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REVIEW ARTICLE
J Res Med Sci 2022,  27:21

Status of breast cancer screening strategies and indicators in Iran: A scoping review


1 Breast Cancer Research Center, Motamed Cancer Institute, ACECR, Tehran, Iran
2 Department of Lifestyle and Health Management Research, Medical Laser Research Center, ACECR, Tehran, Iran
3 Department of Physical Education and Sport Sciences, Faculty of Humanities, Tarbiat Modares University, Tehran, Iran
4 Department of Neurology and Neurosurgery, McGill University, Montreal, Canada

Date of Submission27-Dec-2020
Date of Decision08-Sep-2021
Date of Acceptance23-Sep-2021
Date of Web Publication17-Mar-2022

Correspondence Address:
Dr. Shahpar Haghighat
Breast Cancer Research Center, Motamed Cancer Institute, ACECR, Tehran
Iran
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jrms.jrms_1390_20

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  Abstract 


Background: This scoping review aimed to investigate the status of breast cancer (BC) preventive behaviors and screening indicators among Iranian women in the past 15 years. BC, as the most common cancer in women, represents nearly a quarter (23%) of all cancers. Presenting the comprehensive view of preventive modalities of BC in the past 15 years in Iran may provide a useful perspective for future research to establish efficient services for timely diagnosis and control of the disease. Materials and Methods: The English and Persian articles about BC screening modalities and their indicators in Iran were included from 2005 to 2020. English electronic databases of Web of Science, PubMed, and Scopus, and Persian databases of Scientific Information Database (SID) and IranMedex were used. The critical information of articles was extracted and classified into different categories according to the studied outcomes. Results: A total of 246 articles were assessed which 136 of them were excluded, and 110 studies were processed for further evaluation. Performing breast self-examination, clinical breast examination, and mammography in Iranian women reported 0%–79.4%, 4.1%–41.1%, and 1.3%-45%, respectively. All of the educational interventions had increased participants' knowledge, attitude, and practice in performing the screening behaviors. The most essential screening indicators included participation rate (3.8% to 16.8%), detection rate (0.23–8.5/1000), abnormal call rate (28.77% to 33%), and recall rate (24.7%). Conclusion: This study demonstrated heterogeneity in population and design of research about BC early detection in Iran. The necessity of a cost-effective screening program, presenting a proper educational method for increasing women's awareness and estimating screening indices can be the priorities of future researches. Establishing extensive studies at the national level in a standard framework are advised

Keywords: Breast cancer, Iran, prevention, scoping review, screening


How to cite this article:
Omidi Z, Koosha M, Nazeri N, Khosravi N, Zolfaghari S, Haghighat S. Status of breast cancer screening strategies and indicators in Iran: A scoping review. J Res Med Sci 2022;27:21

How to cite this URL:
Omidi Z, Koosha M, Nazeri N, Khosravi N, Zolfaghari S, Haghighat S. Status of breast cancer screening strategies and indicators in Iran: A scoping review. J Res Med Sci [serial online] 2022 [cited 2022 Sep 24];27:21. Available from: https://www.jmsjournal.net/text.asp?2022/27/1/21/339778




  Introduction Top


Breast cancer (BC) is the most common female cancer worldwide, representing nearly a quarter (23%) of all cancers in women.[1] In Iran, in 2015, the number of BC patients was 12802, and the age-standardized incidence rate was 32.63/100,000. Hence, the age distribution of BC compared to its counterparts is low because of its relatively young population. Almost 51% of patients were under 50 years old. It is estimated that about 10,000 women are diagnosed and treated for BC each year.[2],[3]

Approaches to reducing cancer's global burden include two major strategies: Screening and early detection and active preventive intervention.[4] Screening, as one of the most critical early detection methods, has been performed in low- and middle-income countries in only 2.2% of women aged 40–49 years.[5] The findings confirmed that screening methods were less common in Iranian women,[2] and there is no systematic screening strategy for BC in Iran.[6]

Screening methods are mammography, breast self-examination (BSE), and clinical breast examination (CBE).[7] Although mammography screening was approved as an effective method, a study demonstrated that this method is not cost-effective in Iran.[6] BSE can enhance women's awareness, empowerment, and responsibility to their health.[8] The previous studies showed that almost 60% of females did not know how to perform BSE or did not have the necessary skills to do it.[9],[10],[11] CBE is considered a low-cost method with a broader implementation ability that requires no equipment.[5] Different factors such as demographic variables, awareness, literacy, social, and economic conditions can affect BC screening behaviors[12] which should be considered in planning a cost-effective strategy to control BC in Iranian women.

