Marked increase in the incidence rate of esophageal adenocarcinoma in a high-risk area for esophageal cancer

BACKGROUND: Esophageal cancer (EC) is the eighth common cancer worldwide. Esophageal squamous cell carcinoma (ESCC) and adenocarcinoma (EAD) are the most common histologic types of EC. Many recent reports showed an increasing trend in EAD and a decreasing trend in ESCC in many Western countries. Golestan Province in northeastern Iran has been known as a high-risk area for EC. The aim of this study was to describe the time trend of EAD in this area between 2000-2009. METHODS: Data on cancer cases were obtained from Golestan Population-based Cancer Registry. Analysis was done using Joinpoint software. To examine the incidence trends, the annual percent change was calculated. The possibilities of anatomic and histologic misclassification were considered by assessing the trend of ESCC and gastric adenocarcinoma. RESULTS: A total number of 1186 histologically-confirmed EC cases were recruited. The incidence rate of EAD showed a significant increasing trend. There was no significant trend in the incidence of ESCC during the study period. A significant increase in the incidence rate of gastric adenocarcinoma was observed during the period of 2000-2005, followed by a plateau during the period of 2005-2009. CONCLUSIONS: We found a significant increasing trend in the incidence rate of EAD. We find no evidence to support an alternative explanation including anatomic and histologic misclassification. So, the observed rise in the incidence of EAD seems to be real. Therefore, designing and implementation of control programs, including control of preventable risk factors of EAD, should be considered in this high- risk area

Temporal and geographical trends of incidence of thyroid cancer in Golestan, Iran, 2004-2013

Background: Thyroid cancer is the most common type of endocrine cancer. We aimed to determine the incidence rates of thyroid cancer across a 10-year period (2004-2013) in Golestan, Iran. Methods: We obtained the thyroid cancer data from Golestan Population-Based Cancer Registry (GPCR). Age-standardized incidence rates (ASR) were calculated and reported per 100 000 person-years. The Joinpoint software was used to assess time trends, and average annual percent changes (AAPCs) and their corresponding 95 confidence intervals (CIs) were reported. Results: Of 326 registered patients, 83 (25.5) were men and 243 (74.5) were women. The mean age was 51.3 and 42.6 years for males and females, respectively. Overall, the ASR of thyroid cancer was 2.2 per 100 000 person-year (AAPC = 2.76; 95 CI: -3.68 to 9.64). The test of co-incidence showed a statistically significant difference in the incidence of thyroid cancer between men (1.3) and women (3.2) (P < 0.001). According to our results, the ASR of thyroid cancer in western parts of Golestan is higher, including Gorgan and Aliabad cities. Conclusion: Increasing trends in incidence rates of thyroid cancer were found in the Golestan province during the study period, especially in women. We found significantly higher rates of thyroid cancer in women. Geographical diversities were seen in incidence rates of thyroid cancer in the Golestan province. Our results may be helpful for designing further researches to investigate the epidemiological aspects of thyroid cancer in the Golestan province. © 2021 Academy of Medical Sciences of I.R. Iran. All rights reserved

Rate Familiarity of the Members of local Organizations in the Northen Provinces of Iran about the Family Physician Programme and Rural Insurance

Introduction: The members of local Organizations in rural regions of Iran can have an effective role in the improvement of health programs due to their resources and logistical influence. Favorable collaboration of them needs sufficienet familiarity and information about the objectives and principles of health programs. This study was Performed to asses the level of familiarity in members of local organizations about the Family Physician (FP) Program and Rural Insurance in Northen Provinces of Iran. Methods: This Cross-Sectional Study was Performed in the Second half of the year 2012. % 25 of health Centers doing FP Program in three Provinces of Golestan, Mazandaran, Gillan (totally 139 Centers out of 552 units). In each selected center, available members of dispute resolation council, village coucil, health council, village magor, school manager and native teacher were enrolled in the research. A researcher- made questinnaire which its validity and reliability were Confirmed was used for data gathering. Data analysis was Performed by SPSS17 with Significant level of P<0.05. Results: 521 (84.7%) individuals (out of 601 members of local organizations) were male. The age range was 19-81 years. Mean and standard deviation of participants age was 45±9.7 years. 47.1% of persons had academic education level. Out of total score 27, mean and SD of the familiarity in village magor was 12.4±4, in health council’s members 11.6±3.7, in village council’s members 11.4±4.1, in school managers 10.6±3.3. in dispute resolation council’s members 10.5±5.1 and in native teachers was 8.8±4.9. There were significant relationships between the level of familiarity and being participated in trustees council of the health center, sex and the work type of local organization (p0.05). Conclusion: This Study Showed that the level of familiarity of members of local organizations in rural regions of Iran is not sufficient and interventional Programs must be Planned and Performed for improvement

