ﺛﺒﺖ ﺳﺮﻃﺎن ﺑﻪ ﻋﻨﻮان ﻣﻨﺒﻌﻲ ﺟﻬﺖ اﻋﺘﻤﺎد ﺑﻪ اﻃﻼﻋﺎت ﻣﺮدﻣﻲ

(1)

نﺎﻃﺮﺳ ﺖﺒﺛ ﺖﻬﺟ ﻲﻌﺒﻨﻣ ناﻮﻨﻋ ﻪﺑ ﻲﻣدﺮﻣ تﺎﻋﻼﻃا ﻪﺑ دﺎﻤﺘﻋا ﻲﺳرﺮﺑ

رﺎﻳﺮﻬﺷ ﺮﺘﻛد نارﺎﻜﻤﻫ و ﻲﻧﺎﻨﻤﺳ

٨٦

ﻲﺳرﺮﺑ ﻲﻣدﺮﻣ تﺎﻋﻼﻃا ﻪﺑ دﺎﻤﺘﻋا

ﺖﻬﺟ ﻲﻌﺒﻨﻣ ناﻮﻨﻋ ﻪﺑ نﺎﻃﺮﺳ ﺖﺒﺛ

ﺮﺘﻛد ﻲﻧﺎﻨﻤﺳ رﺎﻳﺮﻬﺷ -1

ﺮﺘﻛد ترﺎﺸﺑ ﺎﻤﻴﺳ -2

ﺮﺘﻛد ﻲﻬﻟاﺪﺒﻋ ﻪﺴﻴﻔﻧ -2

لﺪﻨﺷور ﺎﺿﺮﻣﻼﻏ ﺮﺘﻛد 2

ﺮﺘﻛد ﺶﻧاد ﺪﻤﺣا -3

ﺮﺘﻛد ﻲﻨﻴﺴﺣ ﺪﻤﺣا -3

لﺪﻨﺷور لﺎﻴﻧاد -4

ﺮﻴﺒﻛداﻮﺟﺪﻤﺤﻣ

5

هﺪﻴﻜﭼ

فﺪﻫ و ﻪﻨﻴﻣز شور:

"

رﺎﻤﻴﺑ ﺮﺑ ﻲﻨﺘﺒﻣ نﺎﻃﺮﺳ ﺖﺒﺛ

"نﺎﺘﺳ ﺰﻛاﺮﻣ زا ﻲﻜﻴﻨﻴﻠﻛارﺎﭘ و ﻲﻜﻴﻨﻴﻠﻛ هﺪﺷﺬﺧا تﺎﻋﻼﻃا ﺮﺑ

ﻲﻧﺎﻃﺮﺳ دراﻮﻣ مﺎﻤﺗ ﺖﺒﺛ رد ﻲﻳﺎﻬﺘﻳدوﺪﺤﻣ ﺖﺳا ﻦﻜﻤﻣ ﻢﺘﺴﻴﺳ ﻦﻳا ،دراد ﻪﻴﻜﺗ ﻲﻫﺎﮕﺸﻳﺎﻣزآ و ﻲﻧﺎﻣرد ﺑ

رد صﻮﺼﺨ

رد يﺎﻫرﻮﺸﻛ ﺪﺷﺎﺑ ﻪﺘﺷاد ﻪﻌﺳﻮﺗ لﺎﺣ

. نﺎﮕﺘﺴﺑ رد نﺎﻃﺮﺳ عﻮﻗو زا مدﺮﻣ تﺎﻋﻼﻃا زا هدﺎﻔﺘﺳا نﺎﻜﻣا ﻪﻌﻟﺎﻄﻣ ﻦﻳا رد

ﺰﻧ و نﺎﻜﻳد ﺎﻬﻧآ رد ﺎﻬﻧﺎﻃﺮﺳ ﺖﺒﺛ ﺖﻬﺟ ﻲﻠﻤﻜﻣ ﻊﺒﻨﻣ ناﻮﻨﻋ ﻪﺑ ﻢﺘﺴﻴﺳ

"

ﺖﻴﻌﻤﺟ ﺮﺑ ﻲﻨﺘﺒﻣ نﺎﻃﺮﺳ ﺖﺒﺛ

"

درﻮﻣ

دﺮﻴﮔ راﺮﻗ ﻲﺳرﺮﺑ .

شور ﻲﺳرﺮﺑ

،ﻲﻔﻴﺻﻮﺗ ﻪﻌﻟﺎﻄﻣ ﻦﻳا رد: ﺎﺘﺳور ﻪﻧﺎﻴﻟﺎﺳ يرﺎﻤﺷﺮﺳ ﻲﻃ

ﻳ هﺎﻣ ﻦﻳدروﺮﻓ رد ﻲ 1383

ﻲﻫﺎﮔآ ناﺰﻴﻣ ،

نﺎﻜﻳدﺰﻧ و نﺎﮕﺘﺴﺑ رد نﺎﻃﺮﺳ عﻮﻗو زا مدﺮﻣ ﺎﻬﻧآ

ﺪﺷ ﻲﺳرﺮﺑ .

ا رد زا ﻲﺳرﺮﺑ ﻦﻳ ﻲﻣﺎﻤﺗ

يﺎﻫﺎﺘﺳور رد ﻦﻛﺎﺳ داﺮﻓا

نﺎﺘﺳا

، ﺪﺷ ﻪﺘﺳاﻮﺧ ﺎﺗ

ﻲﻃ رد ار دﻮﺧ ﻚﻳدﺰﻧ نﺎﻴﻓاﺮﻃا و نﺎﮕﺘﺴﺑ رد ار نﺎﻃﺮﺳ ﻪﻘﺑﺎﺳ ﺞﻨﭘ

ﺪﻨﻨﻛ ﺮﻛذ ﺮﻴﺧا لﺎﺳ

؛

ﺎﻬﻧآ زا ﺲﭙﺳ ﻳ

ﺪﻧدﻮﺑ هداد دﻮﺧ ﻚﻳدﺰﻧ نﺎﻴﻓاﺮﻃا ﺎﻳ نﺎﮕﺘﺴﺑ رد نﺎﻃﺮﺳ ﻪﻘﺑﺎﺳ ﻪﻛ ﻲ

، ﺪﺷ ﻪﺘﺳاﻮﺧ ﻮﻀﻋ

ﺮﻴﮔرد ﻲﻠﺻا

مﺎﻧ ار ﻼﺘﺒﻣ دﺮﻓ رد ﺪﻧﺮﺒﺑ

. رد هﺪﺷ يروآدﺮﮔ تﺎﻋﻼﻃا ﺖﺤﺻ ﻲﺳرﺮﺑ ﺖﻬﺟ ﺖﻳﺎﻬﻧ

، ﻲﺘﺳﺮﻬﻓ يﺎﻬﻧﺎﻃﺮﺳ دراﻮﻣ زا

ﻲﻧﺎﻗﻮﻓ شراﻮﮔ )

هﺪﻌﻣ و يﺮﻣ (

ﻦﻳدروﺮﻓ لوا زا ﻪﻛ 1381

ﺎﺗ 29 ﺪﻨﻔﺳا 1382 ﺖﻧوﺎﻌﻣ نﺎﻃﺮﺳ ﺖﺒﺛ ﻢﺘﺴﻴﺳ رد

ﺪﻧدﻮﺑ هﺪﺷ ﺖﺒﺛ ﻲﺘﺷاﺪﻬﺑ

، ﻊﻤﺟ تﺎﻋﻼﻃا ﺎﺑ و ﻪﻴﻬﺗ ﺎﺘﺳور ﻪﻧﺎﻴﻟﺎﺳ يرﺎﻤﺷﺮﺳ رد هﺪﺷ يروآ

ﻳ ﻪﺴﻳﺎﻘﻣ ﻲ ﺪﺷ

. ﺖﻬﺟ

لﺎﺳ ود ﻦﻳا رد هﺪﻣآ ﺖﺳد ﻪﺑ تﺎﻋﻼﻃا ﺖﺤﺻ ﻪﺴﻳﺎﻘﻣ )

1381 ﻞﺑﺎﻘﻣ رد 1382 ( يرﺎﻣآ نﻮﻣزآ زا

Chi-Square

رد

ﻲﻨﻌﻣ ﺢﻄﺳ يراد

05 /

P≤0 ﺪﺷ هدﺎﻔﺘﺳا .

