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.

Comparative genomic hybridization (CGH) analysis of chromosomal aberrations in Iranian patients with invasive ductal carcinoma breast cancer.

INTRODUCTION: Breast cancer is one of the most common cancers in women; however, due to the complexity of chromosomal changes, limited data are available regarding chromosomal constitution. MATERIALS AND METHODS: In this study, Comparative Genomic Hybridization (CGH) was used on 16 Iranian patients diagnosed with invasive ductal breast carcinomas. RESULTS: 12 samples had abnormal CGH results (75%), including 21 types of chromosomal imbalance. The most prevalent were chromosomal gain of +1q, +17q, +8q and chromosomal loss of -13q. All three cases with DNA loss at chromosome 13q (-13q) had lymph node metastasis. CONCLUSIONS: CGH is able to detect chromosomal abnormalities which are difficult to identify by conventional cytogenetic techniques. More studies on a larger sample size may help to confirm or rule out any possible correlation between 13q monosomy and lymph node metastasis, which could result in establishing new strategies for prevention and early detection of invasive breast tumors.

Epidemiology of Kaposi's sarcoma in Iran: 1984-2006.

Kaposi's sarcoma (KS) is the rarest cancer among Iranian. This study was conducted to define the epidemiology of KS in Iran. The data of National Cancer Registry (NCR) reports from 2003-2006, Tehran Population Based Cancer Registry (TCR) from 1998 to 2001, and a literature review of the published articles until Aug. 2007 was conducted, the search strategy included all papers containing "Kaposi"were combined with the word "Iran" in their titles or abstracts. In males, the annual age-standardized incidence rate was from 0.10 to 0.17 per 100,000 and in females was from 0.06-0.08 per 100.000. Peak incidence was at ages 50-79. It is more common in male than female. The Male/Female ratio has different reports from 3.2/1 to 1.8/1. Although, there were no published reports about HHV-8 or HIV/AIDS associated with KS in Iran, the elderly might be a common associated factor for KS. The prognosis of KS after renal transplantation is good; simple reduction or cessation of immunosuppression may result in partial or complete remission of the disease.

Prevalence of human papillomavirus genotypes in women with normal and abnormal cervical cytology in Iran.

INTRODUCTION: HPV infection has a prime etiologic role in development and progression of cervical cancer, one of the most frequent forms of cancer among women in developing countries. This study was designed to determine the most prevalent HPV genotypes in women with normal and abnormal cervical cytology in Iran. MATERIALS AND METHODS: Samples from134 patients, including 127 who attended gynecology clinics and 7 with solid cervical tumors were used. All 127 patients underwent routine Pap tests for cytological evaluation and at the same visit a sample of cervical epithelial cells was obtained by scraping the cervix osteum. In each case HPV infection was primarily evaluated by PCR using GP 5/6 primers and then subtyping was performed in proved infected samples with specific primers for HPV 16, 18, 31, 33, 11 and 6. After cytological evaluation, 50 patients with abnormal Pap tests were categorized as the abnormal group and the remaining 77 patients as the normal group. RESULTS: In the normal group, HPV infection was established in 10 cases (13% infection rate), while 30 HPV positive cases were discovered in the abnormal group (60% infected). The most prevalent genotypes among the infected samples were HPV 16 (76%), HPV18 (12.7%) and HPV11/6 (8.5%). Moreover, all 7 tumor samples were positive for HPV general primers of which, 5 samples were infected with HPV 16, two were co-infected with HPV16,18 and HPV16,31 genotypes and one was infected with HPV 18. CONCLUSIONS: Infection with HPV 16 was found to be significantly higher in abnormal group in comparison with normal group (42% vs. 11.6%, P value <0.005), likewise HPV18 genotypes were proved to be more prevalent in abnormal group (8% vs. 0%, P value <0.05). No significant relation between other HPV genotypes and pathologic cervical changes was obtained. According to our study high rates of infection with HPV genotypes in sexually active Iranian women makes molecular investigation for HPV16 and 18 very essential in clinical approaches to patients with proven dysplasia in their screening tests and also for those patients with borderline (i.e. ASCUS) or incongruous pathology reports. Larger studies are required to determine the most appropriate vaccine with highest protection in Iranian women.

