fa تحلیل روند بروز و مرگ سرطان پروستات در ایران با رویکرد سن، دوره و همگروهی اپیدمیولوژی Epidemiology پژوهشي Research <div style="text-align: justify;"><span style="font-size:12pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="tab-stops:346.3pt"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><b><span lang="AR-SA" style="font-size:10.0pt"><span style="background:white"><span b="" lotus="" style="font-family:"><span style="color:black">مقدمه و اهداف:</span></span></span></span></b><span lang="AR-SA" style="font-size:10.0pt"><span style="background:white"><span b="" lotus="" style="font-family:"><span style="color:black"> سرطان پروستات یکی از شایع‌ترین سرطان‌ها در میان مردان ایرانی است که در دهه&shy; های اخیر افزایش چشمگیری در بروز و مرگ داشته است. این مطالعه با هدف تحلیل روندهای زمانی بروز و مرگ سرطان پروستات در ایران با استفاده از رویکرد تحلیلی سن، دوره و همگروهی (</span></span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="background:white"><span style="color:black">APC</span></span></span><span lang="AR-SA" style="font-size:10.0pt"><span style="background:white"><span b="" lotus="" style="font-family:"><span style="color:black">) انجام شد.</span></span></span></span></span></span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="tab-stops:346.3pt"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><b><span lang="AR-SA" style="font-size:10.0pt"><span style="background:white"><span b="" lotus="" style="font-family:"><span style="color:black">روش کار:</span></span></span></span></b><span lang="AR-SA" style="font-size:10.0pt"><span style="background:white"><span b="" lotus="" style="font-family:"><span style="color:black"> داده‌های مطالعه بار جهانی بیماری‌ها (</span></span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="background:white"><span style="color:black">GBD-2021</span></span></span><span lang="AR-SA" style="font-size:10.0pt"><span style="background:white"><span b="" lotus="" style="font-family:"><span style="color:black">) برای مردان </span></span></span></span><span lang="FA" style="font-size:10.0pt"><span style="background:white"><span b="" lotus="" style="font-family:"><span style="color:black">۴۵</span></span></span></span><span lang="AR-SA" style="font-size:10.0pt"><span style="background:white"><span b="" lotus="" style="font-family:"><span style="color:black"> سال به بالا در ایران طی سال‌های </span></span></span></span><span lang="FA" style="font-size:10.0pt"><span style="background:white"><span b="" lotus="" style="font-family:"><span style="color:black">۱۳۷۱</span></span></span></span><span lang="AR-SA" style="font-size:10.0pt"><span style="background:white"><span b="" lotus="" style="font-family:"><span style="color:black"> تا </span></span></span></span><span lang="FA" style="font-size:10.0pt"><span style="background:white"><span b="" lotus="" style="font-family:"><span style="color:black">۱۴۰۰</span></span></span></span><span lang="AR-SA" style="font-size:10.0pt"><span style="background:white"><span b="" lotus="" style="font-family:"><span style="color:black"> استفاده شد. داده‌ها در </span></span></span></span><span lang="FA" style="font-size:10.0pt"><span style="background:white"><span b="" lotus="" style="font-family:"><span style="color:black">۸</span></span></span></span><span lang="AR-SA" style="font-size:10.0pt"><span style="background:white"><span b="" lotus="" style="font-family:"><span style="color:black"> گروه سنی پنج‌ساله و </span></span></span></span><span lang="FA" style="font-size:10.0pt"><span style="background:white"><span b="" lotus="" style="font-family:"><span style="color:black">۶</span></span></span></span><span lang="AR-SA" style="font-size:10.0pt"><span style="background:white"><span b="" lotus="" style="font-family:"><span style="color:black"> دوره زمانی پنج‌ساله طبقه‌بندی شدند. برای تحلیل </span></span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="background:white"><span style="color:black">APC</span></span></span><span lang="AR-SA" style="font-size:10.0pt"><span style="background:white"><span b="" lotus="" style="font-family:"><span style="color:black"> از روش تفاضل مرتبه دوم و برای تحلیل تغییرات عوامل خطر از رگرسیون نقطه اتصال (</span></span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="background:white"><span style="color:black">Joinpoint</span></span></span><span lang="AR-SA" style="font-size:10.0pt"><span style="background:white"><span b="" lotus="" style="font-family:"><span style="color:black">) استفاده شد.