ﻪﺘﻓﺎﻳ ﺎﻫ زا: 137 نﺎﺘﺳا يﺎﻫﺎﺘﺳور رد ﻦﻛﺎﺳ ﻲﻧﺎﻗﻮﻓ ﻲﺷراﻮﮔ نﺎﻃﺮﺳ درﻮﻣ

، ﻂﻘﻓ 35 درﻮﻣ ) 5 / 25 (%

نﺎﮕﺘﺴﺑ ﻂﺳﻮﺗ

راﺰﮔ رﺎﻤﻴﺑ نﺎﻜﻳدﺰﻧ ﺎﻳ ﺪﺷ ش

و رد ﻂﻘﻓ نﺎﻴﻣ نآ زا 20

درﻮﻣ ) 1 / 57 (%

دﻮﺑ هﺪﺷ شراﺰﮔ ﻲﺘﺳرد ﻪﺑ رﻮﻣﻮﺗ ﻞﺤﻣ

؛

لﺎﺳ رد يﺮﺘﺸﻴﺑ ﺢﻴﺤﺻ دراﻮﻣ ﻪﭼﺮﮔا 1381

لﺎﺳ ﺎﺑ ﻪﺴﻳﺎﻘﻣ رد 1382

يرﺎﻣآ ﺮﻈﻧ زا فﻼﺘﺧا ﻦﻳا ﺎﻣا ﺖﺷاد دﻮﺟو

ﻲﻨﻌﻣ دﻮﺒﻧ راد .

ﻪﺠﻴﺘﻧ يﺮﻴﮔ ﻪﺘﻓﺎﻳ سﺎﺳا ﺮﺑ : ﻲﻣ ﺮﻈﻧ ﻪﺑ ،ﻖﻴﻘﺤﺗ ﻦﻳا يﺎﻫ

ﺪﺳر زا تﺎﻋﻼﻃا ﺐﺴﻛ ﻊﺒﻨﻣ رﺎﻤﻴﺑ نﺎﻴﻓاﺮﻃا ﺎﻳ نﺎﮕﺘﺴﺑ

ﻊﻤﺟ ياﺮﺑ يدﺎﻤﺘﻋا ﻞﺑﺎﻗ ﻲﻤﻧ نﺎﻃﺮﺳ ﺖﺒﺛ ﻢﺘﺴﻴﺳ رد ﺎﻬﻧآ ﺖﺒﺛ و تﺎﻋﻼﻃا يروآ

ﺪﺷﺎﺑ .

يﺪﻴﻠﻛ يﺎﻫ هژاو ﺖﻴﻌﻤﺟ ﺮﺑ ﻲﻨﺘﺒﻣ نﺎﻃﺮﺳ ﺖﺒﺛ:

؛ نﺎﺘﺳرﺎﻤﻴﺑ ﺮﺑ ﻲﻨﺘﺒﻣ نﺎﻃﺮﺳ ﺖﺒﺛ

؛ ناﺪﻧوﺎﺸﻳﻮﺧ ؛

نﺎﻃﺮﺳ

ﺪﻨﺟﺮﻴﺑ ﻲﻜﺷﺰﭘ مﻮﻠﻋ هﺎﮕﺸﻧاد ﻲﻤﻠﻋ ﻪﻠﺠﻣ )

هرود 12

؛ هرﺎﻤﺷ 1 و 2 ؛ ﺳ لﺎ 1384 (

نﺎﺘﺴﻠﮔ ﻲﻜﺷﺰﭘ مﻮﻠﻋ هﺎﮕﺸﻧاد ،ﻲﻜﺷﺰﭘ هﺪﻜﺸﻧاد ،ﻲﻠﺧاد ﻲﺷزﻮﻣآ هوﺮﮔ رﺎﻳدﺎﺘﺳا ؛ﺪﺒﻛو ﻲﺷراﻮﮔ يﺎﻬﻳرﺎﻤﻴﺑ ﺺﺼﺨﺗ قﻮﻓ ؛لوﻮﺴﻣ هﺪﻨﺴﻳﻮﻧ١

سردآ : نﺎﮔﺮﮔ - ﻲﺑﺮﻏ يدورو -

ﺴﻠﮔ ﻲﻜﺷﺰﭘ مﻮﻠﻋ هﺎﮕﺸﻧاد نﺎﺘ

- يﺰﻛﺮﻣ نﺎﻣزﺎﺳ

ﻦﻔﻠﺗ : 4424540 - 0171 ﺮﺑﺎﻤﻧ : 4424553 - 0171 ﻲﻜﻴﻧوﺮﺘﻜﻟا ﺖﺴﭘ [email protected] :

ﻚﺷﺰﭘ2

؛ ﻲﺸﻫوﮋﭘ سﺎﻨﺷرﺎﻛ ،

ﻘﺤﺗ ﺰﻛﺮﻣ ﻴ شراﻮﮔ تﺎﻘ نﺎﺘﺴﻠﮔ ﺪﺒﻛو

نﺎﺘﺳا ﺖﺷاﺪﻬﺑ ﺰﻛﺮﻣ سﺎﻨﺷرﺎﻛ ؛ﻚﺷﺰﭘ3

ﻲﻜﺷﺰﭘ يﻮﺠﺸﻧاد4

ﻲﺘﺷاﺪﻬﺑ تﺎﻣﺪﺧ ﺖﻳﺮﻳﺪﻣ ﺪﺷرا سﺎﻨﺷرﺎﻛ5

(2)

٨٧

ﻪﻣﺪﻘﻣ ﺒﺛ ﻢﺘﺴﻴﺳ ﺖ

طﻮﺑﺮﻣ تﺎﻌﻟﺎﻄﻣ ﻲﻠﺻا ﻊﺑﺎﻨﻣ زا ﻲﻜﻳ نﺎﻃﺮﺳ

نﺎﻃﺮﺳ ﻪﺑ ﻲﻣ

ﺪﺷﺎﺑ ) 2،1 .(

ﺖﺒﺛ ﻢﺘﺴﻴﺳ عﻮﻧ ود ﻲﻠﻛ رﻮﻃ ﻪﺑ

دراد دﻮﺟو نﺎﻃﺮﺳ

" ؛ ﺒﻣ نﺎﻃﺮﺳ ﺖﺒﺛ ﻢﺘﺴﻴﺳ ﺘ

ﺖﻴﻌﻤﺟ ﺮﺑ ﻲﻨ

"

" و ﺒﻣ نﺎﻃﺮﺳ ﺖﺒﺛ ﻢﺘﺴﻴﺳ ﺘ

نﺎﺘﺳرﺎﻤﻴﺑ ﺮﺑ ﻲﻨ

"

