The current study aimed to assess the independent effect of a high Decayed, Missing, and Filled Teeth (DMFT) score on the risk of head and neck squamous cell carcinoma (HNSCC) overall and its subsites. Also, we tested for the interaction effect of smoking tobacco and opium with the DMFT score on the risk of developing HNSCC. We included 899 pathologically confirmed cases of HNSCC and 3477 healthy visitor controls. We used multivariable unconditional logistic regression analyses to estimate odds ratios (ORs) and 95% confidence intervals (CIs) adjusted for study centers, age, sex, socioeconomic status, and alcohol, cigarettes, water pipes, and opium use. We found an OR of 2.0 (95% CI: 1.6, 2.5) between DMFT scores higher than 17 and the risk of HNSCC. This was higher for laryngeal (OR: 3.6, 95% CI: 2.5, 5.2) than lip oral cavity (OR: 1.5, 95% CI: 1.2, 2.0) cancers. We found a positive association between Decayed and Missing teeth, however, it was reversed for the number of Filled teeth. The association for those who had higher DMFT score was significantly higher (OR: 2.3, 95%CI: 1.7, 3.0) among smokers than non-smokers (OR: 1.7, 95% CI: (1.2, 2.3). A higher DMFT score was associated with an increased risk of HNSCC, with an interaction between DMFT score and smoking.

Opium consumption was recently classified as carcinogenic to humans by the International Agency for Research on Cancer (IARC). With Iran having the highest global prevalence of opium consumption, understanding the national and provincial prevalence of opium use is critical for cancer control efforts. This study integrated multiple data sources to estimate the prevalence of opium use across Iran. Using population-based cohorts and case-control studies we calculated opium use prevalence for 17 provinces of Iran. A regression model was then developed to explain geographical variation in opium use prevalence, incorporating demographic, socioeconomic, and opium-related national enforcement variables. The model was trained and validated using leave-one-out cross-validation for the 17 provinces with individual-level data, and was subsequently used to predict prevalence in the 14 remaining provinces lacking individual-level data. The age-standardized predicted prevalence of opium use among Iranian adults aged > 30 years was estimated at 5.93% (95% CI 2.76–8.20%), with a significant difference between men [10.40% (95% CI 4.69–14.30%)], and women [1.46% (95% CI 0.83–2.09%)]. Older age, lower socioeconomic status, unemployment, and higher quantities of seized opium were associated with higher opium use prevalence at provincial levels (all P-values < 0.05). Significant geographical variations in opium use prevalence were observed, with the highest rates estimated for the eastern provinces bordering Afghanistan, the world’s largest producer of opium, and the lowest rates in the northwestern provinces. The highest rates were calculated for Sistan and Baluchestan (15.00%), Golestan (13.43%), and Qom (13.07%), while the lowest were in Markazi (1.30%), Ilam (1.30%), and Zanjan (1.32%). Although the overall prevalence differed substantially between men and women, the geographic distribution patterns were similar for both. Opium consumption is highly prevalent among Iranian men and in populations residing in the eastern and southeastern provinces. Targeted public health interventions are urgently needed to reduce opium use, particularly in high-risk regions. These efforts should be integrated into national cancer control programs to effectively address the associated health burden.

