Iranian Journal of Public Health
Volume:52 Issue: 10, Oct 2023

Preventive care can support and direct the nurse's efforts to deliver an asthma intervention for children as part of nursing interventions. Despite the significance, there have been few meta studies demonstrating the effectiveness of nursing interventions for the treatment of childhood asthma that includes only randomised controlled trials (RCTs). Therefore, this meta study was conducted to comprehensively evaluate the efficacy of nursing care interventions for the management of childhood asthma.

STATA 14.2 (StataCorp, College Station, TX, USA) was used to conduct the meta-analysis. From 1964 to July 2022, we searched Medline, the Cochrane library, EMBASE, Scopus Science Direct, and Google Scholar. Depending on the type of outcome, a meta-analysis was performed using a random-effects model, pooled weight mean difference (WMD), standardised mean difference (SMD), and/or risk ratio (RR) with stated 95 percent confidence intervals (CIs). PRISMA guidelines were followed for conducing this study.

Nine studies were analysed in total. The pooled RR for emergency visits was 0.49 (95%CI: 0.32 to 0.77), for hospitalizations was 0.64 (95%CI: 0.21 to 1.89). The pooled SMD for frequency of asthma attacks was -2.88 (95%CI: -3.22 to -2.54), quality of life was 0.49 (95%CI: 0.22 to 0.75) and asthma control was 1.25 (95%CI: -0.77 to 3.28).

Paediatric asthma patients who received nursing interventions reported an improved quality of life and a decrease in emergencies and acute attacks due to asthma. Future RCTs should focus on uncovering the short- and long-term effects of these nursing interventions to provide optimal management and care.

Cesarean delivery rates have been increasing which leads to a rise the problems experienced. After cesarean deliveries important problems for the mother and baby may be seen. The most common problems in the mothers after cesarean delivery are; bleeding, infection, fatigue, sleep disorders, breast problems, self-care issues, and sense of inadequacy in care of the newborn. The method used in this study was narrative review. A literature review was conducted by searching the materials published in databases including Web of Science, PubMed, Google Scholar search engine and, the WHO website. Pain, maternal death, breastfeeding problems, worsened sleep quality and comfort, anxiety, delayed recovery, prolonged hospitalization and infection rates in the cesarean deliveries are higher than in vaginal deliveries. Nurses can facilitate adaptation to the role of motherhood and prevent risky situations by evaluating mothers’ care needs and providing proper interventions and support. Nurses should not only focus on the physical care needs of the mother and baby; they should also ensure the physical and psycho-social adaptation of family members in the face of role changes.

Stigma is a sociological concept that is important in medicine and health because it threatens health as much as the disease itself. We aimed to explore the causes, stigmatizers, consequences and coping strategies related to the stigma of diseases by systematically analyzing relevant literature.

This systematic review examined 65 articles on Disease-Related Stigma by searching Noormags, Magiran, SID, Google Scholar, and PubMed databases. The articles were published in Persian and English between 2001 and 2022 and conducted in Iran. We used a three-step systematic review process to select articles that met the research criteria.

Conflict in society, lack of knowledge, specific characteristics of the disease, and the contagious nature of disease are the main causes of stigma, leading to stigmatization by different groups such as significant others, generalized others, institutional others, and macro others. Patients experiencing stigma face various psychological, physical, and social complications, and they may use concealment as a coping strategy, which can pose a potential threat to society's general health.

By knowing the causes and stigmatizers of disease-related, it is possible to reduce stigma with less cost and time.

Suicide rate in South Korea is the highest among Organization for Economic Cooperation and Development countries. Particularly it is a major public health concern among adolescents. We investigated the factors affecting suicidal ideation among female Korean adolescents who had experienced sexual intercourse.

This study was a secondary data analysis using the 18th Korea Youth Risk Behavior Survey, conducted using a complex sampling design in 2022. A complex sample multiple logistic regression was performed to analyze data of 1,166 female students who had experienced sexual intercourse.