سﺎﺳا ﺮﺑ ﻪﻛ ،

ﺗ فﺪﻫ ﺄ نﺎﻃﺮﺳ ﺖﺒﺛ ﻢﺘﺴﻴﺳ ﺲﻴﺳ

، ﻦﻳا زا ﻚﻳ ﺮﻫ ﻢﺘﺴﻴﺳ

ﺎﻫ

ﺎﺳﺎﻨﺷ ياﺮﺑ ﻲﺻﺎﺧ ﻲﺣاﺮﻃ ياراد ﻳ

ﻊﻤﺟ و ﻲ تﺎﻋﻼﻃا يروآ

نﺎﻃﺮﺳ ﻪﺑ طﻮﺑﺮﻣ ﺎﻫ

ﻲﻣ ﺪﻨﺷﺎﺑ . ﻪﭼﺮﮔا

"

ﺮﺑ ﻲﻨﺘﺒﻣ نﺎﻃﺮﺳ ﺖﺒﺛ

نﺎﺘﺳرﺎﻤﻴﺑ

"

،دراد نارﺎﻤﻴﺑ زا ﺖﺒﻗاﺮﻣ دﻮﺒﻬﺑ رد ﻲﻤﻬﻣ ﺶﻘﻧ

"

ﻊﺑﺎﻨﻣ نداد صﺎﺼﺘﺧا رد

ﺖﻳﻮﻟوا و ﻲﺘﺷاﺪﻬﺑ ﻪﻣﺎﻧﺮﺑ يﺪﻨﺑ

ﻤﻋ ﺖﺷاﺪﻬﺑ يﺎﻫ ﻲﻣﻮ

) ﻪﻴﻜﺗ ﺎﺑ

ﻚﻳژﻮﻟﻮﻴﻣﺪﻴﭘا تﺎﻌﻟﺎﻄﻣ ﺮﺑ (

رادرﻮﺧﺮﺑ يﺮﺗﻻﺎﺑ ﺖﻴﻤﻫا زا

ﻲﻣ ﺪﺷﺎﺑ ) 2،1 .(

هدﺎﻔﺘﺳا درﻮﻣ ناﺮﻳا رد ﺮﺿﺎﺣ لﺎﺣ رد ﻪﻛ ﻲﺷور ﻦﻳﺮﺘﺠﻳار ﻲﻣ ﻪﻋﻮﻤﺠﻣ ﺮﻳز ار نآ ناﻮﺘﺑ ﺪﻳﺎﺷ و ﺪﺷﺎﺑ زا يا

"

نﺎﻃﺮﺳ ﺖﺒﺛ

نﺎﺘﺳرﺎﻤﻴﺑ ﺮﺑ ﻲﻨﺘﺒﻣ

"

،ﺪﻴﻣﺎﻧ

"

يژﻮﻟﻮﺗﺎﭘ

"

ﻲﻣ ﺪﺷﺎﺑ . ا رد نﺎﻃﺮﺳ مﺎﻤﺗ شور ﻦﻳ سﺎﺳا ﺮﺑ ﺎﻫ

ﺰﻛاﺮﻣ و ﺎﻬﻧﺎﺘﺳرﺎﻤﻴﺑ زا هﺪﺷ يروآدﺮﮔ ﻚﻳژﻮﻟﻮﺗﺎﭘ تﺎﺷراﺰﮔ ﺖﺒﺛ يژﻮﻟﻮﺗﺎﭘ ﻲﻣ

ﺪﻧﻮﺷ . ناﺪﻘﻓ ،شور ﻦﻳا ﻲﻠﺻا ﺺﻘﻧ

شور ﻪﺑ هﺪﺷ هداد ﺺﻴﺨﺸﺗ دراﻮﻣ ﻪﺑ طﻮﺑﺮﻣ تﺎﻋﻼﻃا ﻲﺳ ،ﻲﻓاﺮﮔﻮﻳدار ﺮﻴﻈﻧ ﻲﻜﻴﻨﻴﻠﻛارﺎﭘ و ﻲﻜﻴﻨﻴﻠﻛ ﻲﺗ

و ﻦﻜﺳا

ﻲﻓاﺮﮔﻮﻧﻮﺳ ﻲﻣ

ﺪﺷﺎﺑ . دراﻮﻣ ﻦﻳا رد ﺐﻴﺳآ يﺎﻬﻴﺳرﺮﺑ

ﻲﺳﺎﻨﺷ

ﻲﻤﻧ مﺎﺠﻧا دﻮﺷ

ًﻻﻮﻤﻌﻣ نﺎﻜﺷﺰﭘ و ﺖﺒﺛ ﺰﻛاﺮﻣ ﻪﺑ ار دراﻮﻣ ﻦﻳا

ﻲﻤﻧ شراﺰﮔ نﺎﻃﺮﺳ ﺪﻨﻨﻛ

ﻦﻳاﺮﺑﺎﻨﺑ ؛ ،ﺖﻳدوﺪﺤﻣ ﻦﻳا ﻪﺑ ﻪﺟﻮﺗ ﺎﺑ

يﺎﻬﻧﺎﻃﺮﺳ ﺖﺒﺛ ترﺪﻗ ﻪﻛ ﺖﺳا زﺎﻴﻧ درﻮﻣ يﺮﺘﻠﻣﺎﻛ ﻢﺘﺴﻴﺳ ﻪﺘﺷاد ار ﻲﻜﻴﻨﻴﻠﻛارﺎﭘ و ﻲﻜﻴﻨﻴﻠﻛ شور ﻪﺑ هﺪﺷ هداد ﺺﻴﺨﺸﺗ ﺪﺷﺎﺑ . ﻪﻛ نﺎﺘﺴﻠﮔ نﺎﺘﺳا لﺎﺳ رد

1378 دﻮﺧ نﺎﻃﺮﺳ ﺖﺒﺛ ﺰﻛﺮﻣ

ﺗ نﺎﮔﺮﮔ ﺮﻬﺷ رد ار ﺄ

دﻮﻤﻧ ﺲﻴﺳ

، ﻦﻳا دراد ﻢﻴﻤﺼﺗ نﻮﻨﻛا

ﻢﺘﺴﻴﺳ ﻪﺑ ار ﻢﺘﺴﻴﺳ

"

ﻪﻛ ،

نﺎﻃﺮﺳ ﺖﺒﺛ رد ﻲﻌﻣﺎﺟ شور ﻲﻣ

ﺪﺷﺎﺑ ) 3 ( ﺪﻳﺎﻤﻧ ﻞﻳﺪﺒﺗ .

ﻦﻳا رد

نﺎﻃﺮﺳ ﻲﻟﺎﻤﺘﺣا دراﻮﻣ ﻪﺑ طﻮﺑﺮﻣ تﺎﻋﻼﻃا شور )

دﺎﻨﺳا

ﻲﻜﻴﻨﻴﻠﻛارﺎﭘ و ﻲﻜﻴﻨﻴﻠﻛ (

، ﺑ ﻚﻳژﻮﻟﻮﺗﺎﭘ تﺎﺷراﺰﮔ ﺮﺑ هوﻼﻋ ﻪ

يروآ ﻊﻤﺟ ،نﺎﻃﺮﺳ ﻲﻌﻄﻗ دراﻮﻣ زا هﺪﻣآ ﺖﺳد ﻲﻣ

دﻮﺷ ﺲﭘ و رد مزﻻ يراﺬﮔﺪﻛ ﺎﺑ نﺎﻃﺮﺳ ﻦﻴﻘﻳ ﻪﺑ لﺎﻤﺘﺣا دراﻮﻣ يﺮﮕﻧزﺎﺑ زا

ﺖﺒﺛ نﺎﻃﺮﺳ ﺖﺒﺛ ﻢﺘﺴﻴﺳ ﻲﻣ

ﺪﻧﻮﺷ .

