Cancer Incidence in Kerman Province, Southeast of Iran: Report of an ongoing Population-Based Cancer Registry, 2014

Comprehensive analysis of the role of ubiquitin-specific peptidases in colorectal cancer: A systematic review

BACKGROUND

Colorectal cancer (CRC) is the third most frequent and the second most fatal cancer. The search for more effective drugs to treat this disease is ongoing. A better understanding of the mechanisms of CRC development and progression may reveal new therapeutic strategies. Ubiquitin-specific peptidases (USPs), the largest group of the deubiquitinase protein family, have long been implicated in various cancers. There have been numerous studies on the role of USPs in CRC; however, a comprehensive view of this role is lacking.

AIM

To provide a systematic review of the studies investigating the roles and functions of USPs in CRC.

METHODS

We systematically queried the MEDLINE (via PubMed), Scopus, and Web of Science databases.

RESULTS

Our study highlights the pivotal role of various USPs in several processes implicated in CRC: Regulation of the cell cycle, apoptosis, cancer stemness, epithelial-mesenchymal transition, metastasis, DNA repair, and drug resistance. The findings of this study suggest that USPs have great potential as drug targets and noninvasive biomarkers in CRC. The dysregulation of USPs in CRC contributes to drug resistance through multiple mechanisms.

CONCLUSION

Targeting specific USPs involved in drug resistance pathways could provide a novel therapeutic strategy for overcoming resistance to current treatment regimens in CRC.

Incident cancers attributable to using opium and smoking cigarettes in the Golestan cohort study

Background

Opium consumption has recently been identified as a carcinogen, but the impact of opium use on cancer burden is unknown. We aimed to evaluate the fraction of cancers that could be attributed to opium use alone and in combination with cigarette smoking in a region where opium is widely used.

Methods

50,045 Iranian adults were recruited to this prospective cohort study between 2004 and 2008 and were followed through January 2022. We assessed the association between using opium and/or cigarette smoking and various cancers using proportional hazards regression models. We then calculated population attributable fractions (PAFs) for all cancers and for groups of cancers causally linked to opium and cigarette smoking.

Findings

Of the total participants, 8% only used opium, 8.3% only smoked cigarettes, and 9% used both substances. During a median 14 years of follow-up, 2195 individuals were diagnosed with cancer, including 215 opium-related cancers (lung, larynx, and bladder) and 1609 tobacco-related cancers (20 types). Opium use alone was estimated to cause 35% (95% CI: 26%-45%) of opium-related cancers, while smoking cigarettes alone was estimated to cause 9% (6%-12%) of tobacco-related cancers in this population. Using opium and/or cigarettes was estimated to cause 13% (9%-16%) of all cancers, 58% (49%-66%) of opium-related cancers, and 15% (11%-18%) of tobacco-related cancers. Moreover, joint exposure to opium and cigarettes had the greatest impact on cancers of the larynx, pharynx, lung, and bladder, with PAFs ranging from 50% to 77%.

Interpretation

Using opium and smoking cigarettes account for a large proportion of cancers in this population. To reduce the cancer burden, prevention policies should aim to decrease the use of both substances through public awareness campaigns and interventional efforts.

Funding

The Golestan Cohort Study work was funded by the Tehran University of Medical Sciences, Cancer Research UK, U.S. National Cancer Institute, International Agency for Research on Cancer. The presented analysis was supported by the International HundredK+ Cohorts Consortium (IHCC).

Factors Affecting Survival of Patients with Cervical Cancer

Background

Cervical cancer is the fourth leading cause of cancer-related death among women worldwide. We aimed to identify the factors affecting the survival rate of cervical cancer patients, as these factors are vital for preventing the progression and effective treatment of cancer.

Methods

In this retrospective cohort study, 254 patients with cervical cancer who were registered in The Kerman Population-Based Cancer Registry (KPBCR) between 2012 and 2022 and whose status was known to be alive or dead were enrolled. Since the proportional hazard assumption was not established for the type of treatment, the extended Cox model was used to determine the variables influencing the survival of the patients.

Results

The mean survival time of the patients was 91.28 ± 3.02 months. The results of fitting the extended Cox model showed that the risk of death increases by 1.02 per year of age at diagnosis (HR=1.02; 95% CI: 1.00, 1.04). Moreover, for a one-unit increase in body mass index (BMI), the risk of death increased by 0.93 (HR=0.93; 95% CI: 0.88, 0.98). The risk of death in patients with disease stages III&IV was 3.08 times that of patients with disease stages I&II (HR=3.08; 95% CI: 1.05, 9.03). The risk of death in patients receiving at least one of the radiotherapy and chemotherapy treatments after 18 months was 7.11 times that of patients undergoing surgery (HR=7.11; 95% CI: 1.69, 29.91).

Conclusion

The age of diagnosis, BMI, disease stage, and type of treatment significantly affect the survival of patients. Thus, raising women's awareness of periodical examinations and early diagnosis can reduce the risk of death and prevent cervical cancer progression.