BACKGROUND:There is large variation in case-fatality rates of breast cancer in young women across the world. The objective of this study was to estimate the ten-year overall survival of women diagnosed with breast cancer before age 40 in six countries, by clinical presentation and by treatments received. METHODS:Data were supplied by seven centers in six countries, including the USA, Canada, Poland, Iceland, Iran and Thailand, totaling 36,861 women diagnosed with breast cancer before age 40, from 1977 to 2020. American patients from the SEER registry were sub-divided into (Non-Hispanic) White and Black. The following factors were compared across countries: year of diagnosis, tumor size, lymph node status, estrogen receptor (ER) status, use of chemotherapy, use of tamoxifen and use of radiotherapy. The Kaplan-Meier method was used to estimate ten-year overall survival for patients in each center. Cross-center comparisons are provided. The Cox Proportional Hazards model was used to estimate the impacts of the various factors on death for each center separately and for all centers combined, for all patients and for patients with stage I breast cancer. For these comparisons, SEER white women were considered the reference group. RESULTS:The mean age of diagnosis was 35.4 years. The percentage of patients with node-positive breast cancer ranged from 48.5% in Poland to 53.4% in Iceland. Mean tumor size ranged from 2.1 cm in Poland to 3.5 cm in Iran. The percent of patients with ER-negative breast cancer ranged from 34.0% in USA White women to 47.4% in Canada. The use of chemotherapy ranged from 65.4% in Thailand to 78.8% in Poland. Ten-year survival rates ranged from 52.5% (95%CI: 50.4%-54.7%) in Thailand to 77.9% (95%CI: 75.5%-80.3%) in Poland. A two-fold variation in case-fatality across centers persisted after adjusting for year of diagnosis, stage, tumor features and treatment. The difference in case-fatality across countries was greatest for patients with stage I breast cancer (four-fold variation). CONCLUSIONS:There is a wide disparity around the world in the long-term survival of women diagnosed with breast cancer before age 40, which cannot be accounted for by differences in screening, tumor stage at presentation or other tumor features. It is possible that differences in survival are due to inherent ethnic differences and/or differences in cancer management, but more research is required.

BACKGROUND:Cervical cancer (CC) incidence in Italy has declined due to organized screening and HPV vaccination programs. However, disparities persist among vulnerable populations, including foreign-born women. This study aims to retrieve and synthesize evidence from population-based studies focusing on CC incidence among foreign-born women in Italy. METHODS:A systematic review was conducted to identify population-based epidemiological studies on CC in Italy. A comprehensive and systematic search was performed in PubMed, CINAHL, and Scopus. Studies were included if they reported data comparing foreign-born and Italian-born women in Italy and were based on cancer registry records. Due to heterogeneity in study designs and data, we used a descriptive and comparative approach rather than a meta-analysis. RESULTS:A total of five pertinent articles were identified and included in the review. Findings consistently indicate a higher incidence or relative risk of CC among foreign-born women in Italy, with estimates ranging from a modest increase to more than double the risk compared with Italian-born women. Higher incidence of both invasive cervical cancer and high-grade pre-malignant lesions was observed across multiple regions, particularly among women originating from countries with high HPV prevalence and high migratory pressure. CONCLUSION:These findings highlight persistent inequalities in cervical cancer risk between foreign-born and Italian-born women in Italy. Differences by country of origin may be associated with unequal access to timely and adequate care and with cultural barriers faced by specific immigrant women. Targeted policies and culturally sensitive interventions are needed to increase awareness, accessibility, healthcare navigation ability, and participation in cervical cancer screening, while addressing structural, linguistic, and informational barriers among high-risk migrant groups.

Breast cancer survivorship is frequently accompanied by impaired quality of life (QoL). Diet-related systemic inflammation may influence physical, emotional, and psychological well-being, yet evidence linking the inflammatory potential of diet to QoL in women with breast cancer remains limited. In this cross-sectional study, 600 women with confirmed breast cancer were recruited from the Isfahan Breast Cancer Registry between 2021 and 2023. Dietary intake and lifestyle characteristics were collected through structured telephone interviews. The Dietary Inflammatory Index (DII®) and energy-adjusted DII (E-DII™) were calculated, and QoL was assessed using a five-point Likert scale. Associations of DII and E-DII with QoL were examined using multivariable linear regression with adjustment for potential confounders. Quartile-based analyses and tests for linear trend were also performed. Higher DII scores were associated with lower QoL in adjusted models (β = −0.12; 95