ﻢﺘﺴﻴﺳ ﻦﻳا رد ﻪﭼﺮﮔا

، تﺎﻋﻼﻃا زا ﻲﻌﻴﺳو ﻒﻴﻃ

ﻊﻤﺟ راﺮﻗ ﻲﺳرﺮﺑ درﻮﻣ و يروآ ﻲﻣ

،دﺮﻴﮔ ﻲﻟو و ﺖﻴﻔﻴﻛ ﺖﻴﻤﻛ

ﺎﭘ ﻳ هﺪﺷ يروآدﺮﮔ ﻲﻜﻴﻨﻴﻠﻛارﺎﭘ و ﻲﻜﻴﻨﻴﻠﻛ دﺎﻨﺳا ﻦﻴ )

ﺑ صﻮﺼﺨ

ﻪﻌﺳﻮﺗ لﺎﺣ رد يﺎﻫرﻮﺸﻛ رد (

ﺎﻧاﻮﺗ ﺖﺳا ﻦﻜﻤﻣ ﻳ

رد ار نآ ﻲ

نﺎﻃﺮﺳ ﺖﺒﺛ ﺪﻫد ﺶﻫﺎﻛ هداد خر يﺎﻫ

) 5،4 .(

رد ﺎﺑ ﻦﺘﻓﺮﮔ ﺮﻈﻧ

و نﺎﻃﺮﺳ ﺖﺒﺛ ﻢﺘﺴﻴﺳ رد ﻲﻧﺎﻃﺮﺳ دراﻮﻣ مﺎﻤﺗ ﺖﺒﺛ ﺖﻴﻤﻫا ترﻮﺻ ﻪﺑ ﻪﻛ يدراﻮﻣ ﻦﺘﻓﺮﮔ هﺪﻳدﺎﻧ لﺎﻤﺘﺣا ﺶﻫﺎﻛ ﻲﻜﻴﻨﻴﻠﻛ

هداد ﺺﻴﺨﺸﺗ ﻲﻜﻴﻨﻴﻠﻛارﺎﭘ ﺎﻳ ﻲﻣ

ﺪﻧﻮﺷ ) 6 ( هﺪﻳدﺎﻧ ﻦﻴﻨﭽﻤﻫ و

راﺮﻗ ﻲﺳرﺮﺑ درﻮﻣ روﺎﺠﻣ يﺎﻬﻧﺎﺘﺳا رد ﻪﻛ ﻲﻧارﺎﻤﻴﺑ ﻦﺘﻓﺮﮕﻧ ﻲﻣ ناﺪﻧوﺎﺸﻳﻮﺧ ﻲﻫﺎﮔآ زا هدﺎﻔﺘﺳا نﺎﻜﻣا ﻪﻌﻟﺎﻄﻣ ﻦﻳا رد ،ﺪﻧﺮﻴﮔ

نﺎﻃﺮﺳ ﻪﺑ ﻼﺘﺒﻣ دﺮﻓ نﺎﻃﺮﺳ عﻮﻗو ﻪﺑ ﺖﺒﺴﻧ

، ﻊﺒﻨﻣ ناﻮﻨﻋ ﻪﺑ

ﻊﻤﺟ ﺖﻬﺟ ﻲﻠﻤﻜﻣ ﺮﻣ تﺎﻋﻼﻃا يروآ

درﻮﻣ نﺎﻃﺮﺳ ﻪﺑ طﻮﺑ

راﺮﻗ ﻲﺳرﺮﺑ ﻦﻴﻨﭽﻤﻫ ؛ﺖﻓﺮﮔ

يﻻﺎﺑ زوﺮﺑ ناﺰﻴﻣ ﻪﺑ ﻪﺟﻮﺗ ﺎﺑ

نﺎﻃﺮﺳ ﻲﻧﺎﻗﻮﻓ شراﻮﮔ هﺎﮕﺘﺳد يﺎﻫ )

هﺪﻌﻣ و يﺮﻣ (

نﺎﺘﺳا رد

رد نﺎﺘﺳا ﻲﺘﺷاﺪﻬﺑ ﺖﻧوﺎﻌﻣ رد دﻮﺟﻮﻣ تﺎﻋﻼﻃا ،نﺎﺘﺴﻠﮔ عﻮﻗو زا مدﺮﻣ ﻲﻫﺎﮔآ ﺎﺑ هﺪﻌﻣ و يﺮﻣ يﺎﻬﻧﺎﻃﺮﺳ صﻮﺼﺧ نﺎﻜﻳدﺰﻧ و نﺎﮕﺘﺴﺑ رد نﺎﻃﺮﺳ ﺎﻬﻧآ

ﻪﺴﻳﺎﻘﻣ ﺪﺷ . بﺎﺨﺘﻧا ﻞﻴﻟد

ﺎﻫﺎﺘﺳور ﻦﻴﻨﻛﺎﺳ

، ﻲﻧﺎﻜﻣ ﻲﻜﻳدﺰﻧ و ﻲﻋﺎﻤﺘﺟا ﻲﮕﺘﺴﺒﻤﻫ ﺮﺘﺸﻴﺑ

ﺎﺘﺳور ﻳ نﺎﻴ ﺖﺒﺴﻧ دﻮﺧ نﺎﻴﻓاﺮﻃا و ﻪﻌﻣﺎﺟ ﻪﺑ دﻮﺑ

.

شور ﻲﺳرﺮﺑ

،ﻲﻔﻴﺻﻮﺗ ﻪﻌﻟﺎﻄﻣ ﻦﻳا رد ﺎﺘﺳور ﻪﻧﺎﻴﻟﺎﺳ يرﺎﻤﺷﺮﺳ ﻲﻃ

ﻳ ﻲ

ﻦﻳدروﺮﻓ رد 1383

ﻪﻣﺎﻨﺸﺳﺮﭘ ، ﻲﻤﺳر يﺎﻬﻣﺮﻓ ﻪﺑ يا

ﺘﺳور ﻦﻴﻨﻛﺎﺳ ﻲﻣﺎﻤﺗ زا و ﺪﺷ ﻪﻤﻴﻤﺿ يرﺎﻤﺷﺮﺳ نﺎﺘﺳا يﺎﻫﺎ

ﻲﻃ رد ار نﺎﻃﺮﺳ ﺪﻳﺪﺟ دراﻮﻣ ﺎﺗ ﺪﺷ ﻪﺘﺳاﻮﺧ نﺎﺘﺴﻠﮔ ﺞﻨﭘ

لﺎﺳ

ﺪﻨﻫد شراﺰﮔ دﻮﺧ ﻚﻳدﺰﻧ نﺎﻴﻓاﺮﻃا و نﺎﮕﺘﺴﺑ رد ﺮﻴﺧا .

رد

ﺖﺒﺜﻣ ترﻮﺻ ار نﺎﻃﺮﺳ عﻮﻧ ﺎﺗ ﺪﺷ ﻪﺘﺳاﻮﺧ داﺮﻓا زا ،ﺦﺳﺎﭘ ندﻮﺑ

ﺎﺑ ﻮﻀﻋ ﺮﻛذ ﺪﻨﻳﺎﻤﻧ ﺺﺨﺸﻣ ﺮﻴﮔرد ﻲﻠﺻا

. ﺖﺤﺻ ﻲﺳرﺮﺑ ياﺮﺑ

ﻊﻤﺟ تﺎﻋﻼﻃا

،هﺪﺷ يروآ ﻲﺘﺳﺮﻬﻓ

ﻴﺑ زا ﻪﺑ ﻼﺘﺒﻣ نارﺎﻤ

دﻮﺑ ﻦﻛﺎﺳ نﺎﺘﺳا يﺎﻫﺎﺘﺳور رد ﻪﻛ هﺪﻌﻣ و يﺮﻣ يﺎﻬﻧﺎﻃﺮﺳ ﺪﻧ

ﻢﺘﺴﻴﺳ رد و

"

يژﻮﻟﻮﺗﺎﭘ ﺮﺑ ﻲﻨﺘﺒﻣ نﺎﻃﺮﺳ ﺖﺒﺛ

"

ﺖﻧوﺎﻌﻣ رد

لﺎﺳ ود ﻲﻃ ﻲﺘﺷاﺪﻬﺑ 1381

و 1382 دﻮﺑ هﺪﺷ ﺖﺒﺛ

، و ﻪﻴﻬﺗ

(3)

٨٨ ﻊﻤﺟ تﺎﻋﻼﻃا ﺎﺑ هﺪﺷ يروآ

، ﺪﺷ ﻪﺴﻳﺎﻘﻣ .

