Iranian Journal of

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Background & Objectives: The Disability-Adjusted Life Year (DALY) was developed by the World Health Organization (WHO) to measure, compare, and analyze the burden of various diseases. The aim of this study was to estimate and compare the burden of cesarean section (CS) and normal delivery (ND) in Isfahan during 2008 year by employing DALY.
Methods: Burden of CS and ND was estimated based on information provided by hospitals located in Isfahan. The incidence of complications of both vaginal delivery and cesarean section at the time of delivery and 2, 4, 6 weeks after calculated by using hospitals files. Dismod II and STAT.10 software were used to calculate YLD, YLL and DALY of delivery and their complications.
Results: DALYs for cesarean and vaginal deliveries were estimated to be 20.70 years per 1000 deliveries and 8.89 years per 1000 with their complications, respectively. DALY from cesarean section was 23.404 years per 1000 deliveries in private hospitals and 15.67 years per 1000 deliveries for governmental hospitals. DALY from vaginal delivery was 8.98 in private hospitals and 8.137 years in governmental hospitals per 1000 deliveries.
Conclusion: This study showed a considerable burden for cesarean section particularly in private hospitals. This important finding should be considered by health policy makers in Iran.

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Background & Objectives: Knowledge of the magnitude of attributable burden of cardiovascular diseases (CVDs) due to diabetes is necessary for health policy, priority setting and preventing CVD deaths. Our study aimed at estimating the attribute of proportion of diabetes to the burden of cardiovascular diseases in Kermanshah, West of Iran.

Methods: World Health Organization Comparative Risk Assessment methodology was used to calculating Potential Impact Fraction (PIF). Data on the Prevalence of newly diagnosed diabetes mellitus (People who have fasting plasma glucose (FPG) equal or greater than 126 mg/dl) were obtained from 3rd Iranian surveillance of risk factors of non- communicable diseases and data on corresponding measures of effect were derived from a national- specific study with age and multivariate adjusted hazard ratios.

Results: Based on multivariate- adjusted hazard ratios, by reducing the percent of women with diabetes from 8.1 percent to the zero level and the feasible minimum risk level i.e. 4 percent, 11.2% and 5.7% of attributable Disability Adjusted Life Years (DALYs) to CVD are avoidable, respectively. The corresponding value for men at the theoretical (zero level) and feasible minimum risk level (3 percent) were 5.6% and 2.9%, respectively.

Conclusion: To better planning, decision making and priority setting, PIF should be applied to updated and revised burden of CVDs in Iranian Health system.

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Background and Objectives: Colorectal cancer, as the third common cancer, is one of the main health problems in Iran. We assessed the burden of colorectal cancer, as one of the high-priority indices, in this cross-sectional study in Iran in 2008.

Methods: CANMOD software was used for calculation. The input data included the population of Iran, all-cause and colorectal cancer mortality rates, and incidence rate of colorectal cancer, which were all obtained from the Iran Statistic Center, Mortality Registry System, and Cancer Registry System.

 Results: The total burden of colorectal cancer according to DALY in Iran in 2008 was 52534 years in the total population. Years of lost life (YLL) amongst males and females were 26455 and 19887 years, respectively. Years lived with disability (YLD) were 3473 and 2719 years for males and females, respectively. The burden of colorectal cancer per 1000 population was 75.4 years for males and 65.7 years for females. The peak age of colorectal cancer burden rate was in the age group 45-79 years.

 Conclusion: The burden of the colorectal cancer in Iran has increased compared to the last study (2003) which is due to the increase in its incidence and the related mortality during this period. Due to the possibility of prevention and effective intervention, this cancer should be a priority in the health care system. However, the final judgment should be made after calculation of the burden of other cancers, diseases, and damages at the country level and their respective rankings.

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  Background and Objectives : Breast cancer is the second most common cancer among Iranian women. The peak age of breast cancer in Iran is one decade lower than the global estimates. The aim of this cross-sectional study was to estimate the burden of breast cancer in Iranian women in the country level.

 Methods: In this study, the CANMOD software was used for the calculation of DALYs as the sum of YLL and YLD. The required data was the population of the Iranian women, mortality due to breast cancer, incidence cases of breast cancer, and mean time of the stages of breast cancer that was obtained from the Mortality Registry System, Cancer Registry System, and expert panel views .

  Results : In this study, the total burden of breast cancer in Iranian women was 75811 years in 2009. Moreover, the years of life lost (YLL) was 54938 years while years lived with disability (YLD) was estimated 20873 years. The rate of DALYs per 100000 female population was 220.9 years. The peak age of breast cancer burden was in the age group 45-59 years. The incidence to mortality ratio was 3/2.

  Conclusion: The incidence rate, mortality rate, and the burden of breast cancer in Iranian women increased in 2009 when compared to a previous study in 2003. The findings of this study may provide Iranian health managers with some information on the determinants of the burden of breast cancer in order to design preventive measures as well as screening programs for early detection of breast cancer.