Awareness of General Public Towards Cancer Prostate and Screening Practice in Arabic Communities: a Comparative Multi-Center Study

The current study aimed at exploring the knowledge and beliefs of men aged forty years and over towardsprostate cancer screening and early detection in three Arab countries. The field work was conducted in threecountries; Saudi Arabia, Egypt and Jordan, during the period February through December 2011. Our targetpopulation were men aged 40 years and over. It was a population-based cross sectional study comprising 400subjects at each site. In addition to socio-demographic data, history of the present and past medical illness,practice history of prostatic cancer examination, family history of cancer prostate; participants were inquiredabout their knowledge and attitude towards prostate cancer and screening behavior using two different likertscales. The percentage of participants who practiced regular prostate check up ranged from 8-30%. They hadpoor knowledge and fair attitude towards prostate cancer screening behavior, where the mean total knowledgescore was 10.25±2.5, 10.76±3.39 and 11.24±3.39 whereas the mean total attitude score was 18.3±4.08, 20.68±6.4and 17.96±5.3 for Saudi Arabia, Egypt and Jordan respectively. The respondents identified the physicians as themain sources of this information (62.4%), though they were not the main motives for regular checkup. Knowledgewas the only significant predictor for participants’ attitude in the multiple regression models. Participants’attitudes depends mainly on level of knowledge and quantity of information provided to the patients and theirfamilies. Such attitudes should rely on a solid background of proper information and motivation from physiciansto enhance and empower behaviors towards prostate cancer screening practices.     

Toward Prostate Cancer Early Detection in Iran

Background: The aim of this study was to document the epidemiological features of prostate cancer in Iranand to define its public health priorities for an early detection program. Methods: A review of published articlesfrom 1975 to October 2008 was conducted using different search engines and 147 Persian medical journals.Abstracts only were excluded. Inclusion criteria were studies on prostate cancer clinical and epidemiologicaldata. Results: In all, 40 full texts, 7 national reports, and 10 provincial reports were accessed. The incidence rateof prostate cancer was 9.6 (3.2 to16.0) per 100,000 in multi geographical settings. The crude prostate cancermortality rate was 4.5 per 100.000 in 2004. The prevalence of prostate cancer among patients with benignprostate hyperplasia (BPH) presentation was 6.3%. The overall prostate cancer detection rate was reported3.6% in male over 40 years old by population screening programs. Conclusion: The rate of prostate cancerincidence in Iran is significantly less than those in developed countries and similar to Eastern MediterraneanRegions. However, it is expected to rise dramatically in the future because of the anticipated increase in lifeexpectancy and percentage of old age groups. Therefore, prostate cancer control should be integrated into theNational Cancer Control Program focusing on prevention and early detection in men over 40 years old or withsymptomatic BPH. An appropriate PSA cut off point for screening should be defined by population pilot studies.     

Epidemiology of Oral Cancer in Iran: a Systematic Review

Background: Oral cancer stands among the 10 top causes of cancer death in the world. Considering the roleof epidemiologic information on planning and effective interventions, the present study aimed to investigatethe epidemiology of oral cancer in Iran. Materials and Methods: The required information for this systematicreview study was obtained from PubMed, Google Scholar, CINAHL,SID, Medlib, Magiran and Iranmedexdatabases, using key words “cancer”, “oral cancer”, “squamous cell carcinoma”, “oral cavity carcinoma” andtheir Persian equivalents in combination with keywords of epidemiology, prevalence, etiology, frequency, and Iranfrom 1990 to 2014. From 1,065 related studies found, finally 25 were included to the study. Results: The meanage of 8,248 patients in 25 studies was 54.0±15.1 years. The male/female ratio for oral cancer was 1.91. Tonguewith average percentage of 29.9 was the most involved site. Regarding microscopic grade, 65.7% of cases weregrade 1. SCCs, accounting for an average of 70.0%, was the most common among all types of oral cancer. In themajority of studies, smoking including cigarette, hookah, and tobacco consumption was found to be a risk factor.Conclusions: The epidemiological pattern of oral cancer in Iran is somewhat similar to that of other countries.Yet the information on hand in this field is limited and considering the role of epidemiological data we suggestconducting more accurate studies to catch data that is required for effective programs and interventions.     