ﻦﺘﺷاﺪﻫﺎﮕﻧ ﻪﻧﺎﻣﺮﺤﻣ ﺖﻬﺟ مزﻻ تﺎﻣاﺪﻗا ﻪﻌﻟﺎﻄﻣ ﻦﻳا رد ﻃا ﻲﻗﻼﺧا ﻪﺘﻴﻤﻛ و ﺖﻓﺮﮔ ترﻮﺻ نارﺎﻤﻴﺑ ﻲﻜﺷﺰﭘ تﺎﻋﻼ ﺪﻴﻳﺄﺗ ار قﻮﻓ ﻪﻌﻟﺎﻄﻣ مﺎﺠﻧا نﺎﺘﺴﻠﮔ ﻲﻜﺷﺰﭘ مﻮﻠﻋ هﺎﮕﺸﻧاد

دﻮﻤﻧ . ود ﻦﻳا رد هﺪﻣآ ﺖﺳد ﻪﺑ تﺎﻋﻼﻃا ﺖﺤﺻ ﻪﺴﻳﺎﻘﻣ ﺖﻬﺟ

لﺎﺳ ) 1381 ﻞﺑﺎﻘﻣ رد 1382

( زا نﻮﻣزآ يرﺎﻣآ

Chi-Square

رد ﻲﻨﻌﻣ ﺢﻄﺳ يراد

05 /

P≤0 ﺪﺷ هدﺎﻔﺘﺳا .

ﻪﺘﻓﺎﻳ ﺎﻫ ﺳا سﺎﺳا ﺮﺑ ﻲﻃ ﻲﺘﺷاﺪﻬﺑ ﺖﻧوﺎﻌﻣ ﻪﺑ ﻲﻟﺎﺳرا يژﻮﻟﻮﺗﺎﭘ دﺎﻨ

يﺎﻬﻟﺎﺳ 1381 و 1382 ، 217 رد يﺮﻣ و هﺪﻌﻣ نﺎﻃﺮﺳ درﻮﻣ

دﻮﺑ هﺪﺷ ﺖﺒﺛ ﺖﻧوﺎﻌﻣ نآ نﺎﻃﺮﺳ ﺖﺒﺛ ﻢﺘﺴﻴﺳ .

فﺬﺣ زا ﺲﭘ

سردآ ﺎﻳ و ﺪﻧدﻮﺑ نﺎﺘﺳا يﺎﻫﺮﻬﺷ ﻦﻛﺎﺳ ﻪﻛ يدراﻮﻣ ﻪﺑ طﻮﺑﺮﻣ هﺪﺷ ﺖﺒﺛ تﺎﻋﻼﻃا ،ﺪﻨﺘﺷاد ﻲﺼﺨﺸﻣﺎﻧ 137

درﻮﻣ

ﺑ تﺎﻋﻼﻃا ﺎﺑ هﺪﻧﺎﻤﻴﻗﺎﺑ ﻪ

ﺎﻫﺎﺘﺳور ﻦﻴﻨﻛﺎﺳ زا هﺪﻣآ ﺖﺳد

،

ﺪﺷ ﻪﺴﻳﺎﻘﻣ .

رد لوﺪﺟ 1 ﻦﻳا ﻚﻳژﻮﻟﻮﺗﺎﭘﻮﻜﻴﻨﻴﻠﻛ و يدﺮﻓ تﺎﺼﺨﺸﻣ

نارﺎﻤﻴﺑ ﺖﺳا هﺪﺷ ﻪﺋارا .

يﺎﻬﻟﺎﺳ ﻲﻃ رد 1381

و 1382 ، 137 يﺮﻣ نﺎﻃﺮﺳ درﻮﻣ

ﺖﻧوﺎﻌﻣ نﺎﻃﺮﺳ ﺖﺒﺛ ﻢﺘﺴﻴﺳ رد ﺺﺨﺸﻣ سردآ ﺎﺑ هﺪﻌﻣ و هﺪﺷ مﺎﺠﻧا ﻲﺳرﺮﺑ رد ﺎﻣا ،دﻮﺑ هﺪﺷ ﺖﺒﺛ نﺎﺘﺳا ﻲﺘﺷاﺪﻬﺑ نﺎﮕﺘﺴﺑ ﻪﺑ ﻂﻘﻓ داﺮﻓا ﻦﻳا نﺎﻴﻓاﺮﻃا و 35

درﻮﻣ ) 5 / 25 (%

ﺎﻬﻧآ زا

ﻂﻘﻓ هﺪﺷ شراﺰﮔ دراﻮﻣ نﺎﻴﻣ رد و ﺪﻧدﻮﺑ هدﻮﻤﻧ هرﺎﺷا 25

ﺮﻔﻧ

ﺪﻧدﺮﻛ شراﺰﮔ ﻲﺘﺳرد ﻪﺑ ار نﺎﻃﺮﺳ ﻞﺤﻣ .

نﺎﻳﺎﻨﺷآ و نﺎﮕﺘﺴﺑ ﻂﺳﻮﺗ هﺎﺒﺘﺷا ﻪﺑ ﻪﻛ ﻲﻳﺎﻬﻧﺎﻜﻣ ﺮﻳﺎﺳ نﻮﺧ و گرﺰﺑ هدور ،ﻪﻳر ،نﺎﺘﺴﭘ ﻞﻣﺎﺷ ،دﻮﺑ هﺪﺷ ﺮﻛذ نارﺎﻤﻴﺑ دﻮﺑ

. ﻦﻳا دﺮﻓ ﻦﺳ و دﻮﺑ ﻪﺑﺎﺸﻣ ﺲﻨﺟ ود ﺮﻫ رد شراﺰﮔ هﻮﺤﻧ

شراﺰﮔ ﻲﮕﻧﻮﮕﭼ رد يﺮﻴﺛﺄﺗ ﻲﻓﻮﺘﻣ )

ﻂﻠﻏ ﺎﻳ ﺢﻴﺤﺻ (

ﺖﺷاﺪﻧ .

لﺎﺳ رد ار ﻲﻧﺎﻃﺮﺳ دراﻮﻣ نارﺎﻤﻴﺑ نﺎﻳﺎﻨﺷآ و ماﻮﻗا ﻪﭼﺮﮔا 1381 ﺪﻧدﻮﺑ هدﻮﻤﻧ شراﺰﮔ يﺮﺘﺸﻴﺑ ﺖﺤﺻ ﺎﺑ )

3 / 53 % رد

ﻞﺑﺎﻘﻣ 7 / 46 (%

ﻲﻨﻌﻣ يرﺎﻣآ ﺮﻈﻧ زا توﺎﻔﺗ ﻦﻳا ﺎﻣا دﻮﺒﻧ راد

) 05 /

P>0 (.