The relationship between stress and breast cancer (BC) remains a topic of debate. We investigated the association between stress experienced within the past year and the risk of BC. Population-based incident case-control study of 600 newly diagnosed BC cases and 600 population controls (18-75 years) recruited in Isfahan, Iran between 2021 and 2023. Logistic regression model with short-term stress as main exposure was used to estimate odds ratios (ORs) and 95% confidence intervals (CI) after adjusting for confounders. Multiplicative interaction was tested between stress and menopausal status as well as other confounders. One-year stress level was significantly associated with BC risk. Compared with women reporting low stress levels, the odds of BC were higher among those with high stress levels in both the unadjusted model (OR = 3.10, 95%Cl: 2.45-3.92) and the fully adjusted model (OR = 3.38; 95%CI (2.56, 4.47)). Based on the statistical test for multiplicative interaction, the association appeared stronger among premenopausal women (adjusted OR = 4.88, 95% CI: 3.17-7.52) than among postmenopausal women (adjusted OR = 2.34, 95% CI: 1.53-3.58), with evidence of interaction by menopausal status (p for interaction = 0.018). Despite the inherent limitations of case-control studies, including potential recall and selection biases, the findings of the current study suggest that higher levels of stress experienced within the past year may be associated with an increased risk of breast cancer, particularly among premenopausal women. Further prospective studies are warranted to clarify the nature and direction of this association.

Background: Breast cancer (BC) is responsible for a high proportion of cancer-related morbidity and mortality. A varied diet may play a role in the onset of BC. Objectives: We aimed to investigate the association between dietary diversity and BC risk. Methods: This population-based case-control study was conducted between May 2021 and October 2023, comprising 600 incident BC cases and 600 general population controls. We employed a valid and reliable 168-item food frequency questionnaire, with data collected one year prior to the date of diagnosis for cases and within the past year for controls. A dietary diversity score (DDS), focusing on consuming a variety of 5 food groups, with attainable scores between 0 and 10, was created as an indicator of total nutritional quality. Potential confounders were also assessed, including educational year, menopause, age at menarche, family socioeconomic status during adolescence, multivitamin intake, and benign breast diseases. We employed logistic regression models to estimate crude and adjusted odds ratios (ORs), controlled for potential confounders, to estimate the effect of DDS on BC risk. Results: DDS was associated with BC odds when analyzed as both a continuous and a categorical variable. The OR for DDS as a continuous variable was 0.90 [95% confidence interval (CI): 0.82, 0.99]. For participants with a DDS between 2.5 and 6, the OR was 0.58 (95% CI: 0.36, 0.95), and for those with a DDS >6, the OR was 0.41 (95% CI: 0.23, 0.73). A clear dose-response association was also observed [test for trend: OR= 0.66 (0.49, 0.86)]. Conclusions: We identified DDS, a measure of a balanced diet, as a novel protective factor for BC. Given the global increase in BC morbidity and mortality, this finding underscores the need for public health interventions and educational programs targeting diverse and balanced dietary patterns.

The prevalence of waterpipe smoking (WPS) is increasingly recognised as a growing global public health concern. Available studies show that WPS exposes users to toxicants at levels similar to or higher than those in cigarette smoke, contributing to respiratory disease, cardiovascular damage and cancer. The WHO has flagged WPS as a growing threat, especially among adolescents and young adults, where use is rapidly increasing. Yet research progress is constrained by small samples, inconsistent exposure measures and inadequate adjustment for confounders. These limitations highlight the need for more rigorous epidemiological, clinical and toxicological studies. Importantly, the persistence and expansion of WPS cannot be explained solely by individual behaviours or perceptions of health risk. A range of socioeconomic, political and commercial forces-including industry marketing, weak regulatory oversight, cultural acceptance, low cost and the spread of waterpipe cafés-continues to drive WPS and shape patterns of use. These structural factors are likely to undermine the impact of current public health measures but remain under-researched. Expanding the evidence based on these upstream determinants is crucial for developing more effective and context-appropriate policies. In response to these challenges, experts from multiple disciplines convened in June 2024 to examine the evolving WPS epidemic. Participants emphasised the need for comprehensive, multisectoral strategies that integrate robust research, strengthen surveillance systems and target public awareness initiatives. The meeting concluded with a set of recommendations outlining priority research areas and a strategic roadmap aimed at addressing the complex and escalating public health threat posed by WPS.