Among the general characteristics, significant differences in suicidal ideation depending on grade, household income, living with family, academic achievement, and allergic dermatitis were observed (P<0.05). Additionally, the factors significantly associated with suicidal ideation were contraceptive use, mental health (generalized anxiety disorder, depressive symptoms, loneliness, and stress), current smoking, drinking, insufficient sleep, and insufficient breakfast consumption (P<0.05). Multiple logistic regression analysis revealed that the factors affecting suicidal ideation were generalized anxiety disorder, perceived stress, loneliness, depressive symptom, and smartphone addiction.

For female adolescents with sexual experience, negative mental health and smartphone addiction needed to be managed to reduce suicidal ideation.

Syphilis remains a major public health concern in China. We aimed to construct an optimum model to forecast syphilis epidemic trends and provide effective precautionary measures for prevention and control.

Data on the incidence of syphilis between 1982 and 2020 were obtained from the China Health Statistics Yearbook. An exponential smoothing model (ES model) and a BP neural network model were constructed, and on this basis, the ES-BP combination model was created. The prediction performance was assessed to compare the MAE (Mean Absolute Error), MSE (Mean Squared Error), MAPE (Mean Absolute Percentage Error), and RMSE (Root Mean Square Error).

The optimum ES model was Brown’s linear trend model, which had the lowest MAE and MAPE values, and its residual was a white noise sequence (P=0.359). The optimum BP neural network model had three layers with the number of nodes in the input, hidden, and output layers set to 5, 11, and 1, and the mean values of MAE, MSE, and RMSE by five-fold cross-validation were 1.519, 6.894, and 1.969, respectively. The ES-BP combination model had three layers, with model nodes 1, 4, and 1. The lowest mean values of MAE, MSE, and RMSE obtained by five-fold cross-validation were 1.265, 5.739, and 2.105, respectively.

The ES, BP neural network, and ES-BP combination models can be used to predict syphilis incidence, but the prediction performance of the ES-BP combination model is better than that of a basic ES model and a basic BP neural network model.

Cigarette smoking has been identified as most perilous risk factor for several health ailments. Increased price may discourage smoking habits. There is limited literature available on impact of price rise on smoking behaviors in Saudi Arabia, which is the fourth largest importer of cigarettes and this study assessed the impact of tax increase (in 2020) on smoking behaviors.

A cross-sectional survey was carried out between July 2021 and December 2021.i.e.one year after new value added tax (VAT) system came into force. Data was collected with 14-item pretested questionnaire from 721 adult smokers in Al-Jouf Region of Saudi Arabia selected through stratified cluster ransom sampling. We measured effects of tax increase on smoking behaviors, its impact on decision to quit and perceived health improvements as outcome variables.

Nearly 40% of the respondents said that increased price lead them to smoke less number of cigarettes per day (P=0.000), decreased smoking improved their health in terms of breathing capacity, mood, ability to exercise and sleep in hierarchy. 67.4% of the participants are currently thinking of quitting smoking due to increased prices (P=0.001) and logistic regression models identified reduced smoking due to tax rise (Odds=5.68), improvement in health (Odds=2.94) and excess spending of above 20% (Odds=1.72) significantly associated with intentions to quit smoking.

Increased price of cigarettes due to VAT significantly decreased smoking behaviors and has impact on smokers’ decision to quit smoking. Future studies needed to assess the long-term effect of increased tax on smoking behaviors and its relapse.

The Syrian Arab Republic (SAR) is experiencing high rates of malnutrition. While many adults experience overweight and obesity, as a direct result of the continuing conflict, SAR is also noted as one of the most food-insecure regions in the Arab world. To combat the health impacts and outcomes related to diet and dietary behaviors, trained nutrition professionals are needed. We aimed to examine current nutrition-affiliated programs offered in post-secondary institutions in the SAR.