ﻪﺠﻴﺘﻧ و ﺚﺤﺑ يﺮﻴﮔ

ﺖﺒﺛ دﻮﺒﻬﺑ ﻪﺑ زﺎﻴﻧ و نﺎﻃﺮﺳ ﺖﺒﺛ ﺖﻴﻤﻫا ﻪﺑ ﻪﺟﻮﺗﺎﺑ ﻢﺘﺴﻴﺳ رد نﺎﻃﺮﺳ

"

ﻦﻳا رد ،

رد نﺎﻃﺮﺳ عﻮﻗو زا مدﺮﻣ ﻲﻫﺎﮔآ زا هدﺎﻔﺘﺳا نﺎﻜﻣا ،ﻪﻌﻟﺎﻄﻣ ﺖﺒﺛ ﺖﻬﺟ ﻲﻠﻤﻜﻣ ﻊﺒﻨﻣ ناﻮﻨﻋ ﻪﺑ ،نﺎﻜﻳدﺰﻧ ﺎﻳ ناﺪﻧوﺎﺸﻳﻮﺧ ﻢﺘﺴﻴﺳ رد نﺎﻃﺮﺳ

"

ﺟ ﺮﺑ ﻲﻨﺘﺒﻣ نﺎﻃﺮﺳ ﺖﺒﺛ

"ﺖﻴﻌﻤ

درﻮﻣ

ﺖﻓﺮﮔ راﺮﻗ ﻲﺳرﺮﺑ .

تﺎﻋﻼﻃا ﻪﻛ داد نﺎﺸﻧ ﻪﻌﻟﺎﻄﻣ ﻦﻳا ﺞﻳﺎﺘﻧ

ﻊﻤﺟ ﻲﻨﺌﻤﻄﻣ ﻊﺒﻨﻣ نارﺎﻤﻴﺑ نﺎﻳﺎﻨﺷآ و نﺎﮕﺘﺴﺑ زا هﺪﺷ يروآ

ﻲﻤﻧ نﺎﻃﺮﺳ ﺖﺒﺛ ياﺮﺑ ﺪﺷﺎﺑ

. ﺮﺘﺸﻴﺑ ﻲﺘﻗو عﻮﺿﻮﻣ ﻦﻳا ﺖﻴﻤﻫا

ﻲﻣ رﺎﻜﺷآ لﺎﺳ ﻦﻳﺪﻨﭼ ﻪﺑ طﻮﺑﺮﻣ تﺎﻋﻼﻃا ﻢﻴﻫاﻮﺨﺑ ﻪﻛ دﻮﺷ

ﻊﻤﺟ ار ﻞﺒﻗ ﻢﻴﻳﺎﻤﻧ يروآ

. توﺎﻔﺗ ﻪﭼﺮﮔا ﺮﻈﻧ زا ﻲﺳﻮﺴﺤﻣ

يﺎﻬﻟﺎﺳ ﻦﻴﺑ رد داﺮﻓا زا هﺪﻣآ ﺖﺳد ﻪﺑ تﺎﻋﻼﻃا ﺖﺤﺻ 1381

و 1382 ﻪﻌﻟﺎﻄﻣ رد ﺪﻳﺎﺷ ﻲﻟو ﺪﺸﻧ هﺪﻫﺎﺸﻣ ﻪﻧﻮﻤﻧ ﻢﺠﺣ ﺎﺑ يا

،ﺮﺘﺸﻴﺑ ﻲﺳرﺮﺑ درﻮﻣ يﺎﻬﻟﺎﺳ و ﺮﺘﺸﻴﺑ ار ﺐﻠﻄﻣ ﻦﻳا ناﻮﺘﺑ ﺮﺘﻬﺑ

دﻮﻤﻧ ﻦﺷور .

ﻪﺘﻓﺎﻳ ﻪﺑ دﺎﻤﺘﻋا مﺪﻋ ﺖﻬﺟ زا ﺮﺿﺎﺣ ﻖﻴﻘﺤﺗ يﺎﻫ

فﻼﺧ ﺮﺑ هﺪﺷ يروآدﺮﮔ تﺎﻋﻼﻃا ﻲﻠﺒﻗ تﺎﻌﻟﺎﻄﻣ زا ﻲﺧﺮﺑ

ﻲﻣ ﺪﺷﺎﺑ ) 7 ( ﺰﻴﻧ ﺮﮕﻳد يﺎﻫرﻮﺸﻛ رد هﺪﺷ مﺎﺠﻧا تﺎﻌﻟﺎﻄﻣ رد ﺎﻣا

ﻲﺧﺮﺑ مﺪﻋ ﻪﺑ نﺎﻘﻘﺤﻣ داﺮﻓا يﺎﻬﺷراﺰﮔ ﻪﺑ دﺎﻤﺘﻋا ﺖﻴﻠﺑﺎﻗ

ﻪﺘﺷاد نﺎﻋذا نﺎﻃﺮﺳ ﻪﺑ ﻼﺘﺒﻣ نارﺎﻤﻴﺑ ﻞﻴﻣﺎﻓ ﺪﻧا

) 8 .(

لوﺪﺟ 1 - ﺘﺴﻠﮔ نﺎﺘﺳا يﺎﻫﺎﺘﺳور رد ﻦﻛﺎﺳ نارﺎﻤﻴﺑ ﻚﻳژﻮﻟﻮﺗﺎﭘ ﻮﻜﻴﻨﻴﻠﻛ و يدﺮﻓ تﺎﺼﺨﺸﻣ نﺎ

يﺎﻬﻟﺎﺳ ﻲﻃ 1381

و 1382

ﺮﻴﻐﺘﻣ

نﺎﻃﺮﺳ عﻮﻧ

ﺺﻴﺨﺸﺗ لﺎﺳ ﺲﻨﺟ

ﺖﻓﺎﺑ رﻮﻣﻮﺗ ﻲﺳﺎﻨﺷ

ﻲﻤﻴﺧﺪﺑ

ﻲﺷﺮﻔﮕﻨﺳ لﻮﻠﺳ

È

ﻲﻤﻴﺧﺪﺑ

هﺪﻏ لﻮﻠﺳ

Ù يا ﺺﺨﺸﻣﺎﻧ

1381 1382 نز دﺮﻣ

يﺮﻣ نﺎﻃﺮﺳ )

ﺪﺻرد

*( 3 / 37 7 / 62 7 / 42 3 / 57 1

/ 69 10

9 / 20

هﺪﻌﻣ نﺎﻃﺮﺳ )

ﺪﺻرد

*( 37 63 5 / 18 5 / 81 0

2

/ 85 8

/ 14

(4)

٢

ﺎﻴﻣ* ﺐﻴﺗﺮﺗ ﻪﺑ هﺪﻌﻣ و يﺮﻣ نﺎﻃﺮﺳ ياﺮﺑ رﺎﻴﻌﻣ فاﺮﺤﻧا و ﻲﻨﺳ ﻦﻴﮕﻧ 36

/

±12 69 / 65 و 31 /

±11 59 / 62 ﻲﻣ ﺪﺷﺎﺑ .

