Participation of the Women Covered by Family Physicians in Breast Cancer Screening Program in Kerman, Iran

  • Jafari, Mohammad (Kerman Province's Health Insurance) ;
  • Nakhaee, Nouzar (Social Medicine, Neuroscience Research Center, Institute of Neuropharmacology, University of Medical Sciences) ;
  • Goudarzi, Reza (Health Economics, Research center for modeling in health, Institute for Futures Studies in Health, Kerman University of Medical Sciences) ;
  • Zehtab, Nooshin (Msc in Health Economics, Social, Determinants of Health Research Center) ;
  • Barouni, Mohsen (Health Economics, Health Services Management Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences)
  • Published : 2015.06.26


Background: Mammography screening is a method for reducing breast cancer mortality in women over 40 years old. A participation rate of at least 70% is a prerequisite for screening programs. This study aimed at determining the participation rate of women in breast cancer screening in Iran. Materials and Methods: The study population in this prospective research consisted of 35 to 69 years old women in the villages and towns Kerman District, in 2013. The data were collected by a well-validated risk assessment questionnaire. The questionnaires were completed with the help of health workers and technicians in the health centers, who were trained on breast cancer screening program. Results: As a whole, 19,651 women were invited to complete the questionnaire, of whom 15,794 women (80.37%) completed it. In the urban region, of 3150 eligible women 2728 women (86.60%) participated in the study. The acceptance rates for mammography in rural and urban regions were 34.95% and 8.75%, respectively. Conclusions: Finally, 3.8% and 16.34% of 35 to 69 years old women in the urban regions were mammographed, respectively. Conclusion: The low participation of eligible women in breast cancer screening program alerts us against including the program in the health insurance package.