The search was conducted between Jan and Feb 2021. An electronic review of universities and colleges’ websites, department webpages, and academic programs’ homepages and resources of all the private and public universities in SAR was conducted to find programs related to nutrition, nutrition sciences, and dietetics.

Only 13%, or 4 out of 30 SAR colleges and universities had bachelor’s programs in nutrition or nutrition science, and none had nutrition programs at the graduate or terminal degree levels.

A pathway for integration of graduates from nutrition sciences into the healthcare and public health workforce should be defined and an understanding of the value of those with a degree in nutrition should be cultivated in clinical and community care settings. Partnering with existing or creating independent organizations charged with defining the scope of practice and ensuring educational quality and competence of graduating students, as well as readiness to practice as part of a healthcare team or in a public health nutrition role will be integral to moving the nutrition profession forward in the SAR.

The three-year the pandemic has increased the preference for "safer and healthier" medical tourism destinations at a global level. Busan in South Korea aims to increase its competitiveness as a "medical city" destination. This study aimed to explore the best marketing strategies designed based on country-specific attraction model.

We collected data from surveys with 10 participants of a focus group from the medical tourism field in Busan and 352 participants of doctors, stakeholders, and moderators working in the medical tourism field in Nov and Dec 2022 to investigate key success factors for the medical tourism in Busan.

The interview identified key target countries and effective strategies such as ease of visa acquisition, non-face-to-face care, insurance billing systems, foreign language expertise, win-win systems for agencies and healthcare organizations, and international accessibility. When participants were asked about their country-specific attraction for patients, they ranked healthcare quality and tourism resources as both important and satisfactory. Although cultural environment, economic support, and administrative support were ranked important, they were less satisfactory. For Japanese patients, the infrastructure showed high levels of importance and satisfaction.

This study identified specific items for a new model of patient attraction customized to target countries. This model was based on cultural background and preferences of each target country. Strategies are needed to strengthen the cultural environment and administrative support. Results of this study can be used to promote medical cities through target specific policies.

Sedentary behavior and physical activity are still ambiguous in their effects on osteoarthritis. We aimed to evaluate the effects of physical activity and sedentary behavior on osteoarthritis to provide a reference for the prevention of osteoarthritis.

This study was conducted in Changchun, China in 2022. We used two-sample Mendelian randomization with the SNP as an instrumental variable to investigate the effect of physical activity and sedentary behavior on osteoarthritis. In addition, a two-step Mendelian randomization method was used to test whether mediating factors (BMI, smoking, Apolipoprotein B) were involved in mediating the effects of exposure factors on osteoarthritis.

TV watching was causally related to knee osteoarthritis and spine osteoarthritis, and they were positively correlated (knee osteoarthritis: OR=1.162,95 %CI: 1.027-1.315, P=0.017; spine osteoarthritis: OR=1.208,95 %CI: 1.033-1.413, P=0.018). BMI played a mediating role in the process of TV watching with knee osteoarthritis and spine osteoarthritis. ((The proportion of BMI mediating effect: knee osteoarthritis: 47.1% (95% CI: 36.7%~63.2%); spine osteoarthritis: 29.5% (95% CI: 19.3%~40.8%)). The proportion of Smoking mediating effect in the process of TV watching with spine osteoarthritis was 16.1% (95% CI: 3.7% ~ 31.6%).

TV watching is a potential risk factor for osteoarthritis and plays a role through modifiable factors such as BMI and smoking, therefore, interventions on these factors have the potential to reduce the burden of osteoarthritis caused by longer TV watching times.

Assessment of quality of life (QoL) during pregnancy can be a starting point for streamlining and promoting the humanization of evidence-based healthcare. We aimed to determine the life quality in pregnant women and its predictors.