Descriptive Epidemiology of Lymphoma in Northern Iran: Results from the Golestan Registry 2004-2013

BACKGROUND: There is currently little known about the epidemiology of lymphomas in Iran. The aim of this paper is to describe the geographic and time variations in incidence rates of lymphomas in the Golestan province between 2004 and 2013. METHODS: The Golestan Population-based Cancer Registry (GPCR) routinely registers primary cancer patients from all sources (e.g. pathology centers, hospitals, etc.) throughout the Golestan province. We obtained data on newly-diagnosed lymphomas in Golestan during 2004-2013 from the GPCR dataset. Crude rates and age standardized incidence (ASR) rates (per 100000) of lymphomas were estimated, joinpoint regression was used to quantify incidence trends and average annual percent changes (AAPCs) were calculated. RESULTS: In total, 898 new cases of lymphoma were registered in the GPCR during 2004-2013. The ASR of Hodgkin lymphoma (HL) was 1.5 and 1.1 in males and females, respectively, while corresponding non-Hodgkin lymphoma (NHL) rates were greater, at 6.5 and 3.4 in males and females, respectively. Our results indicated a significant difference in the trends of HL between males (AAPC = -3.2) and females (AAPC = 3.6, P value = 0.001). The incidence rates of lymphoma were considerably higher in the urban population (ASR = 7.3) compared to those residing in rural areas (ASR = 5.3, P value = 0.054). We also found higher incidence rates for both HL and NHL in the western parts of the Golestan province. CONCLUSION: The incidence rates of lymphoma in the Golestan province are relatively high and vary geographically, with a higher incidence observed in the western area. Such differences may reflect unknown lifestyle and environmental determinants linked to ethnic susceptibility differing between the two areas. © 2020 The Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited

Temporal and geographical variations in colorectal cancer incidence in Northern Iran 2004�2013

Introduction: Colorectal cancer (CRC) is one of the most common cancers in the Golestan province, Northern Iran. The purpose of this study is to describe colorectal cancer incidence patterns and trends in the province 2004�2013. Methods: Data on CRC cases were obtained from the Golestan Population-based Cancer Registry (GPCR). The GPCR is a high-quality cancer registry that collects data on primary cancers according to internationally accepted standard protocols. Age-standardized Incidence rates (ASR) were calculated and the 10-year trend quantified using the average annual percentage change (AAPC) from Joinpoint regressions. Results: The overall ASR of CRC were higher in men (14.8 per 100,000 person-years) and the urban populations (35.4), relative to women (11.5) and the rural populations (17.1), respectively. The overall incidence rate was observed to significantly increase 2004�2013 in men (AAPC = 7.3; 95CI: 2.9�11.8) and women (AAPC = 6.6; 95CI: 2.7�10.6). The analysis also showed that urban areas (AAPC = 8.1; 95CI: 2.4�14.1) had a relatively more rapid increase in rates compared to rural areas (AAPC = 6.9; 95CI: 2.2�11.7). Conclusions: CRC incidence rates in Golestan have been rising during the most recent decade, with a higher incidence and more rapid increases among men and the urban populations. The underlying risk factors should be assessed in the context of developing CRC prevention interventions in Golestan. © 2019 Elsevier Lt

Completeness and Accuracy of Death Registry Data in Golestan, Iran

BACKGROUND: We aimed to evaluate completeness and accuracy of the Golestan Death Registry (GDR) to identify cancer-related causes of death (CCoD). METHODS: The GDR data (2004-2015) were compared with cancer data collected from clinical/pathological sources (the considered gold standard) by the Golestan Population-Based Cancer Registry (GPCR). Using a linkage method, matched cases, including subjects with CCoD and those with ill-defined cause of death (ICoD) (garbage codes), were identified and entered into the final analysis as study subjects. The completeness (percentage of study subjects with CCoD) and accuracy (number of subjects with correct CoD from the total number of study subjects) of the GDR were calculated. RESULTS: In total, 3,766 matched cases were enrolled. Overall, the completeness and accuracy of the GDR for identifying CCoD were 92.7 and 53.2, respectively. There were variations by cancer site and age group, with completeness and accuracy highest for brain cancer (96.3) and leukaemia (79.8) while the lowest accuracy was observed for colorectal cancer (29.9). The completeness and accuracy of GDR was higher in patients aged under 60 years (95.7 and 53.6, respectively). We also found higher completeness (93.7) and accuracy (55.8) in residents of rural areas. CONCLUSION: Linkage of death registry data with cancer registry data can be a significant resource for evaluating quality of the death registry data. Our findings suggested that completeness of the GDR for identifying CCoD is reasonable, but accuracy is relatively low. Access to clinical and pathological data from other sources and enhanced training of death certifiers can improve the present situation. © 2019 The Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited

Increasing trends of lung cancer in Golestan province, Northern Iran (2004�2016)

Introduction: We aimed to present the time trends and geographical distribution of lung cancer in Golestan province, a high-risk area for pulmonary tuberculosis (TB) in Northern Iran (2004-2016). Methods: Data on incident primary lung cancers were obtained from the Golestan population-based cancer registry. The data were analyzed by CanReg-5 software to calculate the age-standardized incidence rates (ASRs). We used Joinpoint software for time trend analysis. Average annual percent changes were calculated. The contribution of population aging, population growth and risk to the overall changes in incidence of lung cancer were determined using partitioning analysis. Results: Overall, 1829 cases of lung cancer were registered by the GPCR during 2004-2016, of which 1274 (69.7, ASR in 2016 = 21.3) were men and 555 (30.3, ASR in 2016 = 11.4) were women. The results of Joinpoint regression suggested a significant increasing trend in incidence of lung cancer in Golestan province during 2004 and 2016 (AAPC = 3.74; p-value = 0.01) with more prominent increasing in rural population (AAPC = 4.93; p-value<0.01). The number of new cases of lung cancer increased by 131.6 (from 98 in 2004 to 227 in 2016), of which 34.1, 22.3 and 75.3 were due to population size, population aging and risk, respectively. Hot points of lung cancer were found in western parts of the Golestan. Conclusion: With high incidence rates and increasing trends of lung cancer, further studies are warranted to clarify the role of TB and other risk factors on its burden in this population. © 2020 Elsevier Lt

Building a cancer biobank in a low-resource setting in Northern Iran: The Golestan Cancer Biobank

Background: We aim to present the development and the initial results of the Golestan Cancer Biobank (GoCB), in a low resource setting in northern Iran. Methods: The GoCB protocol and its standard operation procedures (SOP) were developed according to internationally accepted standards and protocols with some modifications considering the limited resources in our setting. The main biological samples collected by the GoCB include blood sample, urine sample, fresh endoscopy tissue sample, fresh surgical tissue sample and formalin fixed paraffin embedded (FFPE) tissue sample. The GoCB collects patients' demographic data, tumor characteristics as well as data on risk factors. We developed a specific GoCB software for management of patient data and biological sample information. The GoCB dataset is annually linked with the Golestan cancer registry dataset to add complementary data (e.g., survival data). Results: The GoCB started collection of data and biological samples in December 2016. By November 2020, a total number of 1217 cancer patients participated in the GoCB. The majority of the GoCB participants (n = 942, 77) were those with gastrointestinal and breast cancers. Data on risk factors were successfully collected in 684 (56.2) of the participants. Overall, 3563 samples were collected from the GoCB participants and 730 samples were used in 7 national and international research projects. Conclusion: We considered specific strategies to overcome major limitations, especially budget shortage, in the development and maintenance of a cancer-specific biological repositories in our setting. The GoCB may be considered as a model for the development of biobank in low- and middle-income countries (LMICs). © 2021 Academy of Medical Sciences of I.R. Iran. All rights reserved

Recent cancer incidence trends and short-term predictions in Golestan, Iran 2004�2025

Background: We examine recent trends in the major cancers occurring in the Golestan province, a high-risk region for upper gastrointestinal cancers in Northern Iran, and provide short-term cancer predictions of the future cancer burden. Methods: New cancer cases diagnosed in Golestan 2004�2016 were obtained from the Golestan population-based cancer registry (GPCR) database, and age-standardized rates by cancer site, year and sex calculated per 100,000 person-years. Using IARC's DepPred package we fitted time-linear age-period models to the available GPCR data to predict the cancer incidence burden in the year 2025. We calculated the contribution of demographic changes versus changes in risk to the overall changes in incidence from 2016 to 2025. Results: The number of new cancer cases (excluding non-melanoma skin cancers) in 2025 is predicted to increase by 61.3 from 2678 cases in 2016 to 4319 cases. While a 17.6 reduction in the number of esophageal cancer cases is predicted by 2025, the number of new cases for each of the remaining major cancers is predicted to increase over the next decade, including cancers of the stomach (a 36.1 increase from 2016 to 2025), colorectum (56.2), lung (67.8), female breast (93.2), prostate (101.8) and leukemia (96.1). The changes in the population structure and risk contributed 37.8 and 23.5 respectively, to the overall increase in incidence. Conclusion: Other than for the major upper gastrointestinal cancer types, the incidence rates of common cancers observed in the province are on the rise, reinforcing the need for continuous surveillance, as well as the design and implementation of effective cancer control programs. © 202