Iranian Journal of Public Health
Volume:52 Issue: 2, Feb 2023

A good perception of disease risk can help patients adopt correct preventive behaviors and good adherence to treatment. We examined knowledge, awareness, and perception towards thyroid cancer (TC) by a systematic analysis of published literature.

Four databases, including PubMed, Medline, Embase, and Web of science were searched using relevant keywords for papers prior to June 30, 2022. The levels of knowledge, awareness, and perception about TC, as well as risk factors, clinical signs, and sources of health were narratively synthesized.

Ten papers were finally included in this study for analysis. Despite relative good awareness, both the general population and medical students have relatively poor levels of knowledge and perception of TC and risk factors. The results of most studies showed that less than half of the participants had good knowledge about TC and its risk factors. Most participants are increasingly turning to the Internet and social media to obtain information about TC. This study also indicated that poor levels of knowledge regarding TC were strongly related to educational attainment and type of participants.

The findings of this paper provide valuable information for intervention providers to prevent and control of TC and encourage them to carry out health promotion campaigns to enhance knowledge and awareness of TC.

Emerging technology research focusing on promoting healthy lifestyles for the middle-aged and elderly is paramount in recent literature. However, limited evidence is available for the middle-aged population. This paper reviews how emerging technologies can help in promoting a healthy lifestyle for the middle-aged and elderly.

A scoping literature review method was employed. Articles were extracted from online databases published within 2010–2021. Overall, 3,152 articles related to the topic were obtained and 2979 articles were archived via different search procedures. Moreover, 173 articles that met the inclusion criteria underwent qualitative synthesize for conclusive inferences.

Most studies focused on people aged 60 and up, leaving the middle-aged population under-studied and unprepared to age. Older adults have high technology anxiety and resistance to change. Limited studies are available to support technology-based healthy lifestyle promotion for middle-aged people. The emerging technologies that are useful in promoting healthy lifestyle behavior among middle-aged people include: robotics, virtual reality, wearables, artificial intelligence, smart textiles, as well as centralized health information systems.

This review sets as a pace-setter for future research on how emerging technologies can aid in the development of healthy lifestyles for the middle-aged and elderly population, allowing them to live a quality life as they age.

Women prisoners are a population that is vulnerable to mental health problems. Women prisoners have a higher risk of mental health problems than women in the general population. So far, there have been very few studies with specific on women prisoner populations discussing mental health needs in prisons. The high prevalence of mental health problems in women prisoners is inseparable from meeting the mental health needs of women prisoners in prison. This review aimed to identify the mental health needs of women prisoners.

A scoping review was used, a systematic search of the articles on Oxford Academic Journals, Emerald Insight, Science Direct, PubMed, and Google Scholar using the keywords “Mental Health” OR “Health” AND “Needs” OR “Needs Assessment” OR “Addressing Needs” AND “Female” OR “Woman” OR “Women” AND “Inmates” OR “Prisoners” OR “Offenders” OR “Convicts”.

A total of 10 out of 254 selected, were considered eligible for inclusion and the results showed that the six major themes of mental health needs of women prisoners were treatment of substance, drug, and alcohol abuse, support system, empathy, training, mental illness treatment and access to health services, and health intervention: therapy and counselling.

It is recommended for further research to focus more on the problem of access to gender-based mental health services in prisons.

Vertical ground reaction force (VGRF) can lead to the development knee osteoarthritis. This review systematic and meta-analysis aimed to investigate the VGRF in patellofemoral pain patients (PFP) during weight bearing tasks.

Search strategy was conducted in databases: Science Direct, Scopus, PubMed and Google Scholar from Sep 2020 to Jun 2021. The VGRF components we measured were passive impact (Fz1)/peak and propulsion/active peak (Fz2). The quality of the studies was evaluated with Down and Black index and it was divided into three groups: low quality (LQ), medium quality (MQ) and high quality (HQ). The standardized mean difference between PFP and healthy individuals was used to calculate the effect size.

Nine articles were selected for systematic review and meta-analysis of which 5 studies was HQ, 3 studies were MQ and 1 study was LQ were classified. PFP compared to healthy individuals with moderate and small effect size have reduced impact and propulsion respectively. 

The in PFP, VGRF is influenced psychological, behavioral and biomechanical factors. Therefore, psychosomatic therapeutic approaches may have a long time effectiveness on the rehabilitation of PFP.

Governance is one of the critical functions of the health system. Good governance of the health system leads to better performance and outcomes. Evaluation is the first step to improving health system governance. Therefore, this research aimed to identify evaluation tools for health system governance.