A cross-sectional study was conducted on pregnant women from Slovakia from March 2020 to January 2021. A method of purposive sampling was used. The research sample consisted of 393 women (age 29.11±4.65) with physiological pregnancy. Questionnaire method was used. The first part of the questionnaire consisted of a set of questions focused on identification items, which also represented the investigated predictors. The second part was the standardized questionnaire “Quality Of Life-Gravidity Questionnaire“(QOL-GRAV), with Cronbach's alpha value of 0.74. The received data were analysed using descriptive and inferential statistics.

The average life quality score was 18.79±5.04, which oscillates at the level of very good life quality. The lower life quality was recorded in connection with physical changes, satisfaction with social life, concerns about childbirth management failure and a need for physical activity reduction. Education (P=0.008), course of pregnancy (P=0.001), support from healthcare professionals (P=0.003) and concerns about COVID-19 (P=0.001) were the predictors of life quality.

The proven significant predictors of life quality of pregnant women have shown that healthcare professionals should pay increased attention to the pregnant women with higher education and with problematic pregnancy, positively support and motivate pregnant women and be even more attentivedue to the current COVID-19 pandemic.

Gliomas are the most frequent and dangerous primary cerebral tumors. Therefore, there is a need to develop molecular targets for the diagnosis and treatment for glioma.

In September 2020, we retrieved the expression matrix of glioblastoma (GBM) sufferers and pertinent clinical data from the TCGA (The Cancer Genome Atlas) database. Prognostic differences between various families with sequence similarity 110 member C (FAM110C) expression groups were assessed by Kaplan-Meier with log-rank test. The R platform get used to assess the accuracy of FAM110C delivery in predicting the prognosis of PDAC using a time-dependent receptor operating characteristic (ROC) curve. The delivery level of FAM110C was determined by qRT-PCR and western blot. Gene set enrichment investigated possible mechanisms between different FAM110C expression groups in GBM (GSEA). The impact of FAM110C on glioma cell movement was discovered using migration test. The drug's gene-targeting impact was validated by the CCK8 test.

A total of 173 GBM samples were obtained from the TCGA database, with 148 including information on IDH1 mutations and 151 containing information on overall survival. The mRNA expression level of FAM110C was greater in wild-type GBM, according to qRT-PCR data. The connection between FAM110C expression and Hallmark, GO, and KEGG pathway gene sets was investigated using GSEA software. We used migration test to assess the impact of FAM110C on glioma motility in order to confirm the findings of the GSEA analysis.

FAM110C might get used as a possible diagnostic and prognostic biomarker for wild-type GBM, and its inhibition could be used to prevention and treatment wild-type GBM.

In the era of the fourth industrial revolution, there is a requirement of innovative strategies to enhance nursing students’ learning transfer. Virtual Reality Simulation Problem-Based Learning (VRS-PBL) has been validated to be an advantageous strategy that can improve knowledge, clinical performance, and self-efficacy. We aimed to identify the effectiveness of VRS-PBL for improving nursing students’ neurologic examination.

Data were collected in 2021. Seventy-six participants were recruited via the convenience sampling. Students in the control group underwent conventional lecture and demonstration of neurological assessment prior to practicum, whereas students in the experimental group underwent VRS-PBL once a week for 2 weeks (60 minutes per session).

Compared with the control group, the academic self-efficacy (t = -2.80, P = .007) and neurological examination performance (t = -11.62, P < .001) of the nursing students increased significantly in the experimental group. On the other hand, there was no significant difference between the two groups of the transfer motivation (t = -1.76, P = .082).

The nursing students integrated the knowledge and skills learned through VRS-PBL, and improved the effectiveness and efficiency of their learning. VRS-PBL that reflects various clinical situations can be used as a foundation for establishing effective teaching strategies to improve nursing competency from novice to expert nurses.

A good family environment and rearing mode play important roles in children’s physical and psychological growth. This study aims to clarify the specific influence of early family nurturing environment on children’s emotional and social development through longitudinal observation to provide theoretical reference for promoting the healthy development of children’s bodies and minds.

Overall, 1320 parents of children aged 2 to 6 yr old in Xinyang City, Henan Province in 2021, were selected by stratified sampling. The children’s physical and mental development, family rearing environment and emotional and social development were investigated by questionnaire.