ÈSquamous Cell Carcinoma

ÙAdenocarcinoma

Bondy نارﺎﻜﻤﻫ و

ﺰﻴﻧ رد ﻲﻬﺑﺎﺸﻣ ﻪﻌﻟﺎﻄﻣ

، ﺖﻗد

ﻪﺑ طﻮﺑﺮﻣ تﺎﺷراﺰﮔ ﻪﻘﺑﺎﺳ

ﻖﻳﺮﻃ زا ﻪﻛ نﺎﻃﺮﺳ ﻲﻠﻴﻣﺎﻓ

ياراد نارﺎﻤﻴﺑ ناﺪﻧوﺎﺸﻳﻮﺧ ﺎﺑ ﻪﺒﺣﺎﺼﻣ ﻪﺑ ﻲﻛدﻮﻛ مﻮﻛرﺎﺳ

دﻮﺑ هﺪﻣآ ﺖﺳد ار

راﺮﻗ ﻲﺳرﺮﺑ درﻮﻣ ؛ﺪﻧداد

ﻲﻀﻌﺑ رد ﺎﻬﺷراﺰﮔ

ﻦﻴﻳﺎﭘ ﻲﻫﺎﮔ و ﺮﺗﻻﺎﺑ دراﻮﻣ ﺮﺗ

ﻲﻌﻗاو ﺪﺣ زا و دﻮﺑ

ﻪﺠﻴﺘﻧ رد

ﻪﻴﺻﻮﺗ ﺷ كرﺪﻣ ياراد ﺪﻳﺎﺑ هﺪﺷ شراﺰﮔ يﺎﻬﻧﺎﻃﺮﺳ مﺎﻤﺗ ﻪﻛ ﺪ

و ﺪﻨﺷﺎﺑ ﺪﻨﺘﺴﻣ دﻮﻤﻧ ﺎﻔﺘﻛا ﻞﻴﻣﺎﻓ داﺮﻓا شراﺰﮔ ﻪﺑ ﻂﻘﻓ ﺪﻳﺎﺒﻧ

) 9 .(

ﺘﺑا ﺮﻄﺧ ﻲﺑﺎﻳزرا يﺎﻬﻴﺳرﺮﺑ ﺰﻴﻧ و ﻲﺛرا يﺎﻬﻧﺎﻃﺮﺳ ﻪﺑ ﻼ

يﺪﻌﺑ ﻲﻨﻴﻟﺎﺑ هﺪﻤﻋ رﻮﻃ ﻪﺑ ،

ﻪﺘﺴﺑاو دﺮﻓ ﻲﮔداﻮﻧﺎﺧ ﻪﻘﺑﺎﺳ ﻪﺑ

ﺖﺳا ؛ ﻪﻌﻟﺎﻄﻣ رد رﻮﻈﻨﻣ ﻦﻳا ﻪﺑ ﻲﺳرﺮﺑ ياﺮﺑ نﺎﺘﺴﻠﮕﻧا رد يا

،ﻞﻴﻣﺎﻓ داﺮﻓا ﻂﺳﻮﺗ نﺎﻃﺮﺳ شراﺰﮔ ﺖﻗد ناﺰﻴﻣ و ﻲﺑﺎﻳزرا

دراو يروﺮﺿﺮﻴﻏ ترﻮﺻ ﻪﺑ ﻪﻛ يﺪﻧوﺎﺸﻳﻮﺧ داﺮﻓا داﺪﻌﺗ ﻦﻴﻤﺨﺗ ﺮﻏ تﺎﻌﻟﺎﻄﻣ يﺮﮕﻟﺎﺑ

ﻲﻣ

،ﺪﻧﻮﺷ ﻪﻌﻟﺎﻄﻣ ﻪﺘﺷﺬﮔ يا يور ﺮﮕﻧ

595

و ﺖﻓﺮﮔ ترﻮﺻ ﻲﻧﺎﻃﺮﺳ درﻮﻣ ﺖﻗد ﻪﻛ ﺪﺷ هﺪﻫﺎﺸﻣ

شراﺰﮔ دﺮﻓ ﻲﻜﻳدﺰﻧ ناﺰﻴﻣ و نﺎﻃﺮﺳ ﻞﺤﻣ ﻪﺑ ﻪﺘﺴﺑ ﻲﻫد

و ﺖﺳا توﺎﻔﺘﻣ نﺎﻃﺮﺳ ﻪﺑ ﻼﺘﺒﻣ دﺮﻓ ﻪﺑ ﺪﻧوﺎﺸﻳﻮﺧ ﺮﮔا

ﻲﺣاﺮﺟ ﻪﻣﺎﻧﺮﺑ ﺎﻳ ﻚﻴﺘﻛﻼﻴﻓوﺮﭘ يﺎﻫ ﺮﺑ نﺎﻃﺮﺳ ﺖﺒﺛ يﺎﻫ

ﻪﻳﺎﭘ

ﻪﻘﺑﺎﺳ مﺎﺠﻧا ﻲﻠﻴﻣﺎﻓ ﻧﻮﺷ

ﺪ

، داﺮﻓا رد نﺎﻃﺮﺳ ﺺﻴﺨﺸﺗ ﺪﻳﺎﺑ

،تﻮﻓ ﻲﻫاﻮﮔ ﺪﻨﻧﺎﻣ يﺮﮕﻳد يﺎﻬﺷور ﺎﺑ ار ﺪﻧوﺎﺸﻳﻮﺧ هﺪﻧوﺮﭘ

ﺪﻧﺎﺳر تﺎﺒﺛا ﻪﺑ يژﻮﻟﻮﺗﺎﭘ هﺪﻧوﺮﭘ و ﻲﻧﺎﺘﺳرﺎﻤﻴﺑ )

10 .(

Mitchell و

نﺎﺘﺴﻠﮕﻧا رد نارﺎﻜﻤﻫ

، شراﺰﮔ ﻞﻴﻟد ﻪﺑ

ﺪﺣ زا ﺮﺘﻤﻛ

،ﻲﻠﻴﻣﺎﻓ ﻪﻘﺑﺎﺳ ﻲﻌﻗاو رد ار هﺮﻬﭼ ﻪﺑ هﺮﻬﭼ ﻪﺒﺣﺎﺼﻣ

ﻲﻠﻴﻣﺎﻓ ﻪﻘﺑﺎﺳ ﻲﻳﺎﺳﺎﻨﺷ نﺎﻃﺮﺳ ﺮﻄﺧ ضﺮﻌﻣ رد داﺮﻓا رد

ﻲﻓﺎﻛﺎﻧ لﺎﺘﻛرﻮﻟﻮﻛ ﺪﻧدﺮﻛ مﻼﻋا

) 11 .(

ﺎﭘﻮﻧ نﺎﺘﺴﻠﮔ نﺎﺘﺳا رد نﺎﻃﺮﺳ ﺖﺒﺛ ﻢﺘﺴﻴﺳ ترﻮﺻ ﺮﻫ رد ﺖﺳا دراد ﺶﻴﭘ رد ﻞﻣﺎﻛ راﺮﻘﺘﺳا ﺎﺗ يدﺎﻳز هار و .

ﻪﻛ نﻮﻨﻛا

ياﺮﺟا ﻪﻴﻟوا حﺮﻃ رد نﺎﺘﺴﻠﮔ نﺎﺘﺳا

"

ﺖﻴﻌﻤﺟ

"

ﻪﺘﻓﺮﮔ راﺮﻗ

، ﺮﻈﻧ ﻪﺑ ﻲﻘﻄﻨﻣ ﻲﻣ

ﺑ ﺪﺳر دﺎﺠﻳا ﺎ

ﻪﻜﺒﺷ

،يا يﺎﻬﺸﺨﺑ زا ار نﺎﻃﺮﺳ ﻪﺑ طﻮﺑﺮﻣ تﺎﻋﻼﻃا مﺎﻤﺗ

ﺳ رﻮﻃ ﻪﺑ ﻲﺘﻟود و ﻲﺻﻮﺼﺧ و يروآدﺮﮔ ﻚﻴﺗﺎﻤﺘﺴﻴ

ﻦﻳا رد

دراو ﻢﺘﺴﻴﺳ دﺮﻛ

. تﺎﺒﺛا نﺎﻃﺮﺳ دراﻮﻣ ﺖﺒﺛ ﻪﺑ كﻮﻜﺸﻣ ﺎﻳ هﺪﺷ

،هﺪﺷ ﺖﺳرد رﻮﻈﻨﻣ ﻦﻴﻤﻫ ﻪﺑ ﻞﺒﻗ زا ﻪﻛ ﻲﻳﺎﻬﻣﺮﻓ رد نﺎﻃﺮﺳ نﺎﻃﺮﺳ ﺖﺒﺛ نﺎﻜﻣا ﻜﻴﻨﻴﻠﻛ يﺎﻬﻴﺳرﺮﺑ نﺎﻣز رد ار ﺎﻫ

و ﻲ

ﻢﻫاﺮﻓ ﻲﺼﻴﺨﺸﺗ ﻲﻣ

ﺪﻳﺎﻤﻧ و ﻲﻣ ﺖﺒﺛ ﺖﻬﺟ ﻲﻤﻬﻣ ﻞﻤﻜﻣ ﺪﻧاﻮﺗ

ﺪﺷﺎﺑ ﺎﻬﻧﺎﻃﺮﺳ .

