• Asian Pacific Journal of Cancer Prevention
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• 제14권5호
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• pp.2731-2737
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• 2013

Background: This study evaluated the validity and reliability of applying the Katz's Activities of Daily Living (ADL) scale in an Iranian sample of elderly oncologic patients following initial cancer treatment. Materials and Methods: The scale was translated with the forward-backward procedure to give an Iranian version. The ADL scale was then applied in a random sample of 400 oncologic patients aged 60 and older following initial cancer treatment. Assessment of the scale stability was twice, with a 14-days (two weeks) interval, to 30 (of the 400) eligible elderly cancer patients in March 2012. To measure treatment effects, the index was run with 150 patients in a three month recall, following oncology processing. Exploratory and confirmatory factor analysis was performed for assessment of construct validity of the Katz's ADL. Reliability was measured with internal consistency (Cronbach's alpha co-efficient), and test/retest (Spearman's r value) of the instrument. Criterion validity was evaluated by comparing the Katz with Physical Function (PF) subscale of SF 36. Known-group validity was approved by comparing of Katz' ADL between quartile groups of PF subscale of SF 36. Results: In our study the ADL demonstrated a high degree of internal homogeneity (Cronbach's alpha 0.923). There was a high correlation between scores of two time measurement of Katz's ADL (p value of two- related- samples test was 0.3). Construct validity showed a correlation coefficient of 0.572 between the ADL and PF scores. In factor analysis, 2 factors were extracted. Evidence for the reliability of the questionnaire was good and known group validity was approved by significant differences of ADL score between quartiles of the PF subscale of SF36. Conclusions: The results suggest that the Iranian version of ADL applied for oncologic older adult patients following initial cancer treatment is a reliable and a valid clinical instrument and comparable to those reported in other studies.

• Asian Pacific Journal of Cancer Prevention
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• 제15권1호
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• pp.133-137
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• 2014

Background: Today, breast cancer is increasing in nearly all societies. Currently, cancers are the third leading cause of death in Iran after cardiovascular diseases and accidents. Of the cancers, breast cancer is spreading particularly rapidly among Iranian women. Negative effects of discontinuation of care on patient survival have been well documented. Inhibiting or facilitating factors affecting continuity of care at different stages of the patient care continuum should be identified. Materials and Methods: The current study implemented a qualitative method that provided tools to examine factors in detail. This study was conducted on 22 women, undergoing surgery and chemotherapy after being diagnosed with breast cancer. Content analysis was the technique adopted. Results: The effective factors in continuity of care from the patients' perception, based on the participant statements, were classified into three categories of evaluation of symptoms, psychological reactions, and care triggers with several subcategories. Conclusions: According to the outcomes of the current study, it can be noted that, the patient experiences can be brought into use by health-care professionals and assist them in providing patient sand their families with adequate consulting services. It can also provide an opportunity for making interventions tailored to the community culture, and closer adherence of patients to the prescribed treatments.

• Asian Pacific Journal of Cancer Prevention
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• 제14권10호
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• pp.6049-6053
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• 2013

Background: Following research demonstrating an increased risk for meningiomas in the Jewish population of Shiraz (Iran) we conducted a cohort analysis of meningiomas among Jews originating in Iran and residing in Israel. Materials and Methods: We use the population-based registry data of the Israeli National Cancer Registry (INCR) for the main analysis. All benign meningioma cases diagnosed in Israel from January 2000 to the end of 2009 were included. Patients that were born in Iran, Iraq, Turkey, Bulgaria and Greece were used for the analysis, whereby we calculated adjusted incidence rates per 100,000 people and computed standardized incidence ratios (SIRs) comparing the Iranian-born to each of the three other groups. Results: Iranian-born Jews had statistically significant higher meningioma rates rates compared to other Jews originating in Balkan states: 1.46 fold compared to Turkish Jews and 1.86 fold compared to the Bulgaria-Greece group. There was a small increase in risk for the Iranian born group compared to those who were born in Iraq (1.06, not significant). Conclusions: Higher rates of meningiomas were seen in Jews originating in Iran that are living in Israel as compared to rates in neighboring countries of origin. These differences can be in part attributed to early life environmental exposures in Iran but probably in larger amount are due to genetic and hereditary factors in a closed community like the Iranian Jews. Some support for this conclusion was also found in other published research.