Presenting the comprehensive view of preventive modalities of BC in the past 15 years in Iran may provide a helpful perspective for future research to establish efficient services for timely diagnosis and control of the disease. Hence, this scoping review aims to present an overall demonstration of observational and interventional screening status in Iran. Introducing screening indicators in related articles may provide useful data for policy-makers to implement a proper strategy to control the disease.

Scoping review question

“What are the results of articles related to BC screening strategies and indicators in Iran in the past 15 years?”

Scoping review sub-questions

“What are the status of BC prevention behavior and influencing factors on screening behaviors?”

“Which educational interventions are effective in improvement of screening behavior?”

“What are the statistical indicators of BC screening?”

Inclusion criteria

All the published articles about BC prevention in Iran from January 2005 to January 2020 were included in the study. English online electronic databases of Web of Science, PubMed and Scopus, and Persian databases of SID and IranMedex were used.


  Methods Top


This study is part of a big project to study different aspects of BC in Iran. All of the published articles about BC in Iran within the defined time horizon were included in the study. They covered various aspects of epidemiology, genetics, prevention, diagnosis, treatment, and supportive care in BC. The prevention subgroup was categorized into two themes, screening modalities and indicators, prevention behaviors, and their barriers. The studies in the field of screening strategies and indicators were assessed in this scoping review.

Search strategy

Details of data sources and methodology of the big project between 2005 and 2015 time horizon have been presented in another article.[13] The same methodology was extended to articles published up to 2020. The current study consists of all articles published from January 2005 to 2020. English online electronic databases of Web of Science, PubMed, and Scopus, and Persian databases of SID and IranMedex were used. English search formula was “BC” OR “breast carcinoma” OR “breast tumor” OR “breast neoplasm” AND Iran. Persian search formula was a combination of Iran with the words of Breast tumor, BC, Breast carcinoma, and Breast neoplasm [Appendix 1].

Source of evidence screening and selection

Screening of primary search and dividing to subgroups was achieved by three experienced reviewers in the field of BC; two surgeons and one epidemiologist. Totally 7478 studies consisting of 4893 English and 2585 Persian abstracts were included in the main project, of which 949 abstracts were located in the prevention subgroup. In this step, 522 items (225 English and 297 Persian) were included by deleting unrelated studies and duplicated titles, abstracts, and full text of articles. The results of 246 articles in the field of screening strategies and indicators were considered eligible for this review. After assessing full texts, 136 articles were excluded, and 110 studies consisting of 81 English and 29 Persian were evaluated.

It should be noted that the results of the two articles have been presented in two tables jointly. Reasons of exclusion were irrelevancy (53 articles), just abstract presentation (7 articles), no relation to the Iran population (8 articles), letter to editor (3 articles), review article (2 articles), BC population study (4 articles), inaccessible full paper (1 article), qualitative study (3 articles), and duplication (55 articles). In this phase, the reason for duplications was to publish an article in either Persian and English or two or more journals [Chart 1].



Studies reviewed were classified into three categories according to their main themes, including observational (58 articles), interventional (37 articles), and statistical indicators (17 articles).

Data extraction

The research team obtained the full texts of the abstracts. If it was not available, a letter was sent to the author to take the necessary information. Two reviewers critically evaluated the selected articles by a checklist. In case of disagreement, they discussed and decided about their eligibility.

Because of the wide variation in the methodology and results of the included studies, an Excel sheet was designed for data extraction. The first part of the datasheet was “general information” such as the title, the place and time of the study, and publication year. The second part included “methodological information” consisting of study design, sample size, studied population, intervention modality, and measurement tools. The third part was composed of “outcome measurements”, such as performance of the screening method, effect of interventions, different screening indicators such as recall rate, participation rate, response rate, and detection rate. All of the articles were extracted by two reviewers, and the research team manager organized the two extracted forms into one sheet.

Since the main objective of this scoping review was to demonstrate the distribution of BC prevention researches in Iran, no article was excluded from the study due to low quality. To show the limitations of studies, we assigned the incomplete data with “NA,” which stands for “Not Assigned.”

Analysis and presentation of results

Rate of screening behavior performance, affecting factors, the impact of different educational interventions and statistical indicators such as detection rate, recall rate, and participation rate were extracted from the included studies. Articles that more than one-third of the presented data pertained to the years before 2005 were excluded from the study. If an article was published in either Persian and English or two or more journals, just their English version and the first publication were included. The details of data in each subject were presented in a separate table.