Factors Associated with Low Screening Participation and Late Presentation of Cancer amongst Women in the Pacific Island Countries and Territories: A Systematic Review

Background and Objective: In most Pacific Island Countries and Territories (PICTs), cancer patients commonly present at very late stages and by the time the disease is diagnosed, it is often too late for treatment. This review examines the evidence on factors associated with low cancer screening participation and late presentation of cancer among women of the PICTs. Materials and Methods: Medline, PubMed, ProQuest and The Cumulative Index to Nursing and Allied Health Literature were searched to identify relevant studies for this review. Terms of medical subject headings was performed in combination with other key words such as “screening”, “delay”, “determinants”, “awareness”. Results: Eleven studies met the inclusion criteria of this review. Six factors were identified from these studies: resources and facilities, trust in the health care system, culture and tradition, modesty, awareness and socioeconomic status. Conclusion: Due to several barriers and factors, women in the PICTs are hindered from accessing cancer screening practices and often present late with cancer symptoms leading to advanced stage diagnosis. The findings of this study provide a foundation for future studies that could focus more in-depth to explain how these factors contribute to the presentation of cancer in late stages.     

Survival Rate of Colorectal Cancer in Iran: A Systematic Review and Meta-Analysis

Background: Different studies have been conducted to estimate the survival rate of colorectal cancer in Iran butthere is no overall estimate of the survival rate. The aim of this study was to calculate the pooled 1, 3, and 5-year survivalrate of the patients with colorectal cancer in Iran. Methods: To retrieve relevant studies, we conducted a systematicsearch in Iranian databases, including Iran Medex, Magiran, SID, and international databases such as Medlin/PubMed,Scopus, and Google scholar using “Colorectal Neoplasms” and “Survival Rate” as keywords up to December 1st, 2017.We used random effect model to estimate pooled 1, 3, and 5-year survival rates of the patients with colorectal cancerin Iran. To assess the heterogeneity, we used Chi-squared test at the 5 % significance level (p <0.05) and I2 Index. Weused meta-regression and subgroup analysis to find a potential source of heterogeneity. Results: After a systematicsearch, 196 articles were found, of the 38 studies met the eligibility criteria and are included in our meta-analysis. Thepooled 1, 3, and 5-year survival rates in patient with colorectal cancer were 0.84 (95% CI: 0.81-0.87), 0.64 (95%CI:0.59-0.70), and 0.54 (95%CI: 0.49-0.58) respectively. The 5-year survival rate in the subgroup of women was 0.5(0.44-0.56) and in male subgroup was 0.44 (0.40-0.48). In a subgroup of the tumor site, the 5-year survival rate in coloncancer was 0.6 (0.49-0.75) and rectum cancer was 0.54 (0.36-0.69). In multivariable models, there was a significantassociation between years of study and 5-year survival rate as a source of heterogeneity (β = 18.9, P=0.01). Conclusion:According to the results of this study, women had a better survival rate than men, and according to the tumor site, the5-year survival rate in colon cancer was better than the rectum cancer.     

Screening for Breast Cancer in a Low Middle Income Country: Predictors in a Rural Area of Kerala,India

Background: In India, breast cancer is the leading malignancy among women in a majority of the cancerregistries. Therefore it is important to understand screening practices and its predictors, including in ruralareas with high female literacy and good health indices. Materials and Methods: A cross-sectional study withmultistage sampling was conducted in Vypin Block, Ernakulam district, Kerala, India. Four Panchayats (selfadministration units) were randomly chosen and a woman in every second household was invited to participatefrom the tenth ward of each. Thus a total of 809 women were interviewed. Results: The majority of the repondents(82.1%) were not aware of risk factors and about a third (37.9%) were not aware of symptoms of breast cancer.About half of the population studied (46.6%) had undergone screening. Age (35-50 years), being married, healthprofessionals as source of information and working were significant predictors of screening. Logistic regressionshowed that older women (35-50 yrs) were more likely to practice screening. Out of the never screened, about athird (35%) were desirous of doing it, but had not for various reasons and 53.5% were not willing to screen. Thereasons identified for not screening among those desirous of doing it were grouped into knowledge 66 (43.4%),resources 23 (15.1%) and psychosocial 32(21.1%) factors. Unmarried women were significantly more likely toexpress factors related to all the three domains. Conclusions: This study showed that in spite of the absence of apopulation-based screening program, about half of the study population had undergone some type of screening.The older women (35-50 years) in particular were significantly more likely to practice screening. At this criticaljuncture, a high quality breast cancer awareness and screening initiative can help to consolidate the gains andtackle knowledge, resource and psychosocial barriers.     