In the current scoping review, we searched all documents related to health system governance evaluation indexed in Medline, EMBASE, ProQuest, Scopus, Cochrane Library, Science Direct databases, and Google Scholar search engines to 2022, extracted, and assessed. Finally, documents were selected and analyzed by thematic analysis.

Thirty tools were found to evaluate health system governance. Among the proposed tools, 11 specific tools have been designed just for health system governance evaluation, while others have governance as a component of health system evaluation. Health system governance’s significant components are health policy-making, strategic planning, organizing, stewardship, and control. Indicators such as accountability, participation, transparency, equity, efficiency, accountability, corruption control, effectiveness, ethic, the rule of law, and sustainability could be used to evaluate the health system governance. 

Different tools have been used to evaluate governance worldwide, and each governance evaluation tool has different components suitable for governance evaluation. However, these tools cannot fully evaluate governance and have shortcomings. A comprehensive evaluation of governance and sharing lessons denrael will affect the health system's capacity and ability to provide quality, safe and effective health services. It will lead to the stability of the health system.

A large portion of Iranian Working Population (IWP) is becoming at risk of Occupational Noise-Induced Hearing Loss (ONIHL). Several primary studies have evaluated the prevalence of ONIHL in Iran with a variety of prevalence rates. We aimed to estimate the prevalence of ONIHL in the IWP using data from relevant studies.

The present study is a meta-analysis and systematic review of previously published studies on ONIHL in Iran. Accordingly, the relevant articles published until Sep 1, 2021 were searched through PubMed, Scopus, and Google Scholar, together with Iranian scientific electronic databases. Heterogeneity between among the studies and data analysis was assessed using the I2 test and Random-Effect Model (REM) respectively.

Having performed a quality assessment, the meta-analysis was performed on the data from twenty-six studies involving a total of 85685 participants. The prevalence of ONIHL was observed to range from 12.9% to 60.5% in the reviewed studies. Moreover, after combining the results from the primary research by the Random Effects Model (REM) approach, the prevalence of ONIHL among IWP was estimated to be 34.69% (95% CI: 29.10, 40.28).

ONIHL is a significant concern with regard to public and occupational health in Iran. The results also highlighted the urgent need for taking appropriate preventive and control measures in the workplaces; particularly by encouraging the employers and health-related policymakers to focus on preventive noise control techniques along with administrative and legislative approaches to mitigate the risk of developing ONIHL.

The present systematic review aimed to investigate the drug susceptibility patterns of Iranian clinical Candida albicans isolates to antifungal drugs (azoles, polyenes, and echinocandins).

Six electronic databases including “PubMed,” “Scopus,” “Web of Science,” “IranDoc”, “SID”, and “Magiran” were searched from May 2000 to June 2021. The susceptibility of 6322 C. albicans strains from 19967 patients against 14 antifungal drugs was evaluated according to CLSI method.

The pooled prevalence of antifungal resistance ranged from 0% to 26%. The lowest resistance levels among azoles were observed in luliconazole with a frequency of 0% and voriconazole of 3.94%.

Due to the emergence of multi-drug resistant C. albicans, rational drug prescription based on the antifungal stewardship strategy and therapeutic drug monitoring is warranted.

Colorectal cancer is the third most common malignant tumor in the world and substantial death cases are reported each year. We aimed to explore the molecular mechanism underlying colorectal cancer tumorigenesis and progression.

The expression levels of Forkhead box A2 (FOXA2) in colorectal cancer tissues were first analyzed using Gene Expression Profiling Interactive Analysis (GEPIA). More multiple in vitro experiments established the role of FOXA2 in colorectal cancer progression. The potential downstream target of FOXA2 was identified by Western blot analysis.

FOXA2 expression level was significantly up-modulated in colorectal cancer specimens and cells (P<0.05). Silencing FOXA2 remarkably inhibited colorectal cancer cells growth, invasion and migration. BCL2-associated X (BAX) protein was identified as a potential downstream protein of FOXA2.

Our findings demonstrated the essential role of FOXA2 in colorectal cancer progression and identified BAX protein as its potential target.

Although preventive health practices are extremely effective in preventing diseases and mortality, there is still a need to determine the frequency of these practices in different countries and improve these rates. The aim of this study was to evaluate preventive health practices in Turkey.