  Results Top


Search results

The results of 246 articles in the field of screening strategies and indicators were considered eligible for this review. After assessing full texts, 136 articles were excluded, and 110 studies consisting of 81 English and 29 Persian were evaluated [Appendix 2].

Inclusion of sources of evidence

The included studies in this field were subcategorized in observational studies (58 articles), educational interventions (37 articles), and statistical indicators (17 articles). The essential data of those three objectives consisting of general information, methodological information, and outcome measurement indices were recorded in separated tables. More details have been presented in [Appendix 3].

Review finding

The finding results are presented in three following subheadings:

Observational studies of BC screening

Among 58 articles in [Table 1], 56 items were cross-sectional, and 2 items were survey studies. Most of the studied populations were females referred to Healthcare centers (HCCs). Factors influencing screening behaviors consisted of health belief model (HBM) components, fear, proactive coping, state of mind and advocacy, educational level, positive family history of breast cancer, family support, awareness, physician recommendation, and age. Four articles had introduced “physicians and treatment staff” as the most important sources of information about screening behaviors.[14],[15],[16],[17]
Table 1: Observational studies of breast cancer screening

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Achievement of BSE by the best estimate varied from no experience to 79.4%. As well as, regular BSE was 4.5% to 47.5%. Performing annual CBE was reported in 4.1%-41.1% of participants, and mammography had been performed in 1.3%-45% of females. The results of three studies showed 52.9%, 30.9%, and 60% of females did not know how to perform BSE or did not have the necessary skills to do it.[9],[10],[11] The 5-year and lifetime risk perception of BC was subjectively assessed by the visual analog scale (VAS) from 0 to 100. The mean of 5-year BC risk perception was 0.89 ± 0.89, and its lifetime risk perception was 8.87 ± 3.84.[18] Higher 5-year risk perception was demonstrated to have more predictive power for performing mammography while not predicting achieving BSE or CBE.

Effect of educational interventions on screening behavior

[Table 2] demonstrates 37 studies related to educational interventions and their impact on BC screening promotion. The design of studies was clinical trial (6 articles), randomized clinical trial (29 articles), and randomized field trial (2 articles). Females who referred to HCCs consisted majority of participants. The number of the sample ranged from 43 to 600 subjects. The educational methods mostly were in-person, except for two studies which were telephone counseling. Most educational models were HBM (13 studies), extended parallel process model (1 study), BASNEF (1 study), theory of planned behavior (TPB) (2 studies), systematic comprehensive health education and promotion (1 study), and HBM + TPB (1 study). The in-person education was achieved by methods like group discussion, role-playing, or peer education. Different instruments such as short messages, PowerPoint, media, lecture, mobile phone were applied. The result of the studies showed that educational interventions increased the knowledge, attitude, and practice of participants in performing the screening behaviors such as mammography, CBE, and BSE. It led to improved health belief, self-efficacy, the behavioral intention of screening, and perceived susceptibility/severity/benefits/barriers.
Table 2: Effect of educational interventions on screening behavior

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The statistical indicators of BC screening

This category includes the results of statistical studies in the field of BC prevention [Table 3]. Seventeen studies with different designs consisting of cross-sectional (13 articles), clinical trial (1 article), field trial (1 article), longitudinal (1 article), and cost-effectiveness (1 article) were included in this subgroup. The majority of participants were females referred to HCCs. Some studies had presented the psychometric assessment of the Persian version of BSE Behavior Predicting Scale, BC awareness measure, and Champion HBM Scale. The development of some tools in BC prevention strategies consisted of MSS (Mammography Social Support scale in Iran), BC screening chart, and ASSISTS instrument and model. In two studies, the response rate to BSE and CBE ranged from 81% to 100%.[100],[106] The participation rate in the screening program was reported from 3.8% to 16.8% in two studies.[52],[107] BC detection rate has been reported in some studies with different designs. In a cross-sectional study on females admitted to the mammography center in a hospital, BC was detected in 2.3% of 526 screened patients.[107] BC detection rate of non-diagnostic mammography in 9395 subjects was 8.5 per 1000 mammography.[108] In BC screening of 26606 females, the detection rate of 24 per100000 was reported in CBE and mammography evaluation; the false-positive detection rate of mammography was 7.5% in this screening program.[109] Sehhati Shafaie conducted a project on 5,000 females referred to BC hospital for screening. They recorded 996 sonography and 636 mammography reports with 40 and 183 abnormal cases, respectively, and found one BC by performing 14 fine needle aspiration (FNA).[110] The screening mammography, diagnostic sonography, biopsy, and abnormality rates were 27.4%, 26%, 1.4%, and 33% in a screening project, respectively.[107] Results of a study indicated that the mean scores of females' BC screening belief and multidimensional health locus of control were 40.72 ± 10.41 and 67.78 ± 17.67, respectively.[111]
Table 3: The statistical indicators of breast cancer screening