ياﺮﺟا ﺎﺑ تﺎﻌﻟﺎﻄﻣ ﻪﺑ يزﺎﻴﻧ ﺮﮕﻳد شور ﻦﻳا

ﻪﺘﺷﺬﮔ ﺮﮕﻧ ﻲﻤﻧ ﺪﺷﺎﺑ هﺪﺷ يروآدﺮﮔ تﺎﻋﻼﻃا و ﻲﻣ

ﻦﻴﺑ ﺪﻧاﻮﺗ

ﺪﻧﻮﺷ ﻪﻟدﺎﺒﻣ رﻮﺸﻛ ﺢﻄﺳ رد نﺎﻃﺮﺳ ﺖﺒﺛ ﺰﻛاﺮﻣ .

ﺮﻜﺸﺗ و ﺮﻳﺪﻘﺗ

ﻲﻧادرﺪﻗ ﻪﺑ مﺰﻠﻣ ار دﻮﺧ ﻪﻟﺎﻘﻣ نﺎﮔﺪﻨﺴﻳﻮﻧ ﻲﻧﺎﺴﻛ ﻲﻣﺎﻤﺗ زا

ﻲﻣ ﺪﻨﻧاد ﺪﻨﺘﺷاد يرﺎﻜﻤﻫ ﻖﻴﻘﺤﺗ ﻦﻳا رد ﻪﻛ

؛ صﻮﺼﺨﺑ

ﻪﻧﺎﺧ نازرﻮﻬﺑ

،نﺎﺘﺳا ﻲﻳﺎﺘﺳور ﺖﺷاﺪﻬﺑ يﺎﻫ ﺰﻛﺮﻣ نﺎﻨﻛرﺎﻛ

ﻲﺘﺷاﺪﻬﺑ ﺖﻧوﺎﻌﻣ يﺎﻬﻳرﺎﻤﻴﺑ ﺎﺑ هزرﺎﺒﻣ

، و هﺰﻴﮕﻧا يﺎﻗآ بﺎﻨﺟ

جاﺮﺳ ﺮﺘﻛد و ﺖﻗاﺪﺻ يﺪﻬﻣﺮﺘﻛد نﺎﻳﺎﻗآ بﺎﻨﺟ ﻢﻛ ﻦﻳﺪﻟا

.

ﻊﺑﺎﻨﻣ :

1- Fujimoto I, Hanai A, Tsukuma H, Hiyama T. Role of population-based cancer registry in cancer epidemiology- epidemiological studies in the Cancer Registration Scheme in Osaka, Japan. Nippon Eiseigaku Zasshi. 1994; 49 (2):

543- 58.

2- Bouvier AM, Dancourt V, Faivre J. The role of cancer registries in the surveillance, epidemiologic research and disease prevention. Bull Cancer. 2003; 90 (10): 865-71.

3- Rostgaard K, Holst H, Mouridsen HT, Lynge E. Do clinical databases render population-based cancer registers obsolete? The example of breast cancer in Denmark. Cancer Causes Control. 2000; 11 (7): 669-74.

4- Malin JL, Kahn KL, Adams J, Kwan L, Laouri M, Ganz PA. Validity of cancer registry data for measuring the quality of breast cancer care. J Natl Cancer Inst. 2002; 94 (11): 835-44.

5- Teppo L, Pukkala E, Lehtonen M. Data quality and quality control of a population-based cancer registry. Experience in Finland. Acta Oncol. 1994; 33 (4): 365-69.

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6- Lang K, Magi M, Aareleid T. Study of completeness of registration at the Estonian cancer registry. Eur J Cancer Prev. 2003; 12 (2): 153-56.

7- Verkooijen HM, Fioretta G, Chappuis PO, Vlastos G, Sappino AP, Benhamou S, et al. Set-up of a population-based familial breast cancer registry in Geneva, Switzerland: validation of first results. Ann Oncol. 2004; 15 (2): 350-53.

8- Aitken J, Bain C, Ward M, Siskind V, MacLennan R. How accurate is self-reported family history of colorectal cancer? Am J Epidemiol. 1995; 141 (9): 863-71.

9- Bondy ML, Strom SS, Colopy MW, Brown BW, Strong LC. Accuracy of family history of cancer obtained through interviews with relatives of patients with childhood sarcoma. J Clin Epidemiol. 1994; 47 (1): 89-96.

10- Douglas FS, O'Dair LC, Robinson M, Evans DG, Lynch SA. The accuracy of diagnoses as reported in families with cancer: a retrospective study. J Med Genet. 1999; 36 (4): 309-12.

11- Mitchell RJ, Brewster D, Campbell H, Porteous ME, Wyllie AH, Bird CC, et al. Accuracy of reporting of family history of colorectal cancer. Gut. 2004; 53 (2): 291-95.

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٩١

The assessment of possibility of using public data as a source of cancer registration.

Sh. Semnani¹, S. Besharat², N. Abdolahi², Gh.Roshandel², A. Danesh³, A. Hosseini³, D. Roshandel⁴, MJ. Kabir⁵

Abstract

Background and Aim: Cancer registration based on hospital information, clinically and partaclinically derived data from health centers and labs, may have some shortcomings in recording all cancer cases, especially in the developing countries. Thus, in this study we tried to assess the possibility of using public data concerning cancer incidence among their relatives as a complementary source of community-based cancer registration.

Materials and Methods: In this descriptive study, along with the annual census in rural areas in March 2004 a survey was performed in Golestan province to identify public awareness about cancer incidents in their community. People were asked about history of cancer in their close relatives during the last five years.

Those who reported cancer in their relatives were also asked to name the main organ that was involved. A similar list was retrieved from the cancer registry by the department of health in Gorgan and cases with upper GI (esophagus and gastric) cancer diagnosis, from 2002 to 2003, were selected for the study. Finally, these two lists were matched to examine the accuracy of the collected data. For the statistical analysis of the collected data in these two years (i.e. 2002 VS 2003) Chi- Square test was employed and P<0.05 was accounted significant.

Results: We included 137 upper GI cancers with rural residential and known address into our study. Out of 137 cancer cases only 35 (%25.5) cases were reported by the relatives and among them only 20 (%57.1) relatives correctly reported the location of the tumor. Although we found a difference in correctly reporting cancer incidents by year of diagnosis (more correct cases during the second year than the first year), it was not statistically significant.

Conclusion: We found that taking history from relatives is not a reliable source of information for cancer registration and recommend a nationwide cancer registry to record all cancer related information at the time of diagnosis. This strategy will reduce the need for performing retrospective surveys to collect cancer related information.

Key Words: Population-based cancer registry; Hospital-based cancer registry; Cancer; Relatives

1 Corresponding Author; Assistant Professor, Department of Internal Medicine, Faculty of Medicine, Golestan University of Medical Sciences. Gorgan, Iran [email protected]

2 General Practitioner, Researcher, Golestan Research Center of Gastroenterology and Hepatology

3 General Practitioner, Health Services

4 Student of Medicine

5 M.Sc. in Health Services Management