TERT Promoter Mutations as Simple and Non-Invasive Urinary Biomarkers for the Detection of Urothelial Bladder Cancer in a High-Risk Region

Bladder cancer (BC) is the 10th most common cancer in the world. While there are FDA-approved urinary assays to detect BC, none have demonstrated sufficient sensitivity and specificity to be integrated into clinical practice. Telomerase Reverse Transcriptase (TERT) gene mutations have been identified as the most common BC mutations that could potentially be used as non-invasive urinary biomarkers to detect BC. This study aims to evaluate the validity of these tests to detect BC in the Kerman province of Iran, where BC is the most common cancer in men. Urine samples of 31 patients with primary (n = 11) or recurrent (n = 20) bladder tumor and 50 controls were prospectively collected. Total urinary DNA was screened for the TERT promoter mutations (uTERTpm) by Droplet Digital PCR (ddPCR) assays. The performance characteristics of uTERTpm and the influence by disease stage and grade were compared to urine cytology results. The uTERTpm was 100% sensitive and 88% specific to detect primary BC, while it was 50% sensitive and 88% specific in detecting recurrent BC. The overall sensitivity and specificity of uTERTpm to detect bladder cancer were 67.7% and 88.0%, respectively, which were consistent across different tumor stages and grades. The most frequent uTERTpm mutations among BC cases were C228T (18/31), C250T (4/31), and C158A (1/31) with mutant allelic frequency (MAF) ranging from 0.2% to 63.3%. Urine cytology demonstrated a similar sensitivity (67.7%), but lower specificity (62.0%) than uTERTpm in detecting BC. Combined uTERTpm and urine cytology increased the sensitivity to 83.8%, but decreased the specificity to 52.0%. Our study demonstrated promising diagnostic accuracy for the uTERTpm as a non-invasive urinary biomarker to detect, in particular, primary BC in this population.

The Evaluation of Survival Rate in Patients with Prostate Cancer by Bayesian Weibull Parametric Accelerated Failure-Time Model

Background

Prostate cancer is the most prevalent malignancy in men. This study was carried out to determine effective factors on the survival rate of patients diagnosed with prostate cancer in Kerman, Iran.

Methods

The present study was conducted as a retrospective cohort of 238 patients diagnosed with prostate cancer from 2011 to 2019 in Kerman, Iran. First, the demographic and clinical information of patients were collected. Then, the information on patient survival up to June 2019 was tracked, and their latest statuses of death or survival were recorded. Kaplan-Meier method, log-rank test, and Bayesian Weibull parametric accelerated failure-time model were used for data analysis. Data analysis was carried out by Stata and SAS.

Results

The mean age of patients in the diagnosis was 73.28±10.08 year. The patient's 1, 2, 3 and 5-years of overall survival rates were equal to 78.54%, 65.97%, 56.64% and 49.30, respectively. Patients under surgical therapy relatively held longer survival times compared to the rest of the therapies. Patients under chemotherapy had shorter survival times. Age at diagnosis, occupation, chemotherapy, surgery, education, and smoking variables significantly affected patients' survival (P<0.05).

Conclusion

Patients' survival duration increases if the disease is diagnosed at younger ages and its preliminary development stages. Smoking cessation is strongly recommended after diagnosis, as it is associated with a lower survival rate. Patients who underwent radical prostatectomy surgery showed higher survival rates than radiotherapy, hormone ablation, or chemotherapy. Moreover, patients with higher education had more prolonged survival.

Investigation of the affective factors on the survival rate of patients with laryngeal cancer using Cox proportional hazards and Lin -Ying's additive hazards models

Background: Determining the factors affecting survival and appropriate treatment methods leads to improving the survival rate and quality of life in cancer patients; therefore this study was aimed to determine the effective factors on the survival rate of patients with Laryngeal cancer in Kerman city, Iran.

Methods: This retrospective cohort study included 370 patients with Laryngeal cancer who referred to the hospitals of Kerman city, Iran during 2008 to 2018. Data were analyzed using Cox Proportional Hazards and Lin-Ying’s Additive Hazards models. Data analysis was done using SAS software version 9.4. The P-value of less than 0.05 was considered as statistically significant.

Results: The mean age at the time of diagnosis was 58.16±10.60 years. About 92% of the patients were men. The patient’s 1, 3, 5, 7 and 10-years of overall survival rates were equal to 82.38%, 60.68%, 55.98%, 49.83%, and 30.91%, respectively. Age at the diagnosis (p=0.001), radiotherapy (p=0.001), chemotherapy (p=0.015), surgery (p=0.031), and smoking (p=0.001) were found to have significant effect on the patient’s survival rate in the Cox model. These variables were significant in the Lin-Ying model too.

Conclusion: Treatment is an important factor in controlling the disease and survival of cancer patients, and choosing the best treatment depends on the condition of the patient and the disease level.

Bladder Cancer in Iran: An Epidemiological Review

PURPOSE

Bladder cancer is the sixth most common cancer in Iran. Information about the epidemiological situation of the disease and its risk factors is necessary for conducting a planning program to reduce the disease. This study is conducted with the aim of evaluating the epidemiological features of bladder cancer in Iran.

METHODS

This is a systematic review of the published articles in both Persian and English in international and national journals during the years 2000-2019 with key words of Iran and bladder cancer. Articles were selected from the national information database (SID, Magiran) and international databases (PubMed, Scopus, and Web of Science). Articles related to the epidemiological aspects of the disease, including incidence, prevalence, mortality, and risk factors, were evaluated.

RESULTS

The incidence rate of bladder cancer was about 1.6-115; cumulative survival rate was 0.95, mortality rate was 0.5-0.84 and its prevalence in the Iranian population was between 4.10% and 12.8%. The risk of developing malignancy in major risk factor groups, including smoking and opium, was 6.2 (2.04-18.7), increases in protein and animal fat consumption were about 5- and 19-times higher than in the general population, respectively. In terms of occupational exposure, bus and heavy truck drivers were 11.3 (1.3-92.05) more at risk than others.

CONCLUSION

Regarding the increasing trend of this disease, changes in lifestyle to reduce risk factors can be effective in decreasing the incidence and mortality rate of this malignancy.