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  Discussion Top


This paper reviewed the status of BC screening strategies and indicators in Iran. The studies were assessed and discussed in three themes of observational studies, interventional studies, and statistic indicators as follows:

Observational studies of BC screening

At this time, mammography is the gold standard of the BC early detection method. Hence, it is necessary to specify the status of mammography performance in Iran. In the current study, the range of performing of mammography between 2005 and 2020 was 1.3%–45%, while in a systematic review assessing Persian language articles of two databases between 2001 and 2010, 3%–26% of Iranian females had done mammography screening.[12] Although a study showed that the rate of screening mammography in Iran was lower than in developed countries such as the USA and the UK,[52] the results of a screening program in Saudi Arabia resulted in 27.7% of mammography achievement.[120] One of the reasons for this difference may be the lack of a BC screening program in Iran; hence, the results reported were extracted from various limited studies with high heterogeneity regarding the study population, sample size, and design. On the other hand, some research has revealed that mammography is an expensive modality and not a cost-effective method for BC screening in Iran.[6],[109] Further, studies focusing on other screen methods are suggested.

BSE and CBE are considered as more available, low-cost, and low-technical requirement screening strategies. This study showed that the performance of BSE and CBE ranged between 0%–79.4% and 4.1%–41.1%, respectively, and 30.9%–60% of females did not have appropriate skills to do BSE. Similar to our results, a study on Arab females demonstrated that 69% of subjects did not know how to do BSE.[121] According to the current review, the low self-efficacy of females in applying screening behaviors may affect BSE achievement.[44] Self-efficacy is one of the most important predictors of screening behaviors,[43],[44],[46],[47] and the performance of BSE in females with higher self-efficacy is 1.17 times more than others.[35] Therefore, it can be concluded that by improving females' self-efficacy, their skills in screening behaviors will also improve. Hence, education about BC screening methods is worthy of being insisted on by the health system. It may be a more logical strategy for low- and middle-income countries in which breast awareness is more beneficial, too. In conclusion, since there is no national study to demonstrate accurate indicators, most of the current results have been reported from small and limited studies, which cause a wide range of affectivity. It seems that more accurate epidemiologic studies are necessary to indicate the frequency of BSE and CBE achievement in Iranian women.

Effect of educational interventions on screening behavior

The effect of various educational modalities on screening behaviors has been studied in different Iranian researches. The in-person method was used by most studies, except for two studies that used telephone counseling. Most of them showed that education effectively enhanced females' knowledge, attitude, practice of screening behaviors. Still, no study compared in-person with virtual education to reveal which method is more effective in Iran. Given the growth of using the Internet, novel technologies such s online social networks, smartphone applications, and virtual learning can be cost-effective. Some features of this technology, such as more availability, low_price, and offering a more attractive platform, make it a helpful modality for future research studies.

In this scoping review, most educational interventions resulted in satisfied effects.[70],[73],[76],[77] It may show that the health system's educational modalities for BC prevention are more important than the training methods. Selecting a suitable educational method facilitates access to defined objectives, and it depends on many factors, such as socioeconomic status, health priorities, and cancer preventive policies.[122] If early detection of BC is a priority of the health system of Iran, indeed, education programs should be organized as one of the essential correlated factors. On the other hand, promoting the population's awareness induces some diagnostic and treatment demands for BC detection. If we do not provide needed requirements, our health policy goal won't be reached. Related studies in Iran have focused on identifying the educational needs of the specified Iranian population with different races, cultures, incomes, etc.[77],[79],[82],[84],[95],[96] Hence, they cannot be generalized to the total population of Iran. Thus, implementing national research with a more potent methodology and stratified demographic characteristics is suggested.