</span></span></span></span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="tab-stops:346.3pt"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><b><span lang="AR-SA" style="font-size:10.0pt"><span style="background:white"><span b="" lotus="" style="font-family:"><span style="color:black">یافته‌ها:</span></span></span></span></b><span lang="AR-SA" style="font-size:10.0pt"><span style="background:white"><span b="" lotus="" style="font-family:"><span style="color:black"> میزان بروز استانداردشده سنی در سال 1400 به 30/05</span></span></span></span><span lang="AR-SA" style="font-size:10.0pt"><span style="background:white"><span b="" lotus="" style="font-family:"><span style="color:black">&nbsp;و مرگ به </span></span></span></span><span lang="FA" style="font-size:10.0pt"><span style="background:white"><span b="" lotus="" style="font-family:"><span style="color:black">10/66</span></span></span></span><span lang="AR-SA" style="font-size:10.0pt"><span style="background:white"><span b="" lotus="" style="font-family:"><span style="color:black">&nbsp;در هر </span></span></span></span><span lang="FA" style="font-size:10.0pt"><span style="background:white"><span b="" lotus="" style="font-family:"><span style="color:black">۱۰۰,۰۰۰</span></span></span></span><span lang="AR-SA" style="font-size:10.0pt"><span style="background:white"><span b="" lotus="" style="font-family:"><span style="color:black"> نفر رسید که نسبت به سال </span></span></span></span><span lang="FA" style="font-size:10.0pt"><span style="background:white"><span b="" lotus="" style="font-family:"><span style="color:black">۱۳۷۱</span></span></span></span><span lang="AR-SA" style="font-size:10.0pt"><span style="background:white"><span b="" lotus="" style="font-family:"><span style="color:black"> به ترتیب </span></span></span></span><span lang="FA" style="font-size:10.0pt"><span style="background:white"><span b="" lotus="" style="font-family:"><span style="color:black">105/96&nbsp;</span></span></span></span><span lang="AR-SA" style="font-size:10.0pt"><span style="background:white"><span b="" lotus="" style="font-family:"><span style="color:black">و 14/99 </span></span></span></span><span lang="AR-SA" style="font-size:10.0pt"><span style="background:white"><span b="" lotus="" style="font-family:"><span style="color:black">درصد افزایش داشت. اثر سن بر بروز و مرگ مثبت بود. اوج اثر دوره در سال‌های </span></span></span></span><span lang="FA" style="font-size:10.0pt"><span style="background:white"><span b="" lotus="" style="font-family:"><span style="color:black">۱۳۸۱</span></span></span></span><span lang="AR-SA" style="font-size:10.0pt"><span style="background:white"><span b="" lotus="" style="font-family:"><span style="color:black"> تا </span></span></span></span><span lang="FA" style="font-size:10.0pt"><span style="background:white"><span b="" lotus="" style="font-family:"><span style="color:black">۱۳۸۵</span></span></span></span><span lang="AR-SA" style="font-size:10.0pt"><span style="background:white"><span b="" lotus="" style="font-family:"><span style="color:black"> مشاهده شد. اثر همگروهی نشان داد که کوهورت‌های جوان‌تر شتاب کمتری در بروز داشته‌اند. در میان عوامل خطر، بار بیماری منتسب به سیگارکشیدن </span></span></span></span><span lang="FA" style="font-size:10.0pt"><span style="background:white"><span b="" lotus="" style="font-family:"><span style="color:black">17/1&nbsp;</span></span></span></span><span lang="AR-SA" style="font-size:10.0pt"><span style="background:white"><span b="" lotus="" style="font-family:"><span style="color:black">درصد افزایش یافت، درحالی‌که اثر محافظتی &laquo;مصرف کم کلسیم&raquo; و &laquo;مصرف کم شیر&raquo; طی زمان کاهش یافت.</span></span></span></span></span></span></span></span></span></span></span><br> <b><span dir="RTL" lang="AR-SA" style="font-size:10.0pt"><span style="background:white"><span b="" lotus="" style="font-family:"><span style="color:black">نتیجه‌گیری:</span></span></span></span></b><span dir="RTL" lang="AR-SA" style="font-size:10.0pt"><span style="background:white"><span b="" lotus="" style="font-family:"><span style="color:black"> افزایش بروز و مرگ تحت‌تأثیر سه عامل سن- دوره و همگروهی است. کاهش نسبی در کوهورت‌های جدیدتر، ضرورت برنامه‌ریزی هدفمند برای غربالگری را برجسته می‌کند. تقویت سیاست‌های آموزش سلامت و بهبود دسترسی به خدمات تشخیصی می‌تواند بار بیماری را کاهش دهد.