Simulation Models in Gastric Cancer Screening: A Systematic Review

Background: Together with such high-quality approaches as randomized controlled trials and large-scale cohortstudies, simulation models are often employed to evaluate the effect of cancer screening methods and decide ontheir appropriateness. This study aimed to evaluate all effects of gastric cancer screening that have been assessedusing simulation models, including cost-effectiveness, mortality reduction, and early-stage detection. Methods: Weperformed a systematic review using PubMed and Web of Science. We evaluated the effect of screening related tocost, such as incremental cost-effectiveness and incremental cost-effectiveness ratios; we also separately assessedeffects other than cost, such as quality-adjusted life-years, number of deaths prevented, life-years saved, relative riskof mortality from gastric cancer, life expectancy, and incidence reduction. The methods targeted for evaluation wereHelicobacter pylori testing or endoscopy. Results: We identified 19 studies dealing with simulation models in gastriccancer screenings: 14 examined H. pylori screening and 7 focused on endoscopy. Among those studies, two assessedboth H. pylori and endoscopy screening. Most of the studies adopted a Markov model, and all the studies evaluatedcost-effectiveness. Of the 14 H. pylori screening studies, 13 demonstrated cost-effectiveness and 11 also showed goodresults other than cost-effectiveness, such as extension of life-years and increase in early-stage detection. In three of thefive endoscopy studies, the target population was patients; all five studies obtained good results for cost-effectivenessand four observed good results other than for cost-effectiveness. Conclusions: In this study, we showed that the H.pylori screening test was cost-effective in terms of simulation model investigations. However, the H. pylori screeningtest should not ordinarily be recommended since there is insufficient evidence that it reduces gastric cancer mortality.In Japan, simulation modeling should be employed to plan for cancer control, and the appropriate use of simulationmodels should be examined for future use.     

Level of Awareness Regarding Breast Cancer and its Screening amongst Indian Teachers

A total of 441 women teachers from 8 of the schools located in Delhi, India participated in this cross-sectionalstudy, conducted from July 2007 to February 2008. The mean age was 37.2 years. Some 92.7% of the teacherswere aware of at least one sign or symptom of the disease and 63.0% knew at least one high risk factor. However,only 36.1% had heard of the term breast self examination. Only 13.4% knew the correct frequency of once amonth, only 7.3% the correct position and only 1.36% participants the correct time. This dismal awarenesslevel reflects the fact that none had ever practiced breast self-examination. Similarly, v ery few attended regularclinical breast examination (CBE) or had undergone a mammogram. Only 11.8% were aware of the normallook of the breast and 5.4% of the normal feel. There is clearly a need to increase the level of awareness regardingbreast cancer and its screening amongst teachers in India.     

Cancer Screening: A Review with Particular Attention to Areas for Future International Research Efforts

For almost all of the sites of most common cancers, particularly the lung, colo-rectum and cervix, relatively inexpensiveand reliable tests have been available for some time. Advances in imaging techniques now allow identification ofearly tumours in many other organs, including those that are normally associated with a very poor prognosis. Inaddition, increasing knowledge of the risk factors for cancer development in different organs imply more effectivescreening for early malignancies in high risk populations and the associated increase in the predictive value shouldmean that early intervention will result in a marked decrease in the mortality and morbidity due to a wide range ofmajor cancers. However, there are many difficulties which remain to be overcome, especially in the psychosocialarea. Problems with overdiagnosis and distinction of lesions most likely to actually give rise to cancers also requireespecial attention for the full promise of screening to be realised. In addition, choice of the most appropriate approachwill require an in depth understanding of cultural factors impacting on screening behaviour and it is of paramountimportance that both physicians and the public at large be fully aware of pitfalls and potential benefits. Thus researchneeds to be concentrated on effective education approaches as well as how to increase practical sensitivity and specificityof individual tests and determine the best follow-up for individuals testing positive.     

