Total burden of esophageal cancer disability adjusted life years in Golestan Province during 1387

Maintenance of health and its fair and just promotion in any society is the responsibility and duty of its respective government. Appropriate financial allocations and prudent decisions in the health sector requires the definition of an index that would reveal the loss resulting from early deaths of any cause and originate from disabilities due to nonfatal outcomes. The disability adjusted life years [DALY] index has such a characteristic. Esophageal cancer is the third prevalent cancer of the gastrointestinal tract. In Golestan Province, among the variety of cancers, it is the third leading cause of death and its incidence rate in the province is the highest in the country. In this study we try to compute the burden of this cancer. In this manner, while estimating the importance of this disease in Golestan Province, we aim to pave the way for scientific and effective assessments of this disease and determine an action plan for its containment. In this cross-sectional study, we used Dismod II software that has been designed for cancer modeling in populations. With this software, we computed the burden of cancer for the year 1387 in Golestan Province. The data needed as input for Dismod II included the population of the province, mortality and incidence rates that originated from esophageal cancer, all which were obtained from the 1385 census, Mortality Registry System, Cancer Registry' System and expert panel views. Total burden of esophageal cancer according to DALY in Golestan Province during 1387 was 2992/48 years in the total population. Amongst males, it was 1533/65 years and 1408/46 years in females due to years of lost life [YLL]. As a result of years lived with disability [YLD], it was 25/54 years in males and 24/84 years in females. The burden of esophageal cancer per 1000 population of Golestan Province equaled 1 /76 years for females and 1/88 years for males. The peak age of esophageal cancer burden was in the age groups of 60 to 80 years and above 80 years. The relative high burden of esophageal cancer in Golestan Province compared to other parts of the country is justifiable due to the existence of the highest incidence rate in this province. Therefore, we believe that esophageal cancer should be one of the highest priorities of the health system of the province. However, the final and definitive judgment is contingent upon computations of the burden of other cancers and diseases at the provincial level and its respective rankings

[Induction of esophagal reflux after eradication of helicobacter pylori]

The epidemiologic studies have demonstrated that decreasing the Helicobacter pylori [H. Pylori] infection will increase the rate of gastro esophageal reflux disease [GERD]. It also, has been shown that patients suffering from GERD have less episode of the H. pylori infection. In this study 9500 patient recorded files from a private clinic were evaluated to study the prevalence of GERD after complete eradication of H. Pylori infection . The inclusion criteria were: symptoms such as dyspepsia, peptic ulcer disease or gastroduodenitis due to H .pylori infection confirmed by positive rapid urease test[RUT] with the absence of endoscopic examination or clinical signs of GERD. H.Pylori condition and signs of the GERD were considered in the second endoscopy examination. Patients with H . Pylori negative in the second endoscopy examination, were considered as case group, and those who were positive for H. pylori, considered as control group . New incidence of GERD were studied in both groups. A total of 100 patients were included in the study in which, 81 patients were nominated as case group and 19 in control group. The patient's mean age for case group and control group were 37.6+12.6 and 37.4+12.2 years, respectively. Forty-nine percent of case group and 52.6% of control group were male. The duration mean between the first and the second endoscopic examinations was 29.4+7.9 months in case and 32.1+10.1 in control group. The incidence of GERD in case and control groups was 38.3% and 15.8%, respectively. There was no significant difference in age, and gender as well as duration interval between the first and second endoscopic examinations in both the case and control groups. The incidence of the GERD in H.pylori negative patients [case group] was significantly higher than the control group [p=0.05]. Eradication of H . pylori can cause gastro-esophageal reflux . Therefore, when H . pylori positive patients treated for their infection, the GERD should be expected in a considerable number of them