Incidence of Esophageal Cancer in Iran, a Population-Based Study: 2001-2015

Development of Bio-artificial Esophageal Tissue Engineering Utilization for Circumferential Lesion Transplantation: A Narrative Review

The esophagus is the gastrointestinal tract's primary organ that transfers bolus into the stomach with peristaltic motion. Therefore, its lesions cause a significant disturbance in the nutrition and digestive system. Esophageal disease treatment sometimes requires surgical procedures that involve removal and circumferential full-thickness replacement. Unlike other organs, the esophagus has a limited regeneration ability and cannot be transplanted from donors. There are various methods of restoring the esophageal continuity; however, they are associated with certain flaws that lead to a non-functional recovery. As an exponentially growing science, tissue engineering has become a leading technique for the development of tissue replacement to repair damaged esophageal segments. Scaffold plays a significant role in the process of tissue engineering, as it acts as a template for the regeneration of growing tissue. A variety of scaffolds have been studied to replace the esophagus. Due to the many tissue quality challenges, the results are still inadequate and need to be improved. The success of esophageal tissue regeneration will finally depend on the scaffold's capability to mimic natural tissue properties and provide a qualified environment for regeneration. Thereby, scaffold fabrication techniques are fundamental. This article reviews the recent developments in esophageal tissue engineering for the treatment of circumferential lesions based on scaffold biomaterial engineering approaches.

National and Subnational Cancer Incidence for 22 Cancer Groups, 2000 to 2016: A Study Based on Cancer Registration Data of Iran

BACKGROUND

Cancer is an increasing public health concern, and detailed knowledge of the cancer incidence is required for developing effective cancer control plans. The objective of this study is to present the cancer incidence of 22 cancer groups in Iran and all 31 provinces of the country from 2000 to 2016, for both sexes across different age groups.

METHOD

To study the national and provincial cancer incidence in Iran, we extracted data from the Cancer Project, which collects the Iranian cancer registry data and visualizes it in the VIZIT data visualization system. The methodology and statistical analysis that is used in this study follow the cancer project study protocol. Joinpoint analysis was performed to calculate the average annual percent change of the crude rates and age-standardized rates from 2000 to 2016.

RESULTS

Cancer incidence was 126,982 patients in 2016, and the crude rate (CR) of cancer in both sexes and all ages was 155 per 100,000 people. Cancer incidence approximately doubled between 2000 and 2016; however, the age-standardized rate (ASR) had a less drastic increase. The most incident cancers in 2016 were breast, skin, and colorectal cancers; however, the ranking of cancer groups by incidence was different in different age and sex groups and provinces. Some cancers exhibited a unique distribution pattern in the country with high-incidence local areas. Discussion. The study showed that cancer incidence, crude rate, and age-standardized rate (ASR) in Iran had increased in 2000-2016 with vast heterogeneity by cancer type, province, and sex. Moreover, it was shown that the crude rate of cancer in Iran was much less than the global cancer crude rate. Providing such data helps to allocate resources and develop effective national cancer control plans appropriately.

Trend of Gastric Cancer Incidence in an Area Located in the Center of Iran: 2009-2014

PURPOSE

There are remarkable differences between the incidence and mortality of gastric cancer in different places of the world. This study, for the first time, estimated the information around the incidence rates and trends of gastric cancer in the central area of Iran, Arak metropolitan.

METHODS

In this study, all cases with gastric cancer in Arak from 2009 to 2014 were included. Direct standardized method was applied to estimate age-standardized incidence rates (ASIRs) by a STATA package, with efficient interval estimation that might be preferable in the case of rare diseases, including cancer data. The obtained standard errors were used to calculate annual percent changes (APCs) by the Joinpoint analysis.

RESULTS

Annual ASIRs of gastric cancer were 23.92 (95% CI 21.62, 26.37) and 9.60 (95% CI 8.20, 11.18) for male and female, respectively. In male, APC of ASIRs was - 5.00% (95% CI - 9.32, - 0.47). In contrast, among female, it was - 2.69% (95% CI - 31.56, 38.34) that was statistically insignificant.

CONCLUSIONS

The ASIRs have significantly decreased trends in males, but not in females. The preventive strategies should be a focus on the declining of the risk factors and the quick early diagnosis of gastric cancer.

