily select the parameters and algorithms for classification and interactive coloring in the system to produce their personalized maps.ConclusionsDevelopment of WebGIS tools and increased cooperation of people in terms of inserting the spatial labels on the map to report a disease or using their views about reasons of occurring a specific cancer in a specific region may cause turning the process of mono-direction flow of information to users to a bi-directional flow of information. As a result, cancer specialists could use the knowledge of local people and residents of different regions of the country to better analyze the situation of various kinds of cancers.

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Spatial analysis at small geographical levels can provide useful information about the areas at risk. There have been few studies conducted to carefully consider the impact of various socioeconomic factors, health costs, and risk factors on CRC at the level of small geographical units, such as the neighborhoods of a city.

Background: Prostate cancer is the second most common malignancy among Iranian men after stomach cancer. To understand the nature of the disease and plan and develop a population-based cancer registry, it is essential to recognize the clinical and pathological characteristics of the tumors, as well as treatment results. Objectives: The present study aimed to evaluate the clinical and pathological characteristics of prostate cancer and evaluate the routine practice, including treatment outline and results of treatment in six referral centers in Iran. Methods: This prospective observational pilot study recruited patients with prostate cancer between April 2015 and October 2015 at six referral centers in Iran. The participating physicians included consecutive patients according to inclusion criteria. Demographic, clinicopathologic, and treatment data were collected by the physicians using an electronic case report form (eCRF). The patients were followed for 18 months, and during this period, four visits were scheduled for each patient to collect the data. Results: A total number of 102 patients from six centers in five different cities of Iran were included in the study. Sixty-seven (65.7%) patients were diagnosed by needle biopsy as the first diagnostic method, 23 (22.5%) by radical prostatectomy, and 12 (11.8%) by open prostatectomy. Total at-risk times of patients for overall survival (OS) and progression-free survival (PFS) were 1480.9 and 1437 months, respectively. Median (IQR) values of OS and PFS were 18.2 (9.2 - 20.5) and 18.2 (6.8 - 20.4) months, respectively. Forty (39.2%) patients underwent surgery, 58 (56.8%) underwent radiotherapy, and 13 (12.7%) received chemotherapy. Twenty-nine (28.4%) patients experienced adverse events over the follow-up period. Eight deaths were reported that were unrelated to treatment adverse effects. Conclusions: This pilot registry could serve as a valuable tool for the development of a comprehensive nationwide registry for patients with prostate cancer in Iran.