Information Engineering and Workflow Design in a Clinical Decision Support System for Colorectal Cancer Screening in Iran

Background: Colorectal cancer is a major cause of morbidity and mortality throughout the world. Colorectalcancer screening is an optimal way for reducing of morbidity and mortality and a clinical decision support system(CDSS) plays an important role in predicting success of screening processes. DSS is a computer-based informationsystem that improves the delivery of preventive care services. The aim of this article was to detail engineering ofinformation requirements and work flow design of CDSS for a colorectal cancer screening program. Materials andMethods: In the first stage a screening minimum data set was determined. Developed and developing countrieswere analyzed for identifying this data set. Then information deficiencies and gaps were determined by checklist. The second stage was a qualitative survey with a semi-structured interview as the study tool. A total of 15users and stakeholders’ perspectives about workflow of CDSS were studied. Finally workflow of DSS of controlprogram was designed by standard clinical practice guidelines and perspectives. Results: Screening minimumdata set of national colorectal cancer screening program was defined in five sections, including colonoscopy dataset, surgery, pathology, genetics and pedigree data set. Deficiencies and information gaps were analyzed. Thenwe designed a work process standard of screening. Finally workflow of DSS and entry stage were determined.Conclusions: A CDSS facilitates complex decision making for screening and has key roles in designing optimalinteractions between colonoscopy, pathology and laboratory departments. Also workflow analysis is useful toidentify data reconciliation strategies to address documentation gaps. Following recommendations of CDSSshould improve quality of colorectal cancer screening.     

Colorectal Cancer Awareness and Screening Preference: A Survey during the Malaysian World Digestive Day Campaign

Background: Although the incidence of colorectal cancer in Malaysia is increasing, awareness of this cancer, including its symptoms, risk factors and screening methods, remains low among Malaysian populations. This survey was conducted with the aim of (i) ascertaining the awareness level regarding colorectal cancer symptoms, risk factors and its screening among the general populations and (ii) assessing the public preference and willingness to pay for colorectal cancer screening. Materials and Methods: The questionnaire was distributed in eight major cities in West Malaysia during the World Health Digestive Day (WDHD) campaign. Two thousand four hundred and eight respondents participated in this survey. Results: Generally, awareness of colorectal cancer was found to be relatively good. Symptoms such as change in bowel habit, blood in the stool, weight loss and abdominal pain were well recognized by 86.6%, 86.9%, 83.4% and 85.6% of the respondents, respectively. However, common risk factors such as positive family history, obesity and old age were acknowledged only by less than 70% of the respondents. Almost 80% of the respondents are willing to take the screening test even without any apparent symptoms. Colonoscopy is the preferred screening method, but only 37.5% were willing to pay from their own pocket to get early colonoscopy. Conclusions: Continous cancer education should be promoted with more involvement from healthcare providers in order to make future colorectal cancer screening programs successful.     

Effectiveness of Visual Inspection with Acetic Acid (VIA) Screening on Cervical Cancer Mortality and Incidence - A Systematic Review and Meta-Analysis