Bladder cancer is a major public health concern worldwide. While smoking and occupational exposures are established risk factors, the role of dietary fatty acids (FAs) in bladder cancer risk remains unclear. Data were collected from 711 bladder cancer cases and 3,297 controls in the IROPICAN study (2017-2020) across ten Iranian provinces. Dietary intake was assessed using a validated food frequency questionnaire. Intakes of total fat, saturated FAs (SFAs), monounsaturated FAs (MUFAs), polyunsaturated FAs (PUFAs), and trans FAs (TFAs) were analyzed. Principal component analysis (PCA) identified fatty acid consumption patterns. Multivariable logistic regression estimated odds ratios (ORs) and 95% confidence intervals (CIs), adjusting for confounders. PCA suggested that balancing FA intake, specifically increasing omega-3 FAs, moderating omega-6, and reducing saturated fats, was associated with a favorable profile for bladder cancer risk. OR for stearic acid intake was 0.28 (95% CI: 0.12-0.67). Conversely, OR for high intake of palmitoleic acid, alpha-linolenic acid (ALA), and docosapentaenoic acid (DPA) was elevated. Sex-specific effects were found stearic acid was protective in men, while PUFAs were protective in women. No associations were observed for total fat or cholesterol. These results highlight the importance of FA subtypes, rather than total fat intake, in dietary recommendations.

Evidence on the association between dietary patterns (DPs) and colorectal cancer (CRC) is inconclusive. Thus, we aimed to evaluate it in an Iranian population. We analyzed data from a multicenter hospital-based case-control study conducted in Iran during 2017-2020. We derived a posteriori DPs using principal component factor analysis, and used reduced rank regression (RRR) to derive a DP high in unhealthy fats. We estimated adjusted odds ratios (ORs) and corresponding 95% confidence intervals (CIs) for the association between quartiles of DPs and CRC. False discovery rate (FDR)-corrected p-values were computed. We included 865 CRC cases and 3,204 controls in the study. After FDR correction, the Western-type diet (ORQ4vsQ1 4.15; 95% CI 2.49-6.90; ptrend < 0.001) identified through factor analysis was positively associated with CRC. Similarly, the DP high in unhealthy fats derived using RRR (with high factor loadings for animal products) was associated with CRC (ORQ4vsQ1 2.14; 95% CI 1.40-3.26; ptrend < 0.001). Results were consistent among CRC subsites and different participants' characteristics, including cigarette and waterpipe smoking and opium use. Our study showed that both a Western-style diet and DP high in unhealthy fats are associated with CRC, suggesting that consumption of unhealthy foods, including those high in trans and saturated fatty acids, should be reduced.

Due to political and security concerns, Iran has faced stringent sanctions in recent decades, significantly impacting vulnerable cancer patients. According to the latest statistics, the 5-year prevalent cases in Iran were 357,906 for both sexes combined. This study aimed to investigate the perspectives of cancer patients, their families, and non-governmental organizations (NGOs) regarding the ramifications of economic sanctions on cancer diagnosis and treatment. This qualitative study was conducted by semi-structured interviews with 21 cancer patients and their family members, as well as representatives from relevant NGOs based in Tehran in 2020. The interviewees were selected using convenience sampling, and the data were classified and analyzed using qualitative content analysis in MAXQDA-2019 software. The effects of economic sanctions on cancer patients were categorized into four themes: medicines, medical equipment, human resources, and financial resources. Medicines were further categorized into medicine price changes, scarcity, the complexity of dispensing medication, profiteering of drug manufacturers and distributors, and prolonged medical treatment subthemes. Medical equipment included price changes and difficulties in procuring medical devices and their accessories. Human resources comprised inadequate access to specialists and distorted doctor-patient relationships. Finally, financial resources were delineated by the diminished purchasing power of individuals and insufficient support extended to NGOs catering to patients’ needs. The findings underscore the urgency of addressing the multifaceted consequences of sanctions, which exacerbate vulnerabilities among cancer patients and hinder their access to timely and adequate care. Collaborative efforts between policymakers, healthcare providers, and NGOs are essential to mitigate these challenges and ensure equitable access to cancer treatment amidst ongoing sanctions. Furthermore, global health diplomacy could help reduce the effects of economic sanctions and facilitate the provision of medical equipment, medicines, and financial resources.