The study was designed as a cross-sectional research. The study was conducted by utilizing the “Turkey Health Survey 2019” microdata set from the Turkish Statistical Institute. The data of 17,084 people aged 15 years and over were evaluated.

Approximately 54.4% of the participants were women, 24.5% were 15–29 years old, and 21.0% were 60 years of age or older. Approximately 51.2% of the participants stated that their general health status as good. 2.3% of the participants had taken the flu vaccine in the last year, 38% of people aged 50–70 years had undergone a fecal occult blood test in the last 5 years, 32% of women aged 40–69 years had undergone mammography/breast X-ray in the last 2 years, and 44% of women aged 30–65 years had undergone a cervical swab test in the last 5 years.

Although the rate of public participation in cancer screenings in Turkey is considerable, the data show that the rates should be further increased. In contrast, flu vaccination frequency is considerably low. To increase the frequency of preventive health practices, Turkish public should be informed about these practices, where they can be performed, and their importance.

Autism spectrum disorder (ASD) is a widespread mental growth disorder. Children with ASD are unlikely to restore the ability of living independent, which definitely brings their parents greater psychological pressure and psychological problems such as social anxiety. Therefore, it is pressing to conduct intervention research on social anxiety and other problems in parents of children with ASD. 

In 2022, Seventy-three parents of children with ASD were enrolled from Beijing Tongkangyuan Children's Rehabilitation Institute. They were randomly divided into the experiment group (N=36) and the control group (N=37). The experiment group was intervened with psychological counseling based on problem management plus in combination with Tai Chi. The control group did not receive any psychological intervention. Social Anxiety Scale for Children, Parenting Stress Index-Short Form and Social Support Rate Scale were used for measurement before and after the intervention.

The experiment group had significantly higher decreases than the control group in the total score in social anxiety and the scores in its two dimensions after intervention (P=0.001). The experiment group had significant decreases in the total score in parenting stress and the scores in parenting distress and dysfunctional parent-child interaction (P=0.001), while there was no change in the control group. The experiment group had significant improvement in social support, which was also significantly higher than that of the control group (P=0.001).

Psychological counseling based on problem management plus could effectively alleviate social anxiety and parental pressure in parents of children with ASD, improve their social support and play a significant role in enhancing their mental health.

This study aimed to determine the directionality of changes in serum bone remodeling markers and bone mineral density in the pre- and postmenopausal women with diabetes mellitus.

This study was carried out during the years 2016–2017 on the basis of Azerbaijan Medical University and included 142 pre- and postmenopausal women with type 1 and 2 diabetes mellitus (DM 1and DM2) were compared with 43 age-matched non-diabetics. The groups evaluated Ca2+, PTH, CT, 25(OH)D levels, serum bone remodeling markers (ALP, P1NP, b-CTx), lumbar spine, proximal and femoral neck areas using DXA assessment.

The results showed inconsistency observed between bone remodeling processes in women with diabetes. A negative correlation was observed between duration of diabetes and Lumbar T-scores (DM1: r = -0.568, P = 0.001; DM2: r = -0.267, P = 0.04). Lumbar T-scores was negatively correlated with b-CTx level (DM1: r = -0.452, P = 0.002; DM2: r = -0.357, P = 0.09). Postmenopausal groups with DM1 and DM2 were slightly higher b-CTx levels than premenopausal.

The patients with DM2 compared to DM1 had higher average BMD at all measured areas. Bone fragility is the result not so much of a decrease in BMD, but alterations in bone microstructure, as indicated by the disregulation of bone remodeling markers. This suggests that patients with diabetes are at a higher risk of bone turnover disorders compared to individuals without diabetes, which does not necessarily correlate with differences in BMD.

Hypertension, diabetes, and hyperlipidemia are common chronic diseases in South Korea, and medication is a key factor in managing these diseases and preventing disease advancement to multimorbidity. This study aimed to evaluate the effect of chronic disease on medication intake and adherence among Koreans.

This study was conducted utilizing data collected from 5,529 individuals that participated in the Korea Health Panel Survey (KHPS) in 2014-2017. The dependent variables were medication intake and adherence, and independent variables included socioeconomic status and the type of chronic disease. The differences in the medication intake and medication adherence by sociodemographic variables and the type of chronic disease were analyzed by chi-square test. The effect of hypertension, diabetes, and hyperlipidemia on medication intake and adherence was analyzed via multiple logistic regression using SAS statistical software.