The statistical indicators of BC screening

The statistical indicators are one of the most important principles for health policymaking to evaluate the cost-effectiveness of an intervention. They include abnormal rate, detection rate, recall rate, participation rate, etc.[123] The BC detection rate in three studies was reported with a different study population. In one of the studies achieved in Zanjan, a city of Iran, 526 women admitted to the mammography center were assessed. The detection rate had been reported by 2.3% of 526 screened patients.[107] Another research was conducted at a tertiary referral university hospital, and 9395 digital mammographies were performed, and they detected 8.5 cancer patients in 1000 women who underwent nondiagnostic mammography.[108] The third study was conducted in ten cities of Iran in which over 26,000 women aged 35 and higher with low socioeconomic status were evaluated. The results showed a detection rate of 24 per 100000 females.[109] Although all three studies have reported a detection rate, differences in methodology make them non-integral. The detection rates of invasive BC based on accurate population screening are targeted at >0.5, ≥2.7, and ≥5 per 1000 screens in Canada, the United Kingdom, and Australia, respectively. Also, the detection rates for in situ BC in the United Kingdom and Australia are considered ≥0.4 and ≥1.2 per 1000 screens, respectively.[123] The detection rate in Iran has been reported higher than in European countries and even higher than 2.7 in Asian counterpart countries.[124] One of the reasons for this difference is how females were evaluated, which means the reported statistics indicators in Iran were not extracted from a national study and some of them are just the result of limited research in a specific population. The studied population, the recruited sample size, or study design can affect these indices. On the other hand, the limitation of detection rates estimation factors like workforce skill, sensitivity or specificity of equipment, and essential resources have not been appropriately assessed in Iranian studies. Hence, it seems that the evaluation of screening effectiveness in randomized controlled clinical trials at the national level is necessary to reach more accurate information.

Another statistic indicator is the abnormal call rate, which is vital to assessing mammography image quality and interoperation. It is defined as a percentage of abnormal mammography per number of screens.[123] In Iran, it has been reported 28.77% and 33%.[107],[110] The abnormal call rate for the initial screen in Europe is considered <7, and in all of the countries like Canada, the United Kingdom, Australia, and New Zealand are considered <10.[123] This indicator is related to the recall rate. Recall rate indicates if screening mammography resulted in a recommendation for further imaging or surgical/clinical visit because of an abnormality on the screening exam.[125] The European Guidelines and the American College of Radiology considered recall rates <7% and <10%, respectively, as acceptable recall rates.[125] A high abnormal rate induces a high recall rate and increases unnecessary tests and false positives results.[123] According to our result, the recall rate in Iran was 24.7% in total, and for the first and subsequent mammography was 29% and 22%, respectively.[113] Similar to the previously reported indices, the abnormal call rate and recall rate in Iran has not been extracted from a national screening study. As a result, to determine whether our country needs a BC screening program or not, these indicators must be estimated in the standard and targeted studies, and it is beneficial to be considered as a research priority in the health policy system of Iran.

The participation rate represents the percentage of people who participate in a screening program and can be affected by acceptability, accessibility, promotion of screening, and the capacity of the plan.[123] This index showed 16.8%, 20% in urban areas, and 10% in rural areas of Iran.[52],[107] The participation rate in screening mammography in Canada, the United Kingdom, Australia, and New Zealand is estimated at ≥70%. The comparison between statistics shows a low participation rate among Iranian women, which can have consequences such as reducing the cost-effectiveness of screening programs. It may be due to the low level of awareness in Iranian females, which impacts their attitude toward the importance of BC prevention. Females' attitudes can be reformed by cooperating with mass media such as radio, television, or social networks with the health system.

On the other hand, most of the screening costs are paid by patients themselves and may affect their acceptability of some screening strategies and lowers this index compared to the other countries. Some studies have shown that mammography screening is not a cost-effective intervention in Iran.[6],[109] Hence, most insurances support the cost of diagnostic modalities, and the screening tests should be paid out of pocket. Proving more insurance coverage or accessibility facilities by the health system of Iran can improve the participation rate index.

In this review, we did not find any study for evaluating the BSE or CBE cost-effectiveness in the Iranian population. Considering the importance of those screening methods in limited resources countries, establishing a comparative analysis will provide helpful evidence for policy-makers for early detection of BC in Iran.


  Conclusion And Recommendations Top


This scoping review demonstrated that we have many unknown facts about BC early detection in Iran. It is not clear which strategy is the best. Establishing the national level studies with a standard framework may present screening indices more accurately.

Implications of the findings for research

The necessity of a national screening program in a country with a low incidence of BC, presenting a proper educational method for increasing women's awareness, and estimating screening indices can be the priorities of future Iranian researches.

