Incidence, Time Trends and Geographical Distribution of Leukemia and Multiple Myeloma in Golestan Province, Northern Iran, 2004-2017.

BACKGROUND: Leukemia and multiple myeloma (MM) are the most common hematologic malignancies in Iran. This paper describes the geographic and temporal changes in their incidence in Golestan, northern Iran. METHODS: Data on cases of leukemia and MM during 2004-2017 were obtained from the Golestan Population-based Cancer Registry (GPCR). The GPCR is a dynamic database of Golestan residents diagnosed with primary cancers. Age-standardized incidence rates (ASRs) (per 100000) of leukemia and MM were calculated using direct standardization method considering the world standard population. We used Joinpoint regression to assess incidence trends using the average annual percent change (AAPC). RESULTS: In total, 2119 new cases of leukemia and MM were registered by the GPCR during 2004-2017. The ASRs of leukemia were 9.71 and 6.70 in males and females, respectively, while the rates were lower for MM: 2.66 and 1.97 in males and females, respectively. The incidence rates of leukemia suggested an increasing trend in urban population (AAPC=2.73; P value=0.154), while in rural area, the incidence rates were slightly decreasing (AAPC=- 0.73; P value=0.658). There were high incidence areas of leukemia in the central and western regions of Golestan. CONCLUSION: Our results suggested high incidence rates of leukemia and MM in the Golestan province. We also found geographical diversities and increasing trends in the incidence of leukemia in the urban population. Exposure to occupational and environmental carcinogens including pesticides may partly explain high rates and the observed trends. Further investigations should be considered to clarify these points in our population.

Recent cancer incidence trends and short-term predictions in Golestan, Iran 2004-2025.

BACKGROUND: We examine recent trends in the major cancers occurring in the Golestan province, a high-risk region for upper gastrointestinal cancers in Northern Iran, and provide short-term cancer predictions of the future cancer burden. METHODS: New cancer cases diagnosed in Golestan 2004-2016 were obtained from the Golestan population-based cancer registry (GPCR) database, and age-standardized rates by cancer site, year and sex calculated per 100,000 person-years. Using IARC's DepPred package we fitted time-linear age-period models to the available GPCR data to predict the cancer incidence burden in the year 2025. We calculated the contribution of demographic changes versus changes in risk to the overall changes in incidence from 2016 to 2025. RESULTS: The number of new cancer cases (excluding non-melanoma skin cancers) in 2025 is predicted to increase by 61.3% from 2678 cases in 2016 to 4319 cases. While a 17.6% reduction in the number of esophageal cancer cases is predicted by 2025, the number of new cases for each of the remaining major cancers is predicted to increase over the next decade, including cancers of the stomach (a 36.1% increase from 2016 to 2025), colorectum (56.2%), lung (67.8%), female breast (93.2%), prostate (101.8%) and leukemia (96.1%). The changes in the population structure and risk contributed 37.8% and 23.5% respectively, to the overall increase in incidence. CONCLUSION: Other than for the major upper gastrointestinal cancer types, the incidence rates of common cancers observed in the province are on the rise, reinforcing the need for continuous surveillance, as well as the design and implementation of effective cancer control programs.

Descriptive Epidemiology of Lymphoma in Northern Iran: Results from the Golestan Registry 2004-2013.

BACKGROUND: There is currently little known about the epidemiology of lymphomas in Iran. The aim of this paper is to describe the geographic and time variations in incidence rates of lymphomas in the Golestan province between 2004 and 2013. METHODS: The Golestan Population-based Cancer Registry (GPCR) routinely registers primary cancer patients from all sources (e.g. pathology centers, hospitals, etc.) throughout the Golestan province. We obtained data on newly-diagnosed lymphomas in Golestan during 2004-2013 from the GPCR dataset. Crude rates and age standardized incidence (ASR) rates (per 100000) of lymphomas were estimated, joinpoint regression was used to quantify incidence trends and average annual percent changes (AAPCs) were calculated. RESULTS: In total, 898 new cases of lymphoma were registered in the GPCR during 2004-2013. The ASR of Hodgkin lymphoma (HL) was 1.5 and 1.1 in males and females, respectively, while corresponding non-Hodgkin lymphoma (NHL) rates were greater, at 6.5 and 3.4 in males and females, respectively. Our results indicated a significant difference in the trends of HL between males (AAPC = -3.2) and females (AAPC = 3.6, P value = 0.001). The incidence rates of lymphoma were considerably higher in the urban population (ASR = 7.3) compared to those residing in rural areas (ASR = 5.3, P value = 0.054). We also found higher incidence rates for both HL and NHL in the western parts of the Golestan province. CONCLUSION: The incidence rates of lymphoma in the Golestan province are relatively high and vary geographically, with a higher incidence observed in the western area. Such differences may reflect unknown lifestyle and environmental determinants linked to ethnic susceptibility differing between the two areas.