The rate of medication intake and adherence were significantly different among patients with hypertension, diabetes, and hyperlipidemia, especially lower in patients with hyperlipidemia compared to those with hypertension and diabetes. In multiple logistic regression analysis, the probability of medication intake increased in female gender, older age, medical aid, medication adherence was higher in married, lower educational level and lower household income. Compared to hyperlipidemia, patients with hypertension and diabetes had more likely to take medication as prescribed.

The importance of considering the type of chronic disease in developing and implementing public health programs aiming for improved medication adherence. Targeting better medication intake and adherence for each chronic disease could be a valuable policy strategy to effectively manage chronic diseases as well as prevent their complications.

We aimed to explore the risk factors of lung nodules and lung cancer in physical examination population with low-dose multi-slice spiral CT (LDCT) screening, to provide basis for lung cancer screening and follow-up management after CT examination.

The general data, serum tumor markers and CT images of 2,274 patients underwent LDCT in the Physical Examination Center of the Fourth Hospital of Hebei Medical University, China in 2019 were retrospectively analyzed and followed up for three years.

The detection rate of lung nodules was 48.42%. The detection rate of lung nodules was higher in females, those over 70, those with history of smoking, passive smoking, drinking, precious history of lung diseases and family history of malignant tumors, with statistically significant differences (P<0.05). The abnormal rate of serum tumor markers (CA199, CA125 female and CYFRA211) were higher than that in the non-nodule group, with statistically significant differences (P<0.05). Multivariate logistic regression analysis showed that gender, age, history of smoking, passive smoking, family history of malignant tumors and serum tumor markers (CYFRA211 and CA199) were independent risk factors for the occurrence of lung nodules.

Gender female, age>35, history of smoking, passive smoking, history of drinking, history of past lung disease, family history of malignant tumors, abnormal CYFRA211 tumor markers were detected and low dose multi-slice spiral CT image showed ground-glass nodules are risk factors for lung nodules and lung cancer, which should be paid close attention to during physical examination and follow-up.

South Korea has the fastest growing aging population in the world, and the Korean older adult population has been reported to have poor self-rated health (SRH). This cross-sectional descriptive survey aimed to examine the SRH and associated factors among the Korean older adult population using the 2019 Korea National Health and Nutrition Examination Survey (KNHANES) data.

The differences in SRH according to socioeconomic, health-related, and mental health-related factors and their relationships were analyzed using chi-square tests and logistic regression, using data from 1,521 older adults in Korea from the 8th KNHANES.

Self-rated health was higher among older adults with a high family income (odds ratio [OR]=1.58, 95% CI: 1.05−2.36), those who finished elementary school or lower as opposed to those with a middle school diploma (OR=0.52, 95% CI:0.29−0.95), those with a low body mass index (BMI) compared to those with a higher BMI (OR=0.43, 95% CI: 0.21−0.88), those with no unmet health needs (OR=2.00, 95% CI: 1.31−3.06), those with better diet-related circumstances (OR=1.98, 95% CI: 1.15−3.39), those with lower stress (OR=1.77, 95% CI: 1.28−2.44), those with no suicidal ideation (OR=2.92, 95% CI: 1.75−4.87), and those without a history of psychiatric counseling (OR=2.10, 95% CI: 1.02−4.34).

The findings highlight the importance of health behaviors in promoting SRH among older adults in Korea, and emphasize the need for developing and implementing educational programs that reflect these findings.

This study aimed to verify the effectiveness of a virtual reality-based physical education program on physical fitness among Korean elementary school students.

The study, conducted at a public school in South Korea in the second semester of 2022, included experimental and control groups of 45 participants each (N=90). All participants underwent physical fitness tests before and after the experiment. The students assigned to the experimental group participated in the virtual reality-based physical education program three times a week for a total of 8 weeks (40 minutes per session), while those assigned to the control group did not participate in any exercise program. The effect size was confirmed using Cohen's d, and a two-way repeated measures analysis of variance was used to analyze changes in physical factors before and after the experiment for each group.

Among the male participants, we observed significant differences in overall health-related physical fitness, cardiorespiratory endurance, muscular strength and endurance, and power between the experimental and control groups (P<0.05). Among the female participants, we observed significant differences in overall health-related physical fitness, cardiorespiratory endurance, flexibility, and muscular strength and endurance between the groups (P<0.05).

Virtual reality-based physical education may help to improve indicators of physical fitness among elementary school students, especially among those who have experienced deterioration of physical fitness during the COVID-19 pandemic. Our results, therefore, highlight the need to establish virtual reality-based physical education facilities at the elementary school level in Korea.