58.03% family rearing environment is good, 27.95% normal, and 14.02% bad. There were significant differences in positive rates of adaptive ability, social behavior, language, developmental quotient score and emotional sociality among children in different families (all P<0.05). Language/cognition was significantly positively correlated with adaptive ability, social behavior, language and developmental quotient (all P<0.05), and social adjustment/self-care was significantly positively correlated with adaptive ability, social behavior, language and developmental quotient (all P<0.05). Emotional warmth/environmental atmosphere was negatively correlated with implicit behavior and disorder and positively correlated with ability (all P<0.05). Language/cognition was positively correlated with explicit behavior and ability (all P<0.05). Social adjustment/self-care was negatively correlated with explicit behavior and positively correlated with ability (all P<0.05); Neglect/punishment was significantly negatively correlated with explicit behavior, implicit behavior and disorder and significantly positively correlated with ability (all P<0.05).

The early family environment affects children’s physical, mental, emotional and social development.

Vitamin D supplementation or sun exposure increase pregnant women’s Calcidiol levels, lower the blood pressures and increase birth weight. We aimed to compare the effects between sun exposure and vitamin D supplementation on pregnant women’s Calcidiol levels, blood pressures and newborns’ anthropometric indices.

This randomized clinical trial was conducted on 108 pregnant women at 20 wk of gestation on 2021’s dry season in Semarang City, Indonesia. The subjects were randomly and evenly divided into 3 groups of 36 subjects (sunlight exposure, vitamin D supplement, and control). Vitamin D group received 1000 IU daily and sun exposure group was recommended to have 15–30 min for 3 times/week for 17 wk. Compliance was monitored every 2 d through home visits. Calcidiol levels, blood pressures, in all groups were compared before and after intervention. The increments and the newborn anthropometric indices were compared between the groups and controlled for confounding factors.

At baseline, all groups had vitamin D deficiency, different mean Calcidiol levels, systolic, and diastolic blood pressures. The mean Calcidiol levels increased in the sun exposure and vitamin D group after the intervention. Systolic blood pressure decreased in the vitamin D group only (P=0.019). The mean birth weight was the highest in the vitamin D group (3,172±181.8 g) compared to the sun exposure (3,091±362.5g) and control groups (2,861 ± 208.0 g).

Vitamin D supplementation and sun exposure increased Calcidiol levels and birth weights. Vitamin D supplementation maintained systolic blood pressure.

Considering the necessity of health risk management, the present study conducted to provide a comprehensive model for identifying, evaluating, and prioritizing occupational health risks in an oilfield.

We conducted this descriptive-analytical cross-sectional study in 2022 at the North-Azadegan oil field in Iran. The occupational health risk was assessed using the "Harmful Agents Risk Priority Index" (HARPI) method.

Among the employees for the office section in all job groups, ergonomic risks due to people's posture while working has the highest risk score and is the most critical risk for implementing corrective actions. In the operational section, for the HSE group, benzene, the production group, Electromagnetic Fields (EMFs), and other groups, undesirable lighting has the highest risk score, and exposure to Toluene, Ethylbenzene, Xylenes (TEX) has the lowest risk score. In this oil field, controlling exposure to benzene, correcting ergonomic conditions, and controlling noise exposure, with scores of 81.3,74.85 and 71.36, have the highest priority, respectively. Sequentially, Toluene, Xylene, and ethylbenzene, with scores of 10.25,11.61, and 11.61, have the lowest control priority.

 The proposed model can prioritize the workplaces' harmful agents based on the HARPI score due to exposure to chemicals, physical factors, and analysis posture.

Professional driving is associated with overworking, lack of physical activity, and high stress, which are susceptible to cardiovascular diseases (CVDs).  We aimed to determine the prevalence of hypertension and obesity in Iranian professional drivers.