Objectives: Despite being a cheap, easy, and commonly used technique for screening early development of cervical cancer, collective evidence on the effect of visual inspection with acetic acid (VIA) for reducing cervical cancer mortality and incidence are conflicting. We conducted a systematic review and meta-analysis to determine the effectiveness of VIA screening on cervical cancer mortality and incidence. Methods: We searched PubMed, Embase, Cochrane library (Cochrane Database of Systematic Reviews & Cochrane Central Register of Controlled Trials), World Health Organization’s (WHO) International Clinical Trials Registry Platform, and Google Scholar to identify studies conducted among women with no history of cervical cancer that assessed effectiveness of VIA on the cervical cancer mortality and incidence. Random effects model was used to estimate incident rate ratio and sensitivity analysis was conducted using Bayesian methods. Results: Of the included 4 studies, three were cluster randomized trials from India and one was quasi-experimental study done in Thailand. Duration of follow-up ranged from 7 to 12 years. Based on 3 trials, pooled rate-ratio for cervical cancer mortality and all-cause mortality was 0.68 (95% CI: 0.56–0.81, I2=0%) and 0.91 (0.85–0.97, I2=57%), respectively. Pooled rate-ratio of invasive cervical cancer was 0.94 (95% CI: 0.67 – 1.30, I2=84%). Likewise, there was non-significant reduction in incidence of stage IB, >=stage II, and unknown stage cervical cancer. Conclusions: VIA screening may lead to reduction in cervical cancer and all-cause mortality in long run. However, the effectiveness of VIA in preventing invasive cervical cancer is inconclusive.     

Factors that Influence Awareness of Breast Cancer Screening among Arab Women in Qatar: Results from a Cross Sectional Survey

Background: Breast cancer is the most common cancer among women in the State of Qatar. Due to lowparticipation in breast cancer screening (BCS) activities, women in Qatar are often diagnosed with breast cancerat advanced stages of the disease. Findings indicate that low participation rates in BCS activities are significantlyrelated to women’s low level of awareness of breast cancer screening. The objectives of this study were to: (1)determine the factors that influence Qatari women’s awareness of breast cancer and its screening activities:and (2) to find ways to effectively promote breast cancer screening activities among Arabic speaking womenin Qatar. Materials and Methods: A multicenter, cross-sectional quantitative survey of 1,063 (87.5% responserate) female Qatari citizens and non-Qatari Arabic-speaking residents, 35 years of age or older, was conductedin Qatar from March 2011 to July 2011. Outcome measures included participant awareness levels of the mostrecent national recommended guidelines of BCS, participation rates in BCS activities, and factors related toawareness of BCS activities. Results: While most participants (90.7%) were aware of breast cancer, less thanhalf had awareness of BCS practices (28.9% were aware of breast self-examination and 41.8% of clinical breastexams, while 26.4% knew that mammography was recommended by national screening guidelines. Only 7.6% hadknowledge of all three BCS activities). Regarding BCS practice, less than one-third practiced BCS appropriately(13.9% of participants performed breast self-examination (BSE) monthly, 31.3% had a clinical breast exam(CBE) once a year or once every two years, and 26.9% of women 40 years of age or older had a mammogramonce every year or two years). Awareness of BCS was significantly related to BCS practice, education level, andreceipt of information about breast cancer and/or BCS from a variety of sources, particularly doctors and themedia. Conclusions: The low levels of participation rates in BCS among Arab women in this study indicate astrong need to increase awareness of the importance of breast cancer screening in Qatari women. Without thisawareness, compliance with the most recent breast cancer screening recommendations in Qatar will remainlow. An increased effort to implement mass media and public health campaigns regarding the impact of breastcancer on women’s health and the benefits of early detection of breast cancer must be coupled with an enhancedparticipation of health care providers in delivering this message to Qatar population.     

Gastric Cancer in Iran 1966-2006

This review was carried out to provide an up-to-date perspective on gastric cancer clinicoepidemiologicalcharacteristics, to explain geographical differences, and to define public health priorities for prevention andearly detection programs in Iran. A comprehensive search was conducted using different search engines andover 147 Persian medical journals from 1966 to December 2008. Inclusion criteria were published studies ongastric cancer clinical and epidemiological data. Abstracts only were excluded. Twenty five studies and twonational cancer registry reports were also included. The average gastric cancer incidence rates were reported tobe 15.2 (8.1 to 49.1) and 6.7(4.9-25.4) per 100,000 in males and females, respectively, with a ratio of 2.3:1 (1.5 to2.7). More than two thirds of them were diagnosed in stage IV. Crude mortality rates were estimated at 15.5 and8.4 per 100,000 in males and females. The trend for gastric cancer cases was increase from 1969 to 2004; antraladenocarcinomawas shifted to cardia adenocarcinoma in this period. The gastric cancer epidemiological aspectshave changed during 4 decades; a Western pattern has been started in Iran where the incidence rate ofadenocarcinoma of the most proximal cardia region and adjacent gastro-oesophageal junction has increased.Developing a gastric cancer early detection program, investigating gastric cancer risk factors, preventing patientand system delays, and providing national guidelines for treatment and palliation are all recommended.     

