The economic burden of esophageal cancer in Iran

Background: Studies on economic burden demonstrate the impacts of some diseases and provide invaluable information for specifying priorities and resource needs when designing cancer control strategies. The current study aimed to estimate the cost of esophageal carcinoma (EC) in Iran in 2018. Methods: This study was conducted on the prevalence approach to estimate the economic burden of EC in Iran from a social perspective. The direct cost was estimated by summing the diagnosis, treatment, follow-up, terminal care, and transport costs. Additionally, a human capital approach was adopted to estimate productivity losses. Various resources were used for data collection, including the GLOBOCAN 2018 report, and the medical record in the Cancer Institute of Iran. Also, data such as exchange rates, employment, and housekeeping rates were extracted from the Central Bank of Iran Statistics. Results: The economic burden of EC in Iran was $69.2 million in 2018, of which $38.7 million is caused by indirect costs and $30.5 million by direct costs. The mortality cost accounted for 49% of the economic burden, followed by 34% direct medical cost, 10% direct non-medical cost, and 7% morbidity cost. Conclusions: Mortality and medical cost appeared to be the main contributor to the economic burden. Therefore, policy-makers are recommended to adopt early detection and effective treatment as a highly cost-effective strategy for controlling costs

Outcome of breast cancer in Iran: a study of Tehran Cancer Registry data.

BACKGROUND: Breast Cancer is the second most common cancer among Iranian women. This study was conducted to define the outcome of breast cancer which had been registered by Tehran Cancer Registry. METHODS: All Tehranian breast cancer which registered from 1998 to 2001 was selected; the repeated cases were excluded according to their common name, family name, and Father's name. A simple data collection form was used to complete the demographic and diagnostic time and survival situation of the cases by five educated technicians with using phone interviews with patients or their families. All data were entered in Access file and then exported to SPSS-11.5, for descriptive and analytic analysis, p value was significant under 0.05. Since there were some cases had not phone number or the phone numbers were not accessible; 360 cases were selected with Simple Random Sampling and their hospital files were reviewed to complete the demographic and location situations data. Kaplan- Meier regression model was used for computing the survival. RESULTS: Of the 7098 records, 4416 records were interviewed by phone. This phone interviews were succeeded among 2358 cases; Tehranian and other cities were defined in 986 and 1372 records respectively. The Tehranian cases were estimated 36.9% (CI95%: 31.9%-41.8%). The mean age of patients was 51.3+/-12.5, 31.4% of them was under 40 years old, the incidence rate of breast cancer in 100,000 women was estimated 17.09 CI95% (15.67-18.50). Infiltrating duct carcinoma was the most morphology (68.4%). Right, left, and both breast involvement were seen in 48.6% CI95% (43.4%-53.8%), 46.1% CI95 %( 41.0%-51.2%), 0.3% CI95%(0.1%-0.5%) respectively. The tumor size over 2 centimeters was seen in 63.6% of cases at diagnostic time. Lymphadenopathy and metastasis were seen in 48.3% CI95% (43.1%-53.5%), and 19.7% CI95% (15.6%-23.8%) of cases. The median survival was 5.0 years CI95% (4.9 years-5.1 years). CONCLUSION: This retrospective survival study was shown the seven years follow up from 1998 to 2005, women which were diagnosed in 1998, 1999, 2000, and 2001; 55.9%, 61.4%, 60.3%, 66% were alive respectively. Interventional projects for increasing the survival rate, early detection, and effective treatment of breast cancer were recommended.

Burden of breast cancer in Iran: a study of the Tehran population based cancer registry.

BACKGROUND: Breast cancer is the second most common cancer among Iranian women. This study was designed to estimate the burden of breast cancer in Tehran, the capital of Iran. METHODS: In this retrospective study, the existing data of Tehran Population Based Cancer Registry (TCR) from 1998 to 2001 were used; all Tehranian women with breast cancer were followed for computing the survival and remission rates. The World Health Organization's Practical Guide of National Burden of Disease Studies was employed for performing the study. The data for breast cancer were analyzed with DISMOD II software and Disability Adjusted Life Years (DALY) were computed using Excel based software. RESULTS: The mean age of the patients was 51.3+/-12.5, 31.4% being under 40 years old. The incidence rate of breast cancer was estimated to be 17.09 (95 %CI: 15.67-18.50) per 100,000 women. The five year survival rate was 75 %. The DALY for breast cancer was 4,252 years (95 %CI: 3896-4604). CONCLUSION: Breast cancer is a high burden in the community. More than 36% of the tumors occur in women under 40 years old. Comprehensive national cancer control programs including promotion of awareness, early detection, treatment and palliative cares are vitally important for decreasing the burden of breast cancer in Iran. This strategy should be strongly recommended to policy makers and special programs should be considered for women under 40 years old.