Worldwide trends in breast cancer incidence from 1993 to 2012: Age-period-cohort analysis and joinpoint regression

Background:

Breast cancer is the most common cancer accounting for about one-fourth of total cancer cases and 15% of all cancer deaths among women worldwide. It is important to determine its trend across the regions in the world to find the high-focus regions. Hence, the current study was done to assess the global trends and deviations in the incidence of breast cancer.

Materials and Methods:

A descriptive trend analysis was done using the data on breast cancer incidence from the WHO Cancer Incidence Data of Five Continents plus database. Joinpoint regression was performed to determine the average annual percent change (AAPC), and age-period-cohort analysis was done to obtain age-, period-, and cohort-specific deviations and rate ratio.

Results:

All the regions showed an increasing trend in breast cancer incidence, with an exception of America. Maximum increase was observed in Asia (AAPC = 2.6%; 95% confidence interval [CI]: 2.4%–2.9%) followed by Europe (AAPC = 0.7%; 95% CI: 0.5%–1%). There was consistent rise in the breast cancer incidence across the age groups in all the four continents with maximum burden in elderly (P < 0.001). Except in America, all other regions showed consistent rise in the incidence of breast cancer through the periods 1998–2002 to 2007–2012 (P < 0.001). There was consistent increase across the cohorts from 1923–1927 to 1978–1982 in continents such as Asia and Oceania (P < 0.001).

Conclusion:

To summarize, the incidence of breast cancer shows an increasing trend globally with a maximum increase in the Asian region. This makes a strong need for newer strategies irrespective of current prevention and control interventions.

Trends in Mortality Rates for Gastrointestinal Cancers in Fars Province, Iran (2005-2015)

PURPOSE

In Iran, cancers are the third leading cause of death, and gastrointestinal cancers are the primary cause of mortality among all the cancers. This study aimed to determine the trend of crude and age-standardized mortality rates (ASMR) for different types of gastrointestinal cancers over an 11-year period in Fars province (Iran).

METHODS

In this study, all the mortality data for gastrointestinal cancers were derived from the Electronic Death Registration System (EDRS) between 2005 and 2015. Subsequently, we calculated the crude and age-standardized mortality rates (ASMR) and their trends for different types of gastrointestinal cancers based on age groups and gender over the study period.

RESULTS

A total of 6547 deaths from gastrointestinal cancers were identified, with an average age of 66.0 ± 16.4 years. The crude and age-standardized mortality rates for gastrointestinal cancers were respectively 10.9 and 15.0 per 100,000 population in 2005 which significantly increased to 17.4 and 19.4 per 100,000 population in 2015 (P < 0.001). The ASMR for colon, pancreatic, and oral cancers showed an increasing trend; for small intestine cancers, a decreasing trend; and for esophageal, gastric, rectal, and hepatobiliary cancers displayed an almost constant trend.

CONCLUSIONS

Our study shows a higher ASMR and an increasing trend of gastrointestinal cancers in Fars province. Prevention and early diagnosis programs with screening techniques should be implemented to control the mortality rate of gastrointestinal cancers in the future.

Trend of gastric cancer in a province in Western Iran: A population-based study during 2001-2014

BACKGROUND

There are no studies on the trend of gastric cancer (GC) incidence in Kurdistan, a province in the west of Iran. We aimed to estimate the trend, age-standardized incidence rate (ASR), and annual percentage change (APC) of GC in this province during 2001-2014.

MATERIALS AND METHODS

The data of newly diagnosed GC patients were obtained from the regional Cancer Registering Database. The ASRs were calculated per 100,000 population during 2001-2014. Direct standardization and 95% confidence intervals (CI) were calculated by an efficient method. The temporary changes in ASRs were determined based on the APC by the joinpoint regression model.

RESULTS

Overall, 2225 newly diagnosed GC patients were identified. The ASRs ranged from 13.5 (95% CI: 10.4-17.3) to 29.0 (95% CI: 24.5-34.0). The highest ASRs were related to the men and women lived in Divandareh as 32.26 and 13.66, respectively. The respective APC value of GC incidence in women demonstrated a nonsignificant increase during 2001-2008 and a nonsignificant decrease during 2008-2014 (P = 0.1). Accordingly, the incidence of GC in men increased during 2001-2004 (P = 0.1) and decreased during 2004-2014 (P = 0.001).

CONCLUSION

The incidence of GC showed nonsignificant and significant decreasing trends in women and men in Kurdistan province, respectively. Despite such decreasing trends, the Kurdistan province is still considered as one of the regions with high incidence of GC in Iran. Therefore, it is necessary to implement screening programs in the province to early diagnose GC.