Breast Cancer Screening in Malaysia: A Policy Review

Background: Breast cancer is the leading cause of cancer among Malaysian women. The implementation of prevention measures including screening has the potential to reduce the burden of breast cancer which caused by late presentation. Aims: This paper aimed to review the public health policy relating to breast cancer screening in Malaysia that was undertaken in order to contribute to policy development regarding cancer prevention, detection and the improvement of services for Malaysian women. Methods: The policy review strategy included a specific search of the website of the Ministry of Health in Malaysia for relevant policies. In addition, we searched Google and Pubmed for breast cancer screening programmes, policies, and guidelines for women in Malaysia. In addition, experts and stakeholders provided additional resources, published in Malay language. Relevant guidelines in the Malay language were translated into English and included the document review. Results: The policy analysis indicated that although it is known that screening, early detection and diagnosis improve survival rates, delayed diagnosis remains a significant issue.  The Ministry of Health policy stipulates the provision of opportunistic mammography screening. However, the uptake is varied, and implementation is challenging due to a lack of awareness about screening and difficulties related to accessing services, especially in rural areas. The establishment and implementation of referral guidelines is essential to receive timely treatment for breast cancer patients. There is a need to enhance the cancer reporting by the doctors to the national cancer registry, in collaboration with government services and the private cancer-care sector to improve the monitoring and evaluation of cancer control policies and programmes. Conclusion: A focus on raising awareness, increasing the accessibility of screening facilities and improving referral processes and the overall connectivity of the cancer care system are key steps to down-staging breast cancer in Malaysia.     

Costing of a State-Wide Population Based Cancer Awareness and Early Detection Campaign in a 2.67 Million Population of Punjab State in Northern India

Background: Punjab state is particularly reporting a rising burden of cancer. A ‘door to door cancer awareness and early detection campaign’ was therefore launched in the Punjab covering about 2.67 million population, wherein after initial training accredited social health activists (ASHAs) and other health staff conducted a survey for early detection of cancer cases based on a twelve point clinical algorithm. Objective: To ascertain unit cost for undertaking a population-based cancer awareness and early detection campaign. Materials and Methods: Data were collected using bottom-up costing methods. Full economic costs of implementing the campaign from the health system perspective were calculated. Options to meet the likely demand for project activities were further evaluated to examine their worth from the point of view of long-term sustainability. Results: The campaign covered 97% of the state population. A total of 24,659 cases were suspected to have cancer and were referred to health facilities. At the state level, incidence and prevalence of cancer were found to be 90 and 216 per 100,000, respectively. Full economic cost of implementing the campaign in pilot district was USD 117,524. However, the financial cost was approximately USD 6,301. Start-up phase of campaign was more resource intensive (63% of total) than the implementation phase. The economic cost per person contacted and suspected by clinical algorithm was found to be USD 0.20 and USD 40 respectively. Cost per confirmed case under the campaign was 7,043 USD. Conclusions: The campaign was able to screen a reasonably large population. High to high economic cost points towards the fact that the opportunity cost of campaign put a significant burden on health system and other programs. However, generating awareness and early detection strategy adopted in this campaign seems promising in light of fact that organized screening is not in place in India and in many developing countries.     