</span></span></span></span></div> <div style="text-align: justify;"><span style="font-size:12pt"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><b><span style="font-size:11.0pt"><span cen="" mt="" style="font-family:" tw="">Background and Objectives:</span></span></b><span style="font-size:11.0pt"><span cen="" mt="" style="font-family:" tw=""> Prostate cancer is one of the most common cancers among Iranian men and has shown a marked increase in both incidence and mortality over recent decades. This study aimed to analyze temporal trends in prostate cancer incidence and mortality in Iran using an Age&ndash;Period&ndash;Cohort (APC) analytical framework</span></span><span dir="RTL" lang="AR-SA" style="font-size:11.0pt">.</span><span style="font-size:11.0pt"><span style="font-family:"Tw Cen MT",sans-serif"></span></span></span></span></span><br> <span style="font-size:12pt"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><b><span style="font-size:11.0pt"><span cen="" mt="" style="font-family:" tw="">Methods:</span></span></b><span style="font-size:11.0pt"><span cen="" mt="" style="font-family:" tw=""> Data were extracted from the Global Burden of Disease Study 2021 for Iranian males aged 45 years and older during 1992&ndash;2021. Data were stratified into eight 5-year age groups and six 5-year time periods. APC analysis was conducted using the second-order difference method, and Joinpoint regression was employed to assess temporal trends in risk factors</span></span><span dir="RTL" lang="AR-SA" style="font-size:11.0pt">.</span><span style="font-size:11.0pt"><span style="font-family:"Tw Cen MT",sans-serif"></span></span></span></span></span><br> <span style="font-size:12pt"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><b><span style="font-size:11.0pt"><span cen="" mt="" style="font-family:" tw="">Results:</span></span></b><span style="font-size:11.0pt"><span cen="" mt="" style="font-family:" tw=""> In 2021, the age-standardized incidence rate reached 30.05 per 100,000 population, and the mortality rate reached 10.66 per 100,000</span></span> <span style="font-size:11.0pt"><span cen="" mt="" style="font-family:" tw="">representing increases of 105.96% and 14.99%, respectively, compared to 1992. Age effects were positively associated with both incidence and mortality. The period effect peaked during 2002&ndash;2006. Cohort analysis revealed that younger birth cohorts exhibited a slower acceleration in incidence rates. Among risk factors, the disease burden attributable to smoking increased by 17.1%, while the protective effects of low calcium intake and low milk consumption diminished over time</span></span><span dir="RTL" lang="AR-SA" style="font-size:11.0pt">. </span><span style="font-size:11.0pt"><span style="font-family:"Tw Cen MT",sans-serif"></span></span></span></span></span><br> <b><span style="font-size:11.0pt"><span cen="" mt="" style="font-family:" tw="">Conclusion:</span></span></b><span style="font-size:11.0pt"><span cen="" mt="" style="font-family:" tw=""> Rising incidence and mortality are shaped by age, period, and cohort effects. The relative decline in younger cohorts underscores the need for targeted prostate cancer screening programs.</span></span> <span style="font-size:11.0pt"><span cen="" mt="" style="font-family:" tw="">Strengthening public health education policies and improving access to diagnostic services can reduce the disease burden.</span></span></div> سرطان پروستات, بروز, مرگ‌, تحلیل سن - دوره و همگروهی, ایران, بار جهانی بیماری‌ها Prostate cancer, Incidence, Mortality, Age–period–cohort analysis, Iran, Global burden of disease 321 335 http://irje.tums.ac.ir/browse.php?a_code=A-10-3509-1&slc_lang=fa&sid=1 Rasoul Gholamiveis رسول غلامی ویس rasoolgholami597@gmail.com No Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran کمیته تحقیقات دانشجویی، دانشگاه علوم پزشکی کرمانشاه، کرمانشاه، ایران Fatemeh Heydarpour فاطمه حیدرپور fatemeh_hydarpur@yahoo.com No Associate Professor of Epidemiology, Medical Biology Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran دانشیار اپیدمیولوژی، مرکز تحقیقات بیولوژی پزشکی، دانشگاه علوم پزشکی کرمانشاه، کرمانشاه، ایران Mehdi Moradinazar مهدی مرادی نظر m.moradinazar@gmail.com Yes Fertility and Infertility Research Center, Health Technology Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran مرکز تحقیقات باروری و ناباروری، پژوهشکده فناوری سلامت، دانشگاه علوم پزشکی کرمانشاه، کرمانشاه، ایران