• Asian Pacific Journal of Cancer Prevention
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• 제13권5호
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• pp.1881-1886
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• 2012

Breast cancer is a heterogeneous disease that is affected by ethnicity of patients. According to hormone receptor status and gene expression profiling, breast cancers are classified into four molecular subtypes, each showing distinct clinical behavior. Lack of sufficient data on molecular subtypes of breast cancer in Iran, prompted us to investigate the prevalence and the clinicopathological features of each subtype among Iranian women. A total of 428 women diagnosed with breast cancer from 2002 to 2011 were included and categorized into four molecular subtypes using immunohistochemistry. Prevalence of each subtype and its association with patients' demographics and tumor characteristics, such as size, grade, lymph-node involvement and vascular invasion, were investigated using Chi-square, analysis of variance and multivariate logistic regression. Luminal A was the most common molecular subtype (63.8%) followed by Luminal B (8.4%), basal-like (15.9%) and HER-2 (11.9%). Basal-like and HER-2 subtypes were mostly of higher grades while luminal A tumors were more of grade 1 (P<0.001). Vascular invasion was more prevalent in HER-2 subtype, and HER-2 positive tumors were significantly associated with vascular invasion (P=0.013). Using muti-variate analysis, tumor size greater than 5 cm and vascular invasion were significant predictors of 3 or more nodal metastases. Breast cancer was most commonly diagnosed in women around 50 years of age and the majority of patients had lymph node metastasis at the time of diagnosis. This points to the necessity for devising an efficient screening program for breast cancer in Iran. Further, prospective surveys are suggested to evaluate prognosis of different subtypes in Iranian patients.

• Asian Pacific Journal of Cancer Prevention
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• 제15권22호
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• pp.9767-9771
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• 2014

Background: Social support is an important factor in psycho-social well-being of cancer survivors. There is little information about level of social support and its predictors among cancer survivors in Iran or other Middle Eastern countries. The aims of present study were to determine the social support and its prediction factors among Iranian cancer survivors. Materials and Methods: In this descriptive-correlational study 187 cancer patients in one educational center and one private oncology office in northwest of Iran participated using a convenient sampling method. The data collection tool consisted of a researcher-prepared checklist and the Multidimensional Scale of Perceived Social Support Assessment (MSPSS). Data analysis was performed using SPSS statistical software with descriptive statistics and multiple linear regression analysis. Results: The total score of MSPSS was 68 from a possible score between 7 and 84. Participants believed that they received a high level of support from their family members and significant others. Multiple linear regression analysis showed that single and depressed cancer survivors and participants with lower levels of physical activity believed that they received lower levels of social support. Conclusions: Iranian cancer survivors receive high levels of social support and family members are the most important source of this support. In planning any supportive care program for Iranian cancer survivors this strength should be considered. Especially, single and depressed and patients with lower levels of physical activity need more attention.

• Asian Pacific Journal of Cancer Prevention
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• 제17권4호
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• pp.2223-2227
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• 2016

Background: Breast cancer is the most common cancer among Iranian women. Since development of the disease in Iranian women occurs relatively early, the survival rate matters considerably. In different countries, survival of breast cancer patients varies considerably. Therefore, the one-year, three-year, five-year, and ten-year survival rates for breast cancer in Iran were assessed using a meta-analysis. Materials and Methods: This systematic review and meta-analysis was based on valid Iranian sources including SID, MAGIRAN and IRANMEDEX, along with reliable English databases, namely, PUBMED and SCOPUS. In domestic databases, a search was conducted based on key words of breast cancer and survival rate, and in international databases, with "breast cancer" and the equivalent of "neoplasm" of Mesh Word, "survival rate" and "Iran." Then all reviewed papers and theses which met the inclusion criteria were selected for investigation. To conduct the analysis STATA 11.2 software and random-effects models were used. Results: In 24 studies, 22,745 participants were included. The one-year, three-year, five-year and ten-year survival rates were 0.956, 0.808, 0.695 and 0.559, respectively. The minimum and maximum survival rates for 5-years were 0.48 and 0.87. The average age of the onset of the disease was 48.3. Conclusions: As in Iran, since the onset of the disease is at low age, in spite of the relatively high survival rate as compared to other cancers, prevention and screening programs at early age for early stage diagnosis seems necessary.