We aimed to explore the effect of lifestyle interventions on improving lifestyle behaviors on gestational weight gain in pregnant women with normal body mass index (BMI).

The study was conducted in Maternal and Child Health Hospital of Hubei Province (Wuhan, China) between June 2020 and April 2022. A total of 355 pregnant women (<12 weeks of pregnancy) were enrolled and finally completed the program. Participants were divided into the intervention and control groups. The intervention group received an individualized lifestyle intervention focusing on healthy lifestyle, like diet, exercise, and weight monitoring as four sessions at 16–18, 20–24, 28-30 and 34 weeks’ gestation. Participants in the control group received routine antenatal care. The weight of both group was recorded from pregnancy until 6-8 weeks postpartum.

The participants in the intervention group with normal pre-pregnancy BMI (n = 178) had lower GWG, excessive GWG, hypertension, and neonate birth weight compared to the control group (n = 177, P< 0.01). There were no statistically significant differences in the occurrence of gestational diabetes, premature labor, delivery mode, preterm birth, small for gestational age, macrosomia, number of neonates referred to the NICU, and postpartum weight retention.

Even though lifestyle intervention in pregnant women with normal BMI has a relatively limited effect, attention should still be paid to reasonable weight gain during pregnancy and the potential long-term impact of the intervention remains to be assessed.

Estimating Fat-Free Mass (FFM) is an integral part of Body composition measurements, so obtaining an accurate estimation for evaluating FFM is critical for researchers and specialists. We aimed to develop and validate a simple equation for predicting FFM in the adult population.

Participants were 1996 adults (1085 men and 911 women), and 18 to 69 years old from Ahvaz City, southern Iran. They were randomly divided into the derivation (n=1396) and the validation (n=600) groups with no significant differences from Jan 2018 to Feb 2020. FFM was measured by Bioelectrical Impedance Analyzer (BIA) (InBody 770©; Biospace, Seoul, South Korea). Based on the demographic variables retrieved from the Derivation group, 8 FFM predictive equations were developed using multiple regression; finally, the most accurate model (using the coefficient of determination (R2)) was chosen and then validated on the Validation group for more evaluation.

The best equation derived from demographic characteristics was: " FFM= 0.28 × Weight (kg) + 0.57×Height (cm)+7.35×Sex (M=1, F=0)+0.03×Age (years)-70.61"; where sex = 1 for male and 0 for female. R=0.94, R2=0.89, standard error of the estimate=4.04 kg.

Our developed and cross-validated anthropometric prediction equation for fat-free mass estimation using BIA attained a high coefficient of determination, a low standard error of the estimate, and the lowermost coefficient of variation. Predictive equations may be reliable and valuable alternative methods for the clinical evaluation of fat-free mass in the adult population.

HIV/AIDS is a leading cause of mortality and morbidity in Low-and-Middle-Income-Countries (LMICs). It might potentially lead to an economic burden on the health system. There is no certainty about the prevalence of HIV/AIDS in Iran. Therefore, we aimed to estimate the cost of illness of HIV/AIDS in Iran.

We applied a societal perspective to capture the direct and indirect costs attributed to HIV/AIDS in Iran. We used data for age-standardized prevalence produced by the country HIV/AIDS Surveillance System for 2018. The study estimated both direct and indirect costs for a hypothetical cohort of the Iranian adult population (here equates to all registered cases with Surveillance System). For mitigating the uncertainty around the estimations, we have used an optimistic and pessimistic analysis.

The base case scenario showed that total direct costs and indirect costs attributed to the HIV/AIDS were US$7,946,530 and US$ 1,288,586 at the end of 2018. Moreover, the total cost is 8,785,116 US$.

Direct costs have formed approximately 85% of total costs. The policymakers and planners should consider that these costs are only related to diagnosed or registered infected populations. These costs will be raised dramatically with increasing the diagnosed patients.

Due to the invariably progressive nature of multiple sclerosis (MS) and the high economic burden of chronic diseases, this study was performed to estimate the economic burden of MS medications in Iran.

The present research is a descriptive study performed using comprehensive national data of Iran’s Health Insurance Organization (IHIO). The timeframe for study was 2011-2019. In order to calculate the economic burden of MS medications, the cost of illness (COI) method based on the prevalence approach was used. In this study, economic burden estimation was performed according to available data on medication costs. Data mining was also used to perform different stages of study.