Determining the Survival Rate of Colorectal Cancer in Iran: A Systematic Review and Meta-Analysis

Objective: Colorectal cancer is one of the most common causes of death in the world. Despite of remarkableadvances in medical sciences, cancer is an important disease and the second cause of death after cardiovascular diseases.The present study was aimed at determining the survival rate of colorectal cancer in Iran. Methods: The present studyis a systematic review of national and international electronic databases. Studies that had the inclusion criteria wereincluded in the study, electronically published articles over December 2007 and March 2015 were retrieved. The collecteddata were analyzed by meta-analytic method through stata 11.0 Software, and the survival rate was measured. Results:The 1-, 2-, 3-, 4-, and 5-year survival rates of colorectal cancer in Iran were respectively calculated as 85, 75.10, 65,55.40, and 52.The results indicated that there is a significant relationship between anatomic location of tumor andsurvival rate. According to the results of this examination, survival rate of the patients with rectal cancer was 41.9times higher than those with colorectal cancer. Conclusion: Due to the relative high prevalence of this cancer amongyoung people in Iran and the low survival rate, early diagnosis of colorectal neoplasms is necessary before they becomesymptomatic through more effective diagnosis programs of enhancing the patients’ health and survival rate. Moreover,it is necessary to conduct more specialized and relevant studies in order to determine genetic or environmental causes ofcancer such as diet and cultural and behavioral habits at the national level and with different ethnicities.     

食管癌筛查和早诊早治的实践与经验

[目的]报告在高发区居民中食管癌筛查和早诊早治的效果和经验。[方法]分析2006—2008年在6个省中的8个县（市）居民中,开展食管癌筛查和早诊早治的资料。总结工作中的效果和经验。[结果]3年内镜检查共39221人,发现食管癌600例,检出率为1．53％。其中早期食管癌515例,早诊率85．83％。同时,发现胃贲门癌413例,检出率为1．05％。其中,早期贲门癌336例,贲门癌的早诊率81.36％。[结论]食管癌内镜筛查可发现大批早期癌和癌前病变,现阶段作为食管癌防治措施是可行的和有效的。     

Personal and Socio-Cultural Barriers to Cervical Cancer Screening in Iran,Patient and Provider Perceptions: a Qualitative Study

Background: Although cervical cancer is preventable and early screening might decrease the associatedmortality, challenges faced by the women and health care providers can postpone early detection. This qualitativestudy aimed to establish patient and provider perceptions about personal and socio-cultural barriers for cervicalcancer screening in Mashhad, Iran. Materials and Methods: In the present study, which was conducted in 2012,eighteen participants, who were selected purposefully, participated in individual in-depth, semi-structuredinterviews, which were recorded, transcribed verbatim, and analyzed using conventional content analysis andAtlas-Ti software. Results: One theme and two categories were derived from data including: cognitive/behavioralfactors (lack of a community-based approach to cervical cancer, lack of awareness, wrong attitude and lackof health seeking behaviors) and socio/cultural issues (socio-cultural invasion, mismatch between tradition,modernity and religious, extra marital relationships and cultural taboos). Conclusions: Providing communitybased approach education programs and employing social policy are needed for preventing of cervical cancerin Iran.     

Depression in Women with Breast Cancer: A Systematic Review of Cross-Sectional Studies in Iran

Objective: Breast cancer is one of the most common cancers in women and has more severe mental and emotional effects than other types. Depression as a mental disorder affects people’s mental well-being, physical symptoms, occupational performance, and finally quality of life. The aim of this study was to determine depression levels in Iranian women with breast cancer. Methods: A systematic review study was conducted in 2017. English and Persian databases (PubMed, SCOPUS, Web of Science, Google Scholar, SID, Magiran) were searched with key words such as Depression Or Depressive Disorders AND Women AND Breast Cancer OR Tumor OR Neoplasm OR Malignancy AND Iran. Inclusion criteria allowed for cross-sectional studies conducted in Iran (published in English or Persian language journals), studies that had key words in their keywords or their titles and standard instruments for measuring depression in patients. Of the 160 publications found, eight were selected after reviewing the title, abstract and full article. Results: Age of women with breast cancer in selected studies ranged from 43.8 (SD = 47.1) to 55.9 (SD = 14.6) years. Duration of cancer in most studies was about 1-2 years. In most studies, mild levels of depression for women with breast cancer were present. However, in one study it was stated that 69.4% of participants had serious levels of depression. Conclusions: There is increase in the risk of depression in women with breast cancer. Therefore, it seems necessary to plan preventive and therapeutic measures in order to improve the mental health and quality of life of the affected patients.