Increasing trends of lung cancer in Golestan province, Northern Iran (2004-2016).

INTRODUCTION: We aimed to present the time trends and geographical distribution of lung cancer in Golestan province, a high-risk area for pulmonary tuberculosis (TB) in Northern Iran (2004-2016). METHODS: Data on incident primary lung cancers were obtained from the Golestan population-based cancer registry. The data were analyzed by CanReg-5 software to calculate the age-standardized incidence rates (ASRs). We used Joinpoint software for time trend analysis. Average annual percent changes were calculated. The contribution of population aging, population growth and risk to the overall changes in incidence of lung cancer were determined using partitioning analysis. RESULTS: Overall, 1829 cases of lung cancer were registered by the GPCR during 2004-2016, of which 1274 (69.7%, ASR in 2016 = 21.3) were men and 555 (30.3%, ASR in 2016 = 11.4) were women. The results of Joinpoint regression suggested a significant increasing trend in incidence of lung cancer in Golestan province during 2004 and 2016 (AAPC = 3.74; p-value = 0.01) with more prominent increasing in rural population (AAPC = 4.93; p-value<0.01). The number of new cases of lung cancer increased by 131.6% (from 98 in 2004 to 227 in 2016), of which 34.1%, 22.3% and 75.3% were due to population size, population aging and risk, respectively. Hot points of lung cancer were found in western parts of the Golestan. CONCLUSION: With high incidence rates and increasing trends of lung cancer, further studies are warranted to clarify the role of TB and other risk factors on its burden in this population.

Completeness and Accuracy of Death Registry Data in Golestan, Iran.

BACKGROUND: We aimed to evaluate completeness and accuracy of the Golestan Death Registry (GDR) to identify cancer-related causes of death (CCoD). METHODS: The GDR data (2004-2015) were compared with cancer data collected from clinical/pathological sources (the considered gold standard) by the Golestan Population-Based Cancer Registry (GPCR). Using a linkage method, matched cases, including subjects with CCoD and those with ill-defined cause of death (ICoD) (garbage codes), were identified and entered into the final analysis as study subjects. The completeness (percentage of study subjects with CCoD) and accuracy (number of subjects with correct CoD from the total number of study subjects) of the GDR were calculated. RESULTS: In total, 3,766 matched cases were enrolled. Overall, the completeness and accuracy of the GDR for identifying CCoD were 92.7% and 53.2%, respectively. There were variations by cancer site and age group, with completeness and accuracy highest for brain cancer (96.3%) and leukaemia (79.8%) while the lowest accuracy was observed for colorectal cancer (29.9%). The completeness and accuracy of GDR was higher in patients aged under 60 years (95.7% and 53.6%, respectively). We also found higher completeness (93.7%) and accuracy (55.8%) in residents of rural areas. CONCLUSION: Linkage of death registry data with cancer registry data can be a significant resource for evaluating quality of the death registry data. Our findings suggested that completeness of the GDR for identifying CCoD is reasonable, but accuracy is relatively low. Access to clinical and pathological data from other sources and enhanced training of death certifiers can improve the present situation.

Multiway analysis applied to time-resolved chemiluminescence for simultaneous determination of paracetamol and codeine in pharmaceuticals.

This method is based on the enhancing effect of codeine (COD) and paracetamol (PAR) on the chemiluminescence (CL) reaction of Ru(phen)3 (2+) with Ce(IV). In the batch mode, COD gives a relatively sharp peak with the highest CL intensity at 4.0 s, whereas the maximum CL intensity of the PAR appears at ~60 s after injection of Ce(IV) solution. Whole CL time profiles allowed use of the time-resolved CL data in combination with multiway calibration techniques, as multiway partial least squares (N-PLS), for the quantitative determination of both COD and PAR in binary mixtures. In this work, we found that the impact of Ce(IV) concentration on the CL intensity was different for COD and PAR. Therefore, a Ce(IV) concentration mode was added to the time and sample modes to obtain 3D data. The percent relative standard deviation (%RSD) values for 10 determinations of 1.0 × 10(-5)  mol/L of COD and 1.0 × 10(-4)  mol/L of PAR were 6.1% and 8.7%, respectively. The limit of detection (LOD) values (S/N = 3) were 0.9 × 10(-8)  mol/L and 1.0 × 10(-6)  mol/L for COD and PAR, respectively. The proposed method was successfully applied to the determination of PAR and COD in commercial pharmaceutical formulations. Acceptable recoveries (90-110%) were obtained for the quantification of these drugs in the real samples. Copyright © 2016 John Wiley & Sons, Ltd.