Acknowledgments

The researchers at the Breast Cancer Research Center appreciate the financial support of Roche Company for the development of this valuable breast cancer road map which facilitates future researches in Iran. This article does not contain any studies with human participants or animals performed by any of the authors.

Financial support and sponsorship

This study was a part of a comprehensive project to review the different aspects of breast cancer in Iran. A grant from Roche Company funded the leading research.

Conflicts of interest

There are no conflicts of interest.


  Appendix 1: Search strategy Top


Details of data sources and methodology of the big project between 2005-2015 time horizon have been presented in another article (13). The same methodology was extended to articles published up to 2020. The current study consists of all articles published from January 2005 to 2020. English online electronic databases of Web of Science, PubMed, and Scopus, and Persian databases of SID and IranMedex were used. English search formula was “BC” OR “breast carcinoma” OR “breast tumor” OR “breast neoplasm” AND Iran. Persian search formula was a combination of Iran with the words of Breast tumor, BC, Breast carcinoma, and Breast neoplasm.


  Appendix 2 Top


After reviewing the title, 522 items (225 English and 297 Persian) were included by deleting unrelated studies and duplicated titles, abstracts, and full text of articles. The results of 246 articles in the field of screening strategies and indicators were considered eligible for this review. After assessing full texts, 136 articles were excluded, and 110 studies consisting of 81 English and 29 Persian were evaluated.

Reasons of exclusion were irrelevancy (53 articles), just abstract presentation (7 articles), no relation to Iran population (8 articles), letter to editor (3 articles), review article (2 articles), BC population study (4 articles), inaccessible full paper (1 article), qualitative study (3 articles), and duplication (55 articles).







 
  References Top

1.
Gupta A, Shridhar K, Dhillon PK. A review of breast cancer awareness among women in India: Cancer literate or awareness deficit? Eur J Cancer 2015;51:2058-66.  Back to cited text no. 1
    
2.
Cancer Office, CDC of Iran Ministry of Health and Medical Education. Cancer Registration Report; 2015.  Back to cited text no. 2
    
3.
Mousavi SM, Montazeri A, Mohagheghi MA, Jarrahi AM, Harirchi I, Najafi M, et al. Breast cancer in Iran: An epidemiological review. Breast J 2007;13:383-91.  Back to cited text no. 3
    
4.
Meyskens FL Jr., Mukhtar H, Rock CL, Cuzick J, Kensler TW, Yang CS, et al. Cancer prevention: Obstacles, challenges and the road ahead. J Natl Cancer Inst 2016;108:djv309.  Back to cited text no. 4
    
5.
Gutnik LA, Matanje-Mwagomba B, Msosa V, Mzumara S, Khondowe B, Moses A, et al. Breast cancer screening in low- and middle-income countries: A perspective from Malawi. J Glob Oncol 2016;2:4-8.  Back to cited text no. 5
    
6.
Haghighat S, Akbari ME, Yavari P, Javanbakht M, Ghaffari S. Cost-effectiveness of three rounds of mammography breast cancer screening in Iranian women. Iran J Cancer Prev 2016;9:e5443.  Back to cited text no. 6
    
7.
Bashirian S, Mohammadi Y, Barati M, Moaddabshoar L, Dogonchi M. Effectiveness of the theory-based educational interventions on screening of breast cancer in women: A systematic review and meta-analysis. Int Q Community Health Educ 2020;40:219-36.  Back to cited text no. 7
    
8.
Dewi TK, Massar K, Ruiter RA, Leonardi T. Determinants of breast self-examination practice among women in Surabaya, Indonesia: an application of the health belief model. BMC public health. 2019;19:1-8.  Back to cited text no. 8
    
9.
Pirzadeh A. Application of the health belief model in breast self-examination by Iranian female university students. Int J Cancer Manage 2018;11: e7706.  Back to cited text no. 9
    
10.
Simi A, Yadollahie M, Habibzadeh F. Knowledge and attitudes of breast self examination in a group of women in Shiraz, Southern Iran. Postgrad Med J 2009;85:283-7.  Back to cited text no. 10
    
11.
Yadollahie M, Simi A, Habibzadeh F, Ghashghaiee RT, Karimi S, Behzadi P, et al. Knowledge of and attitudes toward breast self-examination in Iranian women: A multi-center study. Asian Pac J Cancer Prev 2011;12:1917-24.  Back to cited text no. 11
    
12.
Naghibi SA, Shojaizadeh D, Yazdani Cherati J, Montazeri A. Breast cancer preventive behaviors among Iranian women: A systematic review. Payesh 2015;14:181-91.  Back to cited text no. 12
    