  1. Abedian Kasgari K, Shahhosseini Z, Adeli H (2006). Health beliefs of women regarding mammography in women referred to Sari health centers in 2004. Mazandaran Medical Sciences University Journal, 16, 90-8.
  2. Abu Samah A, Ahmadian M (2012). Socio-Demographic Correlates of Participation in Mammography: A Survey among Women Aged between 35-69 in Tehran, Iran. Asian Pac J Cancer Prev, 13, 2717-20.
  3. Akbari H, Jeddi Arani TS, Gilassi HR, et al (2013). Motivational factors and reasons for not participating in breast and cervix cancer screening programs in women referred to Kashan healthcare centers. Ilam Medical Sciences University Journal, 22, 137-48.
  4. Alsanabani J¬A, Gilan W, Al Saadi A (2015). Incidence data for breast cancer among yemeni female patients with palpable breast lumps. Asian Pac J Cancer Prev, 16, 191-4.
  5. Asadzadeh VF, Broeders MJ, Kiemeney LA, et al (2011). Opportunity for breast cancer screening in limited resource countries: a literature review and implications for Iran. Asian Pac J Cancer Prev, 12, 2467-75.
  6. Banaian S, Kazemian A, Kheiri S (2005). Awareness, attitude, and attitude of women referred to Boroojen health centers regarding breast cancer screening methods and their affecting factors in 2005. Shahre Kord Medical Sciences University, 7, 280-34.
  7. Bonfill Cosp X, Marzo Castillejo, Pladevall Vila, et al (2001). Strategies for increasing the participation of women in community breast cancer screening (Review). The Cochrane Collaboration, 1, 1-34.
  8. Greif M (2010). Mammographic screening for breast cancer: An invited review of the benefits and costs. Elsevier Ltd. The Breast, 19, 268-72.
  9. GLOBOCAN 2008 (IARC). Breast Cancer Incidence and Mortality Worldwide in 2008. Available at:, INCIDENCE.
  10. Goto R, Hamashima C, Mun S, et al (2015). Why screening rates vary between korea and japan- differences between two national healthcare systems. Asian Pac J Cancer Prev, 16, 395-400.
  11. Davari M, Makarian F, Hosseini M, et al (2013). Evaluation of direct medical costs of breast cancer in Iran; analysis of patients' data in a special hospital for cancer patients in Isfahan. Heath Information Management Journal, 10, 1-10.
  12. Enzejab B, Farajkhoda T, Bokaei M (2004). Obstacles and incentives for performing diagnostic tests of women's common cancers. Shahid Sadooghi Yazd Medical Sciences University Journal, 12, 78-85.
  13. Farshbaf Khalili A, Shahnazi M, Ghahvechi A, et al (1999). Attitude of women referred to Tabriz health center regarding breast self-examination. Nursing and Midwifery Journal, 11, 38-46.
  14. Frank D. (1999). Health beliefs, health locus of control women's mammography behavior. Cancer Nursing, 22, 149-56.
  15. Harirchi I, Mousavi SM, Mohagheghi MA, et al (2009). Do Knowledge, Attitudes and practice of iranian health care providers meet WHO recommendations on early detection for breast cancer? Asian Pac J Cancer Prev, 10, 849-851.
  16. Harris JR, Lippman ME, Morrow M, et al (2001). Diseases of the Breast. Annals of Surgery, 233, 594-96.
  17. HL C, Rashidah S, Shamsuddin K, et al (2003). Factors related to the practice of breast self-examination (BSE) and Pap smear screening among Malaysian women workers in selected electronics factories. BMC Women's Health, 3, 1-11.
  18. Ho V, Yamal JM, Atkinson EN, et al (2005). Predictors of breast and cervical screening in Vietnamese women in Harris County, Houston, Texas. Cancer Nurs, 28, 119-29.
  19. Huang Y, Zhou K, Li H, et al (2011). Knowledge, attitudes, and behaviour regarding breast cancer screening among women from different socio-economic regions in southwest China: a cross-sectional study. Asian Pacific J Cancer Prev, 12, 203-9.
  20. Hughes KS, Roche C, Campbell CT, et al (2003). Prevalence of family history of breast and ovarian cancer in a single primary care practice using a self-administered questionnaire. The Breast Journal, 9, 19-25.
  21. Islam N, Kwon SC, Senie R, et al (2006). Breast and cervical cancer screening among south Asian womenin New York City. J Immigr Minor Health, 8, 211-21.
  22. Kalili S, Shojae Zadeh D, Azam K, et al (2014). Effectiveness of training of health beliefs and attitude of women referred to Shahid Bahtash Clinic in Lavizan region, Tehran, regarding breast cancer screening methods using the model of health belief. Health Journal, 5, 45-8.
  23. Kelikowske K, Smith-Bindman R, Ljung BM, et al (2003). Evaluation of abnormal results and palpable breast abnormalities. Ann Intern Med, 139, 274-84.
  24. Kösters JP, Gøtzsche PC (2003). Regular self-examination or clinical examination for early detection of breast cancer. Cochrane Database Syst Rev, 3, 1-22.
  25. Lebovic GS, Hollingsworth A, Feig SA (2010). Risk assessment, screening and prevention of breast cancer: A look at costeffectiveness. The Breast, 19, 260-7.
  26. Lee CY. (2003). Factors influencing breast self-examination for rural women in korea. JCN, 17, 13-9.
  27. Marmot M, Altman D, Cameron DA, et al (2012). The benefits and harms of breast cancer screening: an independent review. The Lancet, 380, 1778-86.
  28. Mazloomy Mahmood-Abad SS, Shahidi F, Abbasi-Shavazi M, et al (2006). Evaluating knowledge, attitude and behavior of women on reproductive health subjects in seven central towns of Iran. Med J Reproduction & Infertility, 4, 392-400.
  29. Montazeri A, Vahdaninia M, Harirchi I, et al (2008). Breast cancer in Iran: need for greater women awareness of warning signs and effective screening methods. Asia Pac Fam Med, 7, 1-7
  30. Moutel G, Duchange N, Darquy S, et al (2014). Women's participation in breast cancer screeningin France-an ethical approach. BMC Medical Ethics, 15, 2-8
  31. NHS Cancer Screening Programmes. (2005). Consolidated guidance on standards for the NHS breast screening programme, 18-21.
  32. Perry N, Broeders M, De Wolf C, et al (2006). European guidelines for quality assurance in breast cancer screening and diagnosis. 4th edn. Luxembourg: office for official publications of the European communities, 1-409.
  33. Poole B, Gelmon K, Borugian M, et al (2008). Breast cancer screeningand diagnosis in British Columbia. BC MEDICAL JOURNAL, 50, 198-205.
  34. Rezaei Ghazdehi M, Amini L, Parvizi S, et al (2013). Attitudinal obstacles of mammographic screening of breast cancer in women. Mazandaran Medical Sciences University Journal, 74, 68-99.
  35. Salim EI, Moore MA, Al-Lawati JA, et al (2009). Cancer epidemiology and control in the arab world - past, present and future. Asian Pac J Cancer Prev, 10, 3-16.
  36. Shen Y-C, Chee-Jen C, Chiun H, et al (2000). Significant Difference in the trendsof female breast cancer incidence between Taiwanese and Caucasian Americans: Implications from Age-period-Cohort Analysis. Cancer Epidemiol Biomarkers Prev, 14, 1986-90.
  37. Soltan Ahmadi Jila, Abbas Zadeh A, Tirgary B (2010). Rate and reason for participating or not participating of women referred to Kerman clinics in cervix and breast cancer screening programs. Obstetrics and Gynecology Journal of Iran, 13, 37-46.
  38. T Gramand Inger, Lund Eiliv. (2008). Breast cancer screening programme as setting for an adjunct research project: effect on programme attendance. J Med Screening, 15, 44-5.
  39. The National Library of Australia Cataloguing-in-Publication entry. (2010). The impact of Breast Screen SA, 20 year report 1989-2008: with trend data for 1989-2004. 1-145.
  40. Truong DT, Al Khater AH, Al-Bader SB, et al (2013). Arab women's breast cancer screening practices: a literature review. Asian Pac J Cancer Prev, 14, 4519-28.
  41. Wu GH, Chen LS, Chang KJ, et al (2006). Evaluation of breast cancer screening in countries with intermediate and increasing incidence of breast cancer. J Med Screen, 13, 23-7.

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