{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T07:56:04Z","timestamp":1791186964130,"version":"4.1.0"},"reference-count":28,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T00:00:00Z","timestamp":1787702400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T00:00:00Z","timestamp":1787702400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Science Reports"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>Infections are recognized contributors to cancer development. This study aimed to assess the prevalence, socio\u2010demographic characteristics, and risk factors associated with intestinal protozoan parasites in patients with colorectal cancer (CRC) in Western Iran.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This descriptive case\u2010control study enrolled 174 CRC patients and 174 non\u2010CRC healthy controls receiving care at general hospitals in Lorestan Province between October 2022 and August 2024. Fresh stool samples were examined using direct smear, Lugol's iodine, formalin\u2010ether concentration, and permanent staining (Giemsa and Trichrome). Polymerase chain reaction (PCR) was performed on all samples testing positive for\n                      <jats:italic>Entamoeba<\/jats:italic>\n                      species by microscopy. Data were analyzed using\n                      <jats:italic>\u03c7<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      tests and binary logistic regression (SPSS v26.0); a two\u2010sided\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05 was considered statistically significant.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Intestinal protozoan infections were detected in 24\/174 (13.8%) CRC patients and 8\/174 (4.6%) non\u2010CRC controls. CRC patients had significantly higher odds of intestinal protozoan infection than non\u2010CRC controls (OR\u2009=\u20093.32, 95% CI: 1.45\u20137.61; Fisher's exact\n                      <jats:italic>p\u2009<\/jats:italic>\n                      =\u20090.0047). Among the identified protozoan parasites were\n                      <jats:italic>Giardia lamblia<\/jats:italic>\n                      (15\/32, 46.8%),\n                      <jats:italic>Entamoeba histolytica<\/jats:italic>\n                      (6\/32, 18.75%), and\n                      <jats:italic>E. coli<\/jats:italic>\n                      (4\/32, 12.5%), respectively. Using a PCR assay, all\n                      <jats:italic>E. histolytica\/E. dispar<\/jats:italic>\n                      positive samples were confirmed as\n                      <jats:italic>E. histolytica<\/jats:italic>\n                      . Among CRC patients, rural residence, animal contact, agricultural activity, animal husbandry, and consumption of unwashed fruits or vegetables were significantly associated with intestinal protozoan infection (ORs\u2009=\u20092.55\u201365.46;\n                      <jats:italic>p\u2009<\/jats:italic>\n                      &lt;\u20090.05). No significant associations were observed with demographic, socioeconomic, or behavioral factors among non\u2010CRC participants.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study found a higher prevalence of intestinal protozoan parasites in CRC patients compared to controls, emphasizing the clinical importance of parasitic infections in this population. Routine screening, improved sanitation, and public health interventions are recommended to reduce infection risks. Further research is needed to explore the long\u2010term impact of these parasites on cancer progression and immune function.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/hsr2.73093","type":"journal-article","created":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T10:42:43Z","timestamp":1787740963000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Colorectal Cancer and Intestinal Protozoan Infections: Prevalence, Risk Factors, and Molecular Confirmation in Western Iran: A Descriptive Case\u2010Control Study"],"prefix":"10.1002","volume":"9","author":[{"given":"Alireza","family":"Moayyedkazemi","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, School of Medicine, Shahid Rahimi Hospital Lorestan University of Medical Sciences Khorramabad Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-7915-5503","authenticated-orcid":false,"given":"Amal","family":"Khudair Khalaf","sequence":"additional","affiliation":[{"name":"Department of Microbiology, College of Medicine University of Thi\u2010Qar Thi\u2010Qar Iraq"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sima","family":"Nik Khah Behnamiri","sequence":"additional","affiliation":[{"name":"Universal Scientific Education and Research Network (USERN) Office Lorestan University of Medical Sciences Khorramabad Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asghar","family":"Sepahvand","sequence":"additional","affiliation":[{"name":"Social Determinants of Health Research Center Lorestan University of Medical Sciences Khorramabad Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neda","family":"Niazi","sequence":"additional","affiliation":[{"name":"Universal Scientific Education and Research Network (USERN) Office Lorestan University of Medical Sciences Khorramabad Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maryam","family":"Sepahvand","sequence":"additional","affiliation":[{"name":"Universal Scientific Education and Research Network (USERN) Office Lorestan University of Medical Sciences Khorramabad Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4194-393X","authenticated-orcid":false,"given":"Hossein","family":"Mahmoudvand","sequence":"additional","affiliation":[{"name":"Social Determinants of Health Research Center Lorestan University of Medical Sciences Khorramabad Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,26]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers16081530"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm13010040"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.6004\/jnccn.2024.0056"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41579-023-00973-4"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cell.2016.01.013"},{"issue":"3","key":"e_1_2_12_7_1","first-page":"231","article-title":"The Gut Microbiota and Its Relationship With Host Metabolism","volume":"9","author":"Hoyles L.","year":"2018","journal-title":"Gut Microbes"},{"issue":"4","key":"e_1_2_12_8_1","first-page":"1531","article-title":"The Microbiome\u2010Gut\u2010Brain Axis","volume":"100","author":"Cryan J. 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