Marked increase in breast cancer incidence in young women: A 10-year study from Northern Iran, 2004-2013.

INTRODUCTION: Breast cancer is the most frequent cancer among women worldwide. Breast cancer incidence in young women is a health issue of concern, especially in middle-income countries such as Iran. The aim of this study is to report the breast cancer incidence variations in Golestan province, Iran, over a 10-year period (2004-2013). METHODS: We analyzed data from the Golestan Population-based Cancer Registry (GPCR), which is a high-quality cancer registry collecting data on primary cancers based on standard protocols throughout the Golestan province. Age-standardized incidence rates (ASRs) and age-specific incidence rates per 100,000 person-years were calculated. Time trends in ASRs and age-specific rates were evaluated using Joinpoint regressions. The average annual percentage change (AAPC) with correspondence 95% confidence intervals (95%CIs) were calculated. RESULTS: A total of 2106 new breast cancer cases were diagnosed during the study period. Most cases occurred in women living in urban areas: 1449 cases (68%) versus 657 cases (31%) in rural areas. Statistically significant increasing trends were observed over the 10-year study period amongst women of all ages (AAPC = 4.4; 95%CI: 1.2-7.8) as well as amongst women in the age groups 20-29 years (AAPC = 10.0; 95%CI: 1.7-19.0) and 30-39 years (AAPC = 5.1; 95%CI: 1.4-9.0). CONCLUSION: The incidence of breast cancer increased between 2004 and 2013 in Golestan province amongst all age groups, and in particular amongst women aged 20-39 years. Breast cancer should be considered a high priority for health policy making in our community.

Temporal and geographical variations in colorectal cancer incidence in Northern Iran 2004-2013.

INTRODUCTION: Colorectal cancer (CRC) is one of the most common cancers in the Golestan province, Northern Iran. The purpose of this study is to describe colorectal cancer incidence patterns and trends in the province 2004-2013. METHODS: Data on CRC cases were obtained from the Golestan Population-based Cancer Registry (GPCR). The GPCR is a high-quality cancer registry that collects data on primary cancers according to internationally accepted standard protocols. Age-standardized Incidence rates (ASR) were calculated and the 10-year trend quantified using the average annual percentage change (AAPC) from Joinpoint regressions. RESULTS: The overall ASR of CRC were higher in men (14.8 per 100,000 person-years) and the urban populations (35.4), relative to women (11.5) and the rural populations (17.1), respectively. The overall incidence rate was observed to significantly increase 2004-2013 in men (AAPC = 7.3; 95%CI: 2.9-11.8) and women (AAPC = 6.6; 95%CI: 2.7-10.6). The analysis also showed that urban areas (AAPC = 8.1; 95%CI: 2.4-14.1) had a relatively more rapid increase in rates compared to rural areas (AAPC = 6.9; 95%CI: 2.2-11.7). CONCLUSIONS: CRC incidence rates in Golestan have been rising during the most recent decade, with a higher incidence and more rapid increases among men and the urban populations. The underlying risk factors should be assessed in the context of developing CRC prevention interventions in Golestan.

Anticoagulant utilization evaluation in a teaching hospital: a prospective study.

BACKGROUND AND GOAL: Due to the importance of anticoagulation use along with the complications that deep vein thrombosis (DVT) and pulmonary embolism (PE) may bring about for the patients, in this study we decided to carry out a drug utilization evaluation on anticoagulants that are routinely administered in a tertiary teaching hospital. METHOD: Anticoagulants utilization was evaluated in 400 patients from 4 wards (infectious disease, cardiology, nephrology, and cardiac care unit) of a tertiary teaching hospital in a cross-sectional, prospective study. RESULTS: According to the risk stratification, 220 (55%) of the evaluated patients have indication to receive anticoagulants as deep venous thrombosis prophylaxis. With definite diagnosis of DVT or PE, 169 (42.3%) patients have received anticoagulant therapy. In 11 (2.8%) cases, anticoagulants has been ordered inappropriately. In assessment of the anticoagulants regimens that were used as DVT prophylaxis doses of heparin and enoxaparin were appropriate in 75% and 79% of patients, respectively. CONCLUSION: Despite the existence of comprehensive guidelines for the prevention and treatment of DVT and PE, it is not performed accurately.