Overall, 132,452 drivers were included by census sampling methods and those who did not pass periodic examinations were excluded. Demographics and anthropometric data, including height and weight and the driver's blood pressure, were recorded. The criteria for hypertension assumed as the systolic blood pressure ≥ 130 mm and/or diastolic blood pressure ≥ 80 mm, and the criteria for prehypertension assumed as 120–129 systolic and < 80 mm Hg. In addition, body mass index (BMI) ≥ 25 is assumed as overweight, and BMI ≥ 30 is assumed as obesity.

Overall, 113,856 male drivers were included in the final analysis. The prevalence of HTN, pre-HTN, and abnormal blood pressure (HTN + pre-HTN) was calculated to be 14.2%, 57.4%, and 71.6%, respectively. Khuzestan, West Azerbaijan, and Yazd had the most prevalence of abnormal blood pressure. The prevalence of overweight, obesity, and abnormal weight (overweight + obesity) was calculated to be 50.9%, 22.6%, and 73.5%, respectively, and the northwest provinces had the highest prevalence of abnormal weight.

Professional Iranian drivers have a high prevalence of abnormal blood pressure and weight associated with job-related risk factors. Preventive measures should be taken to confront a possible outbreak of CVDs in this population.

One of the negative effects of the COVID-19 illness, which has affected people all across the world, is Alzheimer's disease. Oblivion after COVID-19 has created a variety of issues for many people. Predicting this issue in COVID-19 patients can considerably lessen the severity of the problem.

Alzheimer's disease was predicted in Iranian persons with COVID-19 in using three algorithms: Nave Bayes, Random Forest, and KNN. Data collected by private questioner from hospitals of Tehran Province, Iran, during Oct 2020 to Sep 2021. For ML models, performance is quantified using measures such as Precision, Recall, Accuracy, and F1-score.

The Nave Bayes, Random Forest algorithm has a prediction accuracy of higher than 80%. The predicted accuracy of the random forest algorithm was higher than the other two algorithms.

The Random Forest algorithm outperformed the other two algorithms in predicting Alzheimer's disease in persons using COVID-19. The findings of this study could help persons with COVID-19 avoid Alzheimer's problems.

We used the multistate model to investigate how prognostic factors of breast cancer are seen to affect the disease process.

This cohort study was conducted at Motamed Cancer Institute of Tehran, Iran on 2363 breast cancer patients admitted from 1978 to 2017, and they were followed up until 2018. We applied the multistate models, including four states: diagnosis, recurrence, metastasis, and final absorbing mortality state.

Age over 50 years, positive lymph nodes and tumor size intensified the hazard of transition from diagnosis to metastasis (P=0.002, P<0.001 and P=0.001 respectively) and they also intensified the hazard of transition from diagnosis to mortality (P=0.010, P<0.001 and P<0.001 respectively). At the same time, the educational level decreased the hazard of mentioned transitions (P<0.001). Positive estrogen receptors reduced the hazard of transition from diagnosis to metastasis (P=0.007) and positive lymph nodes also intensified the hazard of transition from metastasis to mortality (P=0.040). Tumor size had an increasing role in the transitions from diagnosis to recurrence, recurrence to metastasis, and metastasis to mortality (P=0.014, P=0.018 and P=0.002 respectively).

Multistate model presented the detailed effects of prognostic factors on progression of breast cancer. Implementing early diagnosis strategies and providing informational programs, especially in younger ages and lower educational level patients may be helpful in reducing the hazard of transition to higher states of breast cancer and increasing the survival of Iranian women with breast cancer by controlling tumor size growth, lymph nodes involvements and estrogen receptor status.

Traditionally, mortality rates are used to estimate public health problems and determine the relative significance of different causes of mortality, but they cannot necessarily determine the burden of premature death.  We aimed to investigate the 16-year trend of burden of premature mortality in Southern Iran.