data on cancer incidence, prevalence, and mortality. This paper reviews the development, current status, and challenges of the Population-Based Cancer Registry (PBCR) program in Iran. Since the 1950s, Iran has made significant efforts to establish systematic cancer registration, culminating in the expansion of PBCRs across multiple provinces. The Golestan Province Cancer Registry was the first Iranian registry included in the international Cancer Incidence in Five Continents (CI5) report in 2014, with Ardabil Province joining in 2023, reflecting growing international recognition. The Iranian PBCR program has evolved through national legislation mandating cancer reporting, expansion from pathology-based to population-based registries, and continuous quality improvement initiatives. Despite progress, challenges remain, including underreporting, data completeness, and timeliness. The most recent national PBCR report (2018) documented approximately 141,000 new cancer cases with age-standardized incidence rates of 182.8 and 165.3 per 100,000 for men and women, respectively. Regional disparities were evident, with higher rates of oesophageal, stomach, and lung cancers in northern provinces and breast, colorectal, and prostate cancers more common centrally. Projections indicate a 42.6% increase in new cancer cases by 2025, underscoring the urgent need for enhanced cancer control strategies. Survival analyses reveal substantial variation by cancer type and region, with higher survival in provinces with better socioeconomic indicators. Furthermore, modifiable risk factors such as smoking, overweight, opium use, and Helicobacter pylori infection contribute significantly to cancer burden in Iran. To strengthen the PBCR program, priorities include timely publication of reports, improving data quality and coverage, and expanding international certification and publication. Sustained political commitment and resource allocation are essential to optimize cancer surveillance and support evidence-based policy to reduce Iran’s growing cancer burden.

BACKGROUND:There is conflicting evidence regarding the association between sunlight exposure and the risk of breast cancer. METHODS:This population-based incident case-control study included 600 newly diagnosed breast cancer cases and 600 population controls (18-75 years) recruited in Isfahan, Iran, between 2021 and 2023. Sunlight exposure (hours/day) used disaggregated data for exposure during adolescence (10-20 years), early adulthood (20-30 years), after 30 years, and lifetime exposure assessed in summer and winter. Logistic regression models were used to estimate ORs and 95% confidence intervals (CI) after adjusting for confounders. RESULTS:Each hourly increase in sunlight exposure during adolescence significantly decreased breast cancer odds (exposure during winter OR, 0.84; 95% CI, 0.78-0.91 and exposure during summer OR, 0.89; 95% CI, 0.83-0.96). No associations were observed for sunlight exposure after the age of 30. However, lifetime sunlight exposure was associated with lower odds of breast cancer: each additional hour (per day) reduced odds by 16% in winter (OR, 0.84; 95% CI, 0.76-0.93) and 9% in summer (OR, 0.91; 95% CI, 0.82-1.00). A dose-response association was observed for both adolescence and lifetime sunlight exposure and the odds of breast cancer. CONCLUSIONS:Sunlight exposure during adolescence and early adulthood is associated with reduced breast cancer risk. Cumulative lifetime exposure also has protective effects in Iranian females. These findings suggest the need for public health strategies that promote moderate sunlight exposure during critical life stages. IMPACT:Identifying key periods when sunlight exposure as a modifiable protective factor reduces breast cancer risk offers a simple prevention strategy and informs safer public health guidelines.

Supplementary Methods interviewer training and data collection protocol.

Poor sleep quality is a common risk factor for a reduced quality of life in patients with breast cancer (BC). The Global Diet Quality Score (GDQS) is a validated measure of dietary quality; however, its association with sleep quality in BC patients remains unclear. This study aimed to evaluate the association between dietary quality, as measured by the GDQS, and sleep quality, as assessed using the Pittsburgh Sleep Quality Index (PSQI), among patients with BC. This cross-sectional study included 600 patients with BC registered in the Isfahan Breast Cancer Registry (2021–2023). Dietary intake was assessed using a validated food frequency questionnaire, and the GDQS was computed for 25 food groups. Sleep quality was evaluated using the Persian version of PSQI. Multiple linear regression models adjusted for confounders were used to assess the association between the GDQS and sleep quality. Each unit increase in the total and positive GDQS was associated with a decrease in the PSQI score and better sleep quality (β = -0.12, 95