• Asian Pacific Journal of Cancer Prevention
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• 제14권11호
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• pp.6905-6911
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• 2013

Background: Breast cancer (BC) is the top cancer among women worldwide and the most frequent malignancy among Iranian women over the past few decades. The increasing trend and high mortality rate of BC in the developing world necessitates studies concentrating on its characteristics in countries in Asia. The current study focused on clinical and histopathological features of BC among Iranian females. Materials and Methods: This retrospective study involved 714 Iranian patients with histopathologically proven BC undergoing resection of primary tumours and axillary clearance. Demographic, clinical and histopathological data were obtained and studied between ten year age groups (${\leq}40$ years, 41-50 years, 51-60 years, 61-70 years, and ${\leq}71$ years) in four chronologic phases from 1994-2009. Results: Mean age of patients was $49.4{\pm}13.1$ years. Most of cases (33.2%) were in 41-50 group. Mean size of primary tumors was $3.94{\pm}2.47$ cm and 87.1% of cases had infiltrative ductal carcinoma. Modified radical mastectomy was the most common method of surgery carried out (48.8%). Some 57.1% of tumors were in pT2 and tumor size decreased significantly during the period (p<0.05). The most common BC stage was llla (27%). Lower BC stages (0 and 1) constituted 13.9% of the diagnosed tumors. Our series of patients aged ${\leq}40$ had larger tumors (mean $4.73{\pm}3.02$ cm) compared to older age groups (p=0.003). Lower stages (0 and I) were more frequent among the oldest patients while nearly 50% of patients aged ${\leq}40$ had tumor stage III. We also observed a significant decreasing trend in the mean LN count (p<0.05) and blood vessel invasion (p=0.023) from younger to older age groups. Conclusions: More aggressive disease for younger age groups, earlier peak incidence age and high rate of advanced BC at the time of diagnosis among Iranian women, were the main findings of this study.

• Asian Pacific Journal of Cancer Prevention
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• 제16권18호
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• pp.8519-8524
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• 2016

After diagnosis of cancer, many patients show more inclination towards religion and religious activities. This qualitative study using semi-structured interviews explored the perspectives and experiences of 17 Iranian cancer patients and their families regarding the role of religion in their adaptation to cancer in one of the hospitals in Tehran and a charity institute. The content analysis identified two themes: "religious beliefs" (illness as God's will, being cured by God's will, belief in God's supportiveness, having faith in God as a relieving factor, and hope in divine healing) and "relationship with God during the illness." In general, relationship with God and religious beliefs had a positive effect on the patients adapting to their condition, without negative consequences such as stopping their treatment process and just waiting to be cured by God. Thus a strengthening of such beliefs, as a coping factor, could be recommended through religious counseling.

• Asian Pacific Journal of Cancer Prevention
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• 제17권3호
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• pp.1193-1196
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• 2016

Background: Colorectal cancer (CRC) is the commonest malignancy in the lower gastrointestinal tract in both men and women. It is the third leading cause of cancer-dependent death in the world. In Iran the incidence of colorectal cancer has increased during the last 25 years. Materials and Methods: In this article we analyzed the survival of 447 colorectal patients of Taleghani hospital in Tehran using parametric competing-risks models. The cancers of these patients were diagnosed during 1985 - 2012 and followed up to 2013. The purpose was to assess the association between survival of patients with colorectal cancer in the presence of competing-risks and prognostic factors using parametric models. The analysis was carried out using R software version 3.0.2. Results: The prognostic variables included in the model were age at diagnosis, tumour site, body mass index and sex. The effect of age at diagnosis and body mass index on survival time was statistically significant. The median survival for Iranian patients with colorectal cancer is about 20 years. Conclusions: Survival function based on Weibull model compared with Kaplan-Meier survival function is smooth. Iranian data suggest a younger age distribution compared to Western reports for CRC.

• Asian Pacific Journal of Cancer Prevention
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• 제15권20호
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• pp.8587-8589
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• 2014

Background: Although a great deal of progress has been made in the management of colorectal cancer in terms of neoadjuvant modalities, surgical techniques and adjuvant therapies, the recurrence of tumors remains an enigmatic complication in patients. A better understanding of colorectal cancer and of factors that lead to recurrence of disease can provide helpful information for designing more effective screening and surveillance methods. Aim: To investigate the factors that may lead to local recurrence of colorectal cancers. Materials and Methods: The current retrospective case study evaluated 617 patients admitted to the Iranian Cancer Institute (the largest referral cancer center in the country) from 1995 to 2009 with confirmed colorectal cancer. Patients with distant metastasis, or with pathology other than adenocarcinoma and no follow-up, were excluded (175 patients). The remainder (442) included 294 (66.5%) with rectal cancer and 148 (33.5%) with colon cancer. The median duration of follow-up was 26 months. Results: The total rate of recurrence was 17.4%, comprising 19.6% and 16.3% recurrence rates in colon and rectal cancer, respectively. Conclusions: Recurrence of colorectal cancer was significantly correlated to tumor grade (p<0.008).