Epidemiology of esophageal cancer in the high-risk population of iran.

The Iranian population includes several ethnic groups scattered throughout Iran, which differ with regard to their rates for cancer. An infamous 'Asian esophageal cancer belt'stretches to the east from the Caspian littoral in Iran via Turkmenistan to the Northern provinces of China. Apart from the eastern part of the Caspian littoral area of Iran which has the highest incidence of esophageal cancer in the world, other parts of the country have variable rates, ranging from 3 to more than 15 cases per 100,000 population, but rates have decreased sharply in the high incidence areas. Studies of the etiology of esophageal cancer in Iran and especially among the Turkmen ethnic population have indicated that several factors are behind the striking high incidence. Certain risk factors such as a family history of esophageal cancer, low socioeconomic status and poor nutritional diet are well studied and plausible evidence for their etiologic contributions exist. While thermal irritation and coarse food (physical damage to the mucosal lining of the esophagus) have attracted attention in correlational studies, conclusions about their etiologic contribution are inconclusive.

Cancer occurrence in Iran in 2002, an international perspective.

For almost 30 years no population-based cancer statistics have been available with which to estimate the cancer burden in Iran. In 2002 and 2003 two separate reports of population based cancer registries were published from Iran and the cancer incidence rates from these sources have permitted informed estimates of cancer incidence and mortality to be prepared. They suggest that more than 51,000 cases of cancer are diagnosed and 35,000 deaths due to cancer occur each year. The 5 most common cancers in males (by ASR) are stomach (26.1 per 10(5)), esophagus (17.6 ), colon-rectum (8.3), bladder (8.0) and leukemia (4.8), and in females are breast (17.1), esophagus (14.4), stomach (11.1), colon-rectum (6.5) and cervix uteri (4.5). The incidence rates of esophageal and stomach cancer in Iran are high, well above the world average, while the incidence of lung cancer is very low. Breast cancer, although the most common cancer of females in Iran, has rates that are low by world standards, especially those observed in Europe and USA. Similarly, the incidence of cervix cancer in Iran is very low, even lower than such low risk countries as China, Kuwait and Spain. Comparing these rates with the data of 30 years ago, the incidence of esophageal cancer has decreased dramatically, but gastric cancer has increased about two fold.

Time trends in the occurrence of major GI cancers in Iran.

OBJECTIVE: The aim of this study was to study the changes in occurrence of esophageal, stomach and colon cancers (cancers of interest) over the last 30 years in Iran. MATERIAL AND METHODS: Cancer cases referred to two main cancer centers in the country (the Shiraz cancer center and the Tehran cancer center) during last 30 years and published by the two centers were utilized. Morbidity odds ratios (MOR) were used to study trend in the occurrence of each cancer site in each center. For this purpose the cancers of interest were considered as cases; childhood cancers as controls; and calendar year as exposure. A regression line was fitted to morbidity odds ratios over years and the slope of the regression line was considered to indicate the overall trend. MORs and 95% CIs comparing the last five and first five years were computed to measure the magnitude of the change over time. RESULT: The overall trend for esophageal cancer was decrease (slopes = -0.02 for Shiraz and -0.03 for Tehran); for stomach was increase (slopes = 0.04 for Shiraz and 0.08 for Tehran), and for colon cancer was sharp increase (slopes = 0.02 for Shiraz and 0.10 for Tehran). The magnitude of changes showed stomach cancer to increase by 35% in Shiraz (MOR = 1.35 with 95% CI 1.1, 1.65) and 13% in Tehran (MOR = 1.13 with 95% CI 0.96, 1.38), esophageal cancer to decrease by 20% in Shiraz (MOR = 0.82 with 95% CI 0.62, 1.11) and 50% in Tehran (MOR = 0.52 with 95% CI 0.45, 0.60), and colon cancer to increase by 65% in Shiraz (MOR = 1.65 with 95% CI 1.26, 2.16) and 82% in Tehran (MOR = 1.82 with 95% CI 1.52, 2.25). CONCLUSION: During the last thirty years the occurrence of major GI cancers has changed in Iran with sharp increase in colon cancer, slight to moderate increase in stomach cancer and sharp decrease in esophageal cancer.