Gastric cancer (GC) remains a significant public health challenge in many low- and middle-income countries, particularly Iran. Despite advances in medical care and public health infrastructure, GC incidence among older adults continues to be alarmingly high. While much research has focused on adult risk factors—such as red meat consumption, smoking, alcohol intake, and Helicobacter pylori infection—emerging evidence suggests that the roots of GC extend far deeper, often tracing back to early-life conditions. Hadji M. and her colleagues published a case-control study in Iran in the current issue of Basic and Clinical Cancer Research (BCCR). They highlighted the profound influence of childhood socioeconomic factors on cancer risk decades later [1]. This study underscores the importance of adopting a life-course approach to understanding GC etiology and prevention, especially in countries like Iran. One of the most striking findings was the nearly threefold increased risk of GC associated with lack of access to clean tap water during childhood. This finding elevates sanitation from a developmental concern to a critical long-term cancer risk factor. It reflects the biological reality that early-life exposures—nutritional deprivation, microbial infections, poor housing, and inadequate hygiene—can cast a long shadow over lifelong health. Older generations in Iran experienced vastly different living conditions compared to today’s youth. Four to five decades ago, access to clean water and refrigeration was limited, particularly in rural and underserved urban areas. Children were frequently exposed to untreated water, a key transmission route for pathogens, including H. pylori [2]. Although infection rates remain high in some regions, national infrastructure improvements have dramatically increased access to electricity, clean water, and refrigeration. These changes have reduced infection rates and improved nutrition, yet the epidemiological consequences of past deprivation persist. The cohorts most affected by early-life disadvantage are now entering their 50s, 60s, and 70s—the age groups at highest risk for GC. Waiting passively for socioeconomic development to reduce GC incidence is both ethically and practically inadequate. It would mean neglecting a large population currently at elevated risk due to conditions endured decades ago: lack of sanitation, refrigeration, healthcare access, and exposure to childhood infections and malnutrition. To reduce GC incidence and mortality today, we must acknowledge these historical inequities and respond proactively. Interestingly, our study also found no significant association between GC and behaviors such as cigarette smoking, opium use, and alcohol consumption. While these are established risk factors in many contexts [3], the lack of significance here may reflect changing substance use patterns, cultural stigma leading to underreporting, or limited sample size. It also suggests that among older Iranian adults, early-life exposures and long-term dietary habits may outweigh midlife behaviors in determining GC risk. Geographic disparities within Iran further complicate the picture. Cancer registries reveal stark variations in GC incidence—from over 20 per 100,000 in northern provinces to under five per 100,000 in southern ones [4]. These disparities closely mirror economic development and infrastructure access and will not resolve without tailored, region-specific policies. Although universal access to clean water and electricity has largely been achieved, the legacy of unequal development endures. The most immediate and cost-effective approach is targeted screening and intervention for older adults who experienced deprived childhood conditions. Outreach programs can identify individuals born in high-risk regions or those reporting limited access to sanitation, refrigeration, and clean water during childhood. These individuals may benefit from endoscopic screening, nutritional counseling, and ongoing clinical monitoring. Concurrently, education campaigns should highlight the lifelong importance of proper nutrition and hygiene, encouraging fruit and vegetable consumption, safe water use, and adequate food storage. Primary care providers should incorporate questions about early-life environmental factors—such as water source, household amenities, and parental occupation—into routine assessments to better stratify gastric cancer risk. In summary, the paper emphasizes that childhood conditions significantly influence adult cancer risk, urging a shift in prevention strategies from midlife interventions to a comprehensive life-course approach starting at birth. For countries like Iran, undergoing health transitions, addressing historical disparities, and accelerating targeted interventions is crucial to effective cancer prevention. Future research priorities include long-term cohort studies to clarify early-life exposures, geospatial mapping to link socioeconomic factors with cancer patterns, and community-based nutritional and screening interventions for high-risk groups to enhance our understanding of the etiology and improve equitable prevention of gastric cancer in Iran and other high-risk countries.