13.
Khosravi N, Nazeri N, Farajivafa V, Olfatbakhsh A, Atashi A, Koosha M, et al. Supportive care of breast cancer patients in Iran: A systematic review. Int J Cancer Manage 2019;12:e83255.  Back to cited text no. 13
    
14.
Bahrami M, Taymoori P, Bahrami A, Farazi E, Farhadifar F. The prevalence of breast and cervical cancer screening and related factors in woman who refereeing to health center of Sanandaj city in 2014. Zanko J Med Sci 2015;16:1-12.  Back to cited text no. 14
    
15.
Moghaddam Tabrizi F, Vahdati S, Khanahmadi S, Barjasteh S. Determinants of breast cancer screening by mammography in women referred to health centers of Urmia, Iran. Asian Pac J Cancer Prev 2018;19:997.  Back to cited text no. 15
    
16.
Tavakoliyan L, Bonyadi F, Malekkzadeh E. The investigation of factors associated with breast cancer screening among Kazeroon women aged 20-65 in 2013. Nurs Vulnerable J 2015;1:17-31.  Back to cited text no. 16
    
17.
Vahedian Shahroodi M, Pourhaje F, Esmaily H, Pourhaje F. The relationship between breast self-examination and stages of change model in health volunteers. J Res Health 2015;5:13-20.  Back to cited text no. 17
    
18.
Nikpour M, Hajian-Tilaki K, Bakhtiari A. Risk assessment for breast cancer development and its clinical impact on screening performance in Iranian women. Cancer Manag Res 2019;11:10073-82.  Back to cited text no. 18
    
19.
Valizadeh S, Akbari N, Seyyed Rasuli A. Health beliefs of nurses about breast self examination. J Med Sci 2006;6:743-50.  Back to cited text no. 19
    
20.
Aghababaii S, Bashirian S. Nursing and midwifery students breast shelf examination knowledge and practice. Int J Cancer Res 2006;2:98-101.  Back to cited text no. 20
    
21.
Abbaszadeh A, Haghdoost AA, Taebi M, Kohan S. The relationship between women's health beliefs and their participation in screening mammography. Asian Pac J Cancer Prev 2007;8:471-5.  Back to cited text no. 21
    
22.
Heidari Z, Mahmoudzadeh-Sagheb HR, Sakhavar N. Breast cancer screening knowledge and practice among women in southeast of Iran. Acta Med Iran 2008;46:321-8.  Back to cited text no. 22
    
23.
Khalili AF, Shahnazi M. Breast cancer screening (breast self-examination, clinical breast exam, and mammography) in women referred to health centers in Tabriz, Iran. Indian J Med Sci 2010;64:149-62.  Back to cited text no. 23
  [Full text]  
24.
Salimi Pormehr S, Kariman N, Sheykhan Z, Alavi Majd H. Investigation of breast cancer screening tests performance and affecting factors in women referred to Ardebil's health and medical centers, 2009. J Ardabil Univ Med Sci 2010;10:310-8.  Back to cited text no. 24
    
25.
Alavi G, Hoseininejad J, Masoom AS, Shakeri MT. Evaluation of prevalence of cervical and breast cancer screening programs between gynecologists. Iran J Obstet Gynecol Infertil 2010;13:1-6.  Back to cited text no. 25
    
26.
Sultan Ahmadi J, Abbas Zadeh A, Tirgari B. A survey on the rate and causes of women's participation or nonparticipation in breast and cervical cancers screening programs. Iran J Obstet Gynecol Infertil 2010;13:37-46.  Back to cited text no. 26
    
27.
Noroozi A, Tahmasebi R. Factors influencing breast cancer screening behavior among Iranian women. Asian Pac J Cancer Prev 2011;12:1239-44.  Back to cited text no. 27
    
28.
Hasani L, Aghamolaei T, Tavafian SS, Zare S. Constructs of the health belief model as predicting factors in breast self-examination. Hayat 2011;17:62-9.  Back to cited text no. 28
    
29.
Samah AA, Ahmadian M. Socio-demographic correlates of participation in mammography: A survey among women aged between 35-69 in Tehran, Iran. Asian Pac J Cancer Prev 2012;13:2717-20.  Back to cited text no. 29
    
30.
Harirchi I, Azary S, Montazeri A, Mousavi SM, Sedighi Z, Keshtmand G, et al. Literacy and breast cancer prevention: A population-based study from Iran. Asian Pac J Cancer Prev 2012;13:3927-30.  Back to cited text no. 30
    