In this cross-sectional study, all deaths due to various causes of death in Fars Province from the electronic population-based death registration system (EDRS) were obtained. Crude and age-standardized mortality rate, Years of Life Lost (YLL) and YLL rate data were calculated and to examine the trend, joinpoint regression was used.  

During the study period, 281,903 deaths occurred, of which, 59.85% (n=168,735) occurred in men. Also, 42.18% of these deaths (n=118,610) occurred due to cardiovascular diseases (CVDs). The total number of YLLs due to premature death was 4,154,828 years. Of these, 2,591,564 years (62.37%) were in men. The highest number of YLL was due to CVDs, external causes of death and cancer. Trend of YLL rate due to premature mortality was decreasing: the annual percent change (APC) was -2.1% (95% CI -2.6 to -1.6, P<0.001) for males, -0.9% (95% CI -1.4 to -0.4, P=0.002) (P=0.002) for females.

Although the trend of premature death has been decreasing during the years of study, but the seven major causes of premature death in 2004 to 2019 were non-communicable diseases, especially ischemic heart diseases, stroke, external cause of morbidity, and cancer.  Furthermore, our findings indicate a change in the role of non-communicable diseases in premature mortality in recent years.

Globally, population growth and ageing are expected to increase the risk of vision impairment for more people. Eye disorders impose heavy social and economic burdens on communities through increased poverty, reduced quality of life, and decreased employment. Weaimed to calculate the economic burden of eye diseases in Iran.

Prevalence-based and top-down cost estimation methods were used with a sociological approach. Data were collected from the Northeastern Ophthalmology Center Institute for Health Assessment, and Evaluation, besides the 2017 census. Eye diseases were classified according to the ICD10. Data were analyzed using Excel 2016 software.

Survey data were collected from 19,113 patients with vision loss and eye disorders. The average cost of vision loss/eye disorders was estimated to be $250.3. The findings indicated that the economic burden of visual diseases was $2,844 million a year, with direct medical costs comprising 87% (66% of inpatient and 21% of outpatient) and direct non-medical and indirect costs estimated at 6% and 7%, respectively. Furthermore, 72.8% of direct medical costs was paid by insurance companies, 20.6% by patients, and 6.6% by the government.

Eye diseases and vision loss in Iran, as in other countries, are costly for the health system and society. Instituting effective policies and measures to address this rising burden should be a national priority. Another suggestion in this area would be to focus on preventive care and policies such as health education, highlighting the role of reorientation of health services and advocacy (for policies that promote eye health), where relevant.

Cervical cancer is the fourth leading cause of cancer-related death among women worldwide. We aimed to identify the factors affecting the survival rate of cervical cancer patients, as these factors are vital for preventing the progression and effective treatment of cancer.

In this retrospective cohort study, 254 patients with cervical cancer who were registered in The Kerman Population-Based Cancer Registry (KPBCR) between 2012 and 2022 and whose status was known to be alive or dead were enrolled. Since the proportional hazard assumption was not established for the type of treatment, the extended Cox model was used to determine the variables influencing the survival of the patients.

The mean survival time of the patients was 91.28 ± 3.02 months. The results of fitting the extended Cox model showed that the risk of death increases by 1.02 per year of age at diagnosis (HR=1.02; 95% CI: 1.00, 1.04). Moreover, for a one-unit increase in body mass index (BMI), the risk of death increased by 0.93 (HR=0.93; 95% CI: 0.88, 0.98). The risk of death in patients with disease stages III&IV was 3.08 times that of patients with disease stages I&II (HR=3.08; 95% CI: 1.05, 9.03). The risk of death in patients receiving at least one of the radiotherapy and chemotherapy treatments after 18 months was 7.11 times that of patients undergoing surgery (HR=7.11; 95% CI: 1.69, 29.91).

The age of diagnosis, BMI, disease stage, and type of treatment significantly affect the survival of patients. Thus, raising women's awareness of periodical examinations and early diagnosis can reduce the risk of death and prevent cervical cancer progression.