The number of patients receiving MS medications covered by IHIO has increased from 19,367 in 2011 to 50,642 in 2019. The economic burden of MS medications of patients covered by the IHIO increased from $81 million to $96 million between 2011 and 2019, respectively. Among the 9 medications studied, Interferon accounted for a very high share of costs in all years. The cost per patient receiving medication has also increased from $7,000 in 2011 to $18,000 in 2019.

Calculations of the economic burden of MS medications in Iran showed an upward trend during the 9 years of the study, which due to the increasing number of patients in Iran, the arrival of new medications and also the increase in prices.

Calculating and predicting the risk of disease plays an important role in preventive medicine. Today, some risk scores have been designed to estimate the risk of cardiovascular diseases (CVDs) by assessing different factors. Obesity is associated with an increased risk of cardiovascular disease, so we decided to calculate the possible risk of heart disease in obese Iranian people to suggest a more accurate calculator.

In this cross-sectional study, we compared the data of 289 people from Framingham Risk Score and ASCVD Risk Score calculations who had been referred to Shariati Hospital Obesity Clinic, Tehran, Iran from 2016 to 2019. In the form of sub-goals, we examined other factors such as blood pressure and hepatic aminotransferases, etc.

The mean age of participants was 51.20±7.58 years, 86.2% being women. Of the whole, 19.72%, 31.83%, 21.11%, and 27.34% were categorized as overweight, Obese I, II, and III, respectively. According to the ASCVD score 80.3%, 4.8%, and 14.9%, and according to the Framingham score 95.5%, 3.5%, and 1% were classified as low-risk, intermediate-risk, and high-risk. Moreover, a fair agreement was observed between the two-risk score in the whole (Kappa=0.236; P<0.001), overweight (Kappa=0.304; P=0.028), Obese I (Kappa=0.210; P=0.048), Obese II (Kappa=0.268; P=0.015), and obese III (Kappa=0.202; P=0.023).

Despite its age limit, ASCVD has a higher risk of CVDs, causing statin care (which has a protective role for cardiovascular disease) to be given to a larger population.

We investigated the expression pattern of a human stem cell-specific, large intergenic noncoding RNA (lincRNA) regulator of reprogramming (lincRNA-ROR) and its spliced transcript variants in breast tumors. Breast cancer is the leading cause of cancer mortality in women; therefore, finding a reliable diagnostic tumor marker, based on the molecular profile of tumor cells, is warranted.

qRT-PCR was used to investigate the expression alteration of a specific stem cell-related lincRNA and its spliced transcript variants in breast tumors which provided by the Iran National Tumor Bank (2014-2016). Suitability of lincRNA-ROR and expression alterations of its spliced transcript variants as breast tumor biomarkers were examined by ROC curve analysis.

Expression was significantly upregulated in lincRNA-ROR variants 1 (NR-048536) and 4 (AB844432) and downregulated in variant 3 (AB844431), with expression levels failing to distinguish between breast tumor types, grades, and malignancy stages. Whereas ROC curve analysis gave good scores to the expressions of variants 1 (AUC=0.7675, P=0.003) and 3 (AUC=0.9383, P=0.00173), suggesting their suitability as potential breast tumor biomarkers, it gave an AUC score of 0.6033 for lincRNA-ROR spliced variant 4 (P=0.4118), denoting its unsuitability as a breast cancer biomarker.

Aberrant expressions of lincRNA-ROR spliced transcript variants could serve as reliable biomarkers with potential usefulness in breast cancer diagnosis. However, further research should elucidate the role and tissue expression of lincRNA-ROR spliced transcript variants in various cancers.

Colorectal cancer is a major health problem both in developing and developed countries. This cancer is among the top three commonly diagnosed cancers in males and females. In this context, assessing the Incidence, Prevalence and Mortality Rate trend of this cancer is of great importance.

We used the data from the GBD 2017 study to assess the global trend of 3 important indicators of colorectal cancer burden and to examine the relationship between trends of these indicators with Human Development Index (HDI). We used the multivariate mixed effects modeling framework with time and HDI as the covariates.

Trend analysis of colorectal cancer burden indicators showed a rather steady trend for mortality rate, while it revealed increasing slopes for both the incidence and prevalence rates. In addition, our findings showed a direct relationship between prevalence and incidence rates of this cancer and HDI level and indirect association between mortality rate and level of HDI.

There were significant changes in indicators of colorectal cancer during the study period. The inverse relationship between mortality due to this cancer and socio-economic status of the countries indicated an urgent need for screening the patients and promoting the level of care in countries with lower levels of HDI.