Global, regional, and national cancer incidence, mortality, years of life lost, years lived with disability, and disability-Adjusted life-years for 29 cancer groups, 1990 to 2017 : A systematic analysis for the global burden of disease study

Importance: Cancer and other noncommunicable diseases (NCDs) are now widely recognized as a threat to global development. The latest United Nations high-level meeting on NCDs reaffirmed this observation and also highlighted the slow progress in meeting the 2011 Political Declaration on the Prevention and Control of Noncommunicable Diseases and the third Sustainable Development Goal. Lack of situational analyses, priority setting, and budgeting have been identified as major obstacles in achieving these goals. All of these have in common that they require information on the local cancer epidemiology. The Global Burden of Disease (GBD) study is uniquely poised to provide these crucial data. Objective: To describe cancer burden for 29 cancer groups in 195 countries from 1990 through 2017 to provide data needed for cancer control planning. Evidence Review: We used the GBD study estimation methods to describe cancer incidence, mortality, years lived with disability, years of life lost, and disability-Adjusted life-years (DALYs). Results are presented at the national level as well as by Socio-demographic Index (SDI), a composite indicator of income, educational attainment, and total fertility rate. We also analyzed the influence of the epidemiological vs the demographic transition on cancer incidence. Findings: In 2017, there were 24.5 million incident cancer cases worldwide (16.8 million without nonmelanoma skin cancer [NMSC]) and 9.6 million cancer deaths. The majority of cancer DALYs came from years of life lost (97%), and only 3% came from years lived with disability. The odds of developing cancer were the lowest in the low SDI quintile (1 in 7) and the highest in the high SDI quintile (1 in 2) for both sexes. In 2017, the most common incident cancers in men were NMSC (4.3 million incident cases); tracheal, bronchus, and lung (TBL) cancer (1.5 million incident cases); and prostate cancer (1.3 million incident cases). The most common causes of cancer deaths and DALYs for men were TBL cancer (1.3 million deaths and 28.4 million DALYs), liver cancer (572000 deaths and 15.2 million DALYs), and stomach cancer (542000 deaths and 12.2 million DALYs). For women in 2017, the most common incident cancers were NMSC (3.3 million incident cases), breast cancer (1.9 million incident cases), and colorectal cancer (819000 incident cases). The leading causes of cancer deaths and DALYs for women were breast cancer (601000 deaths and 17.4 million DALYs), TBL cancer (596000 deaths and 12.6 million DALYs), and colorectal cancer (414000 deaths and 8.3 million DALYs). Conclusions and Relevance: The national epidemiological profiles of cancer burden in the GBD study show large heterogeneities, which are a reflection of different exposures to risk factors, economic settings, lifestyles, and access to care and screening. The GBD study can be used by policy makers and other stakeholders to develop and improve national and local cancer control in order to achieve the global targets and improve equity in cancer care. © 2019 American Medical Association. All rights reserved.Peer reviewe

Evaluation of Zinc, Copper and Iron Concentrations in Breast Milk of Mothers Belonging to Different Economic Classes and their Correlations with Infants Growth

Introduction: Taking into account the importance of micronutrients in health and growth of the infants, the concentrations of zinc, copper, and iron in breast milk of mothers belonging to different economic classes and their effects on infants’ growth were investigated. Methods: Milk samples and information on personal characteristics, anthropometric and 24-hour food recall were collected from 90 lactating women belonging to 3 different socioeconomic classes who had exclusively breastfed their 90-120 day old infants. Concentrations of trace elements were analyzed using atomic absorption spectrophotometry and dietary information of subjects was analyzed by Nutritionist III software program. Statistical tests included Multiple Regression, ANOVA test and Independent t-test. Results: The mean zinc concentrations in mothers’ breast milk belonging to high, moderate and low socioeconomic groups were 1.6, 1.9 and 2.3 mg/l, respectively. Copper levels were 0.41, 0.47 and 0.85 mg/l, respectively and iron levels were 0.75, 0.8 and 0.9 mg/l, respectively. Group comparisons showed significant differences (P<0.05). Although association between mineral concentrations and WAZ or HAZ of infants was not significant, the WAZ of infants whose mothers' milk zinc concentration was more than 2 mg/l was significantly higher than WAZ of other infants (P<0.03). Despite no significant correlation between trace element intake and trace elements in milk, negative and significant correlations between maternal age and milk minerals concentrations were observed. Conclusion: The concentration of studied trace elements in milk of mothers with low economic status was higher but was not related to intakes and it was probably related to mothers' age. So, dietary consultations for older lactating mothers are needed

Evaluation of Food Intake in Ulcerative Colitis Patients

Introduction: Ulcerative colitis (UC) is a chronic inflammatory disorder of the colon of unknown cause that is associated with important nutrition deficiencies such as protein-energy malnutrition, vitamin and mineral deficiencies. Because no study has been carried out to date in Iran, the aim of this pilot study was the assessment of dietary intake of these patients. Methods: In this pilot study, 41 UC patients whose disease severity was mild or moderate were selected. Data about diet restrictions were collected via a questionnaire and dietary intake was assessed 3 times during a 2 month period with 30 days interval and 3-day food-recall (9days in general). Results: Subjects were 26 men and 15 women and 65.9% patients avoided completely or limited milk intake. Dietary limitation about fruits and vegetables was 24.4 and 43.9 percent, respectively and legumes intake was 58.5%. Mean calorie intake in 41 patients was 2125.14±60.83 calories/day and in two groups, calcium and fiber intake was significantly less than the standard dietary recommendation. Conclusion: Dietary intake examination showed some deficiencies such as calcium and iron deficiency and fiber intake was low because the intake of fruits, vegetables and legumes was limited