The relationship between breast cancer (BC) and total dietary and types of fat is well-established, however, the association with dietary fat quality (DFQ) indices remains to be elucidated. Therefore, the aim was to investigate the associations between DFQ indices and odds of BC among women. This hospital-based case-control study included 464 women with pathologically confirmed BC during the past year and 498 apparently healthy controls of similar age and residence. Dietary intake was assessed using a validated food frequency questionnaire (FFQ) and DFQ indices were calculated. The likelihood of BC was evaluated across tertiles of specific DFQ indices scores [atherogenicity index (AI), thrombogenic index (TI), hypo- and hypercholesterolemic fatty acids ratio (h/H), omega-3 to omega-6 polyunsaturated fatty acids ratio (∑ω-3/∑ω-6), polyunsaturated fatty acids/saturated fatty acids ratio (PSR), dietary lipophilic index (LI), cholesterol/saturated fat index (CSI)]. After controlling for several potential confounders, CSI was inversely associated with BC risk among all participants (OR: 0.53, 95% CI: 0.37-0.76; P = 0.001). This association remained significant after stratified analysis in pre-postmenopausal women. In addition, there were higher odds of BC in the highest category of PSR compared to the lowest category in among postmenopausal women (OR: 1.93; 95% CI: 1.07-3.48 P = 0.03). There were no other significant associations between BC risk and the other DFQ indices.PSR and CSI might be directly and inversely associated with the odds of BC, respectively. To confirm the causality of the associations, prospective cohort studies are needed.

Background: Gastric cancer (GC) is the most common cancer among Iranian men. A diet rich in antioxidant compounds has been offered as an appropriate strategy for reducing the risk of GC. This study aimed to determine the possible association between dietary total antioxidant capacity (dTAC) and the Iranian population's GC risk. Methods: In total, 178 newly diagnosed GC patients and 238 healthy controls were recruited for this hospital-based case-control study. Dietary intakes were collected using a validated 146-item diet history questionnaire (DHQ), and dTAC was analyzed using Ferric reducing antioxidant potential (FRAP) assay. Results: The mean value of dTAC was 10.42±5.42 for cases and 11.42±5.86 for controls. Black tea, fruits, and cereals consumption were the main contributors to dTAC in both groups. DTAC was associated with a reduction in the risk of GC (OR 0.54; 95%CI: 0.31–0.92) (second vs. lowest tertile). This association did not change after adjustment for body mass index, education, energy intake, smoking, and Helicobacter pylori infection (0.55; 95% CI: 0.31-0.99). There was no significant association between fruits, vegetables, nuts, and legumes TAC with GC. Conclusion: The whole intake of dTAC from different food sources was not high in the population; however, this amount showed a preventive effect against GC.

Background: The fibrosis 4 (FIB-4) index is typically used in assessing liver fibrosis, and has shown potential in predicting the outcome in various diseases. This study aims to evaluate the predictive power of the FIB-4 index for mortality in COVID-19 patients admitted to a reference hospital in Tehran, Iran. Methods: In this prospective cohort study, 387 patients with COVID-19 without diabetes, were categorized into deceased and surviving groups. We compared anthropometric and demographic data, liver function tests, CT scores, and FIB-4 indices between the groups. Multivariate logistic regression assessed the independent association of FIB-4 with mortality. Results: Among the 387 patients, (all non-diabetics), 58 (15%) died, with a higher mortality rate observed in patients with a FIB-4 index≥2.6 (63.4%) compared to those with FIB-4<2.6 (29.7%). Deceased patients were considerably older and more likely to be hypertensive (P values<0.001). After adjustment of confounding factors, a FIB-4 index≥2.6 was found to be independently associated with increased mortality (OR: 13.511, 95% CI: 1.356-134.580, P=0.026). Conclusion: The FIB-4 index, calculable by routine laboratory tests, may be a valuable prognostic factor for COVID-19 mortality. This easily obtainable marker could help identify high-risk patients early, potentially allowing for more rapid intervention and treatment prioritization.