31.
Aflakseir A, Abbasi P. Health beliefs as predictors of breast cancer screening behaviour in a group of female employees in Shiraz. Iran J Cancer Prev 2012;5:124-9.  Back to cited text no. 31
    
32.
Moodi M, Rezaeian M, Mostafavi F, Sharifirad GR. Determinants of mammography screening behavior in Iranian women: A population-based study. J Res Med Sci 2012;17:750-9.  Back to cited text no. 32
    
33.
Kadivar M, Joolaee S, Joulaee A, Bahrani N, Hosseini N. Breast cancer knowledge, attitudes and screening behaviors in two groups of Iranian women: Physicians and non-health care personnel. J Cancer Educ 2012;27:770-3.  Back to cited text no. 33
    
34.
Fouladi N, Pourfarzi F, Mazaheri E, Asl HA, Rezaie M, Amani F, et al. Beliefs and behaviors of breast cancer screening in women referring to health care centers in northwest Iran according to the champion health belief model scale. Asian Pac J Cancer Prev 2013;14:6857-62.  Back to cited text no. 34
    
35.
Pirasteh A, Khajavi Shojaie K, Kholdi N, Davati A. Stages of change and predicting of self efficacy construct in breast self examination behavior among women attending at tehran health centers, Iran, 2011. Iran J Obstet Gynecol Infertil 2013;16:16-23.  Back to cited text no. 35
    
36.
Asgharnia M, Faraji R, Zahiri Z, Salamat F, Mosavi Chahardah SM, Sefati S. A study of knowledge and practice of woman about breast cancer and its screening, in the case of women who referred to Alzahra hospital in Rasht during 2010-2011. Iran J Surg 2013;21.  Back to cited text no. 36
    
37.
Akhtari-Zavare M, Ghanbari-Baghestan A, Latiff LA, Matinnia N, Hoseini M. Knowledge of breast cancer and breast self-examination practice among Iranian women in Hamedan, Iran. Asian Pac J Cancer Prev 2014;15:6531-4.  Back to cited text no. 37
    
38.
Hajian-Tilaki K, Auladi S. Health belief model and practice of breast self-examination and breast cancer screening in Iranian women. Breast Cancer 2014;21:429-34.  Back to cited text no. 38
    
39.
Mokhtary L, Khorami Markani A. Health beliefs and breast cancer early detection behaviors among health care providers in Tabriz Healthcare Centers, Iran. Basic and Clinical Cancer Research 2014;6:16-22.  Back to cited text no. 39
    
40.
Nojomi M, Namiranian N, Myers RE, Razavi-Ratki SK, Alborzi F. Factors associated with breast cancer screening decision stage among women in Tehran, Iran. Int J Prev Med 2014;5:196-202.  Back to cited text no. 40
    
41.
Shiryazdi SM, Kholasehzadeh G, Neamatzadeh H, Kargar S. Health beliefs and breast cancer screening behaviors among Iranian female health workers. Asian Pac J Cancer Prev 2014;15:9817-22.  Back to cited text no. 41
    
42.
Ghodsi Z, Hojjatoleslami S. Breast self examination and mammography in cancer screening: Women health protective behavior. J Prev Med Hyg 2014;55:46-9.  Back to cited text no. 42
    
43.
Taymoori P, Habibi S. Application of a health belief model for explaining mammography behavior by using structural equation model in women in Sanandaj. Sci J Kurdistan Univ Med Sci 2014;19:103-15.  Back to cited text no. 43
    
44.
Momenyan S, Rangraz Jedi M, Sanei Irani F, Adibi Garakhani Z, Sarvi F. Prediction of breast self-examination in a sample of nursing and midwifery students Qom city using health belief model, Iran. Qom Univ Med Sci J 2014;8:28-33.  Back to cited text no. 44
    
45.
Ahmadipour H, Sheikhizade S. Breast and cervical cancer screening in women referred to urban healthcare centers in Kerman, Iran, 2015. Asian Pac J Cancer Prev 2016;17:143-7.  Back to cited text no. 45
    
46.
Jouybari TA, Mahboubi M, Barati M, Aghaei A, Negintaji A, Karami-Matin B. Mammography among Iranian women's: The role of social support and general self-efficacy. Int J Trop Med 2016;11:50-4.  Back to cited text no. 46
    
47.
Tahmasebi R, Noroozi A. Is health locus of control a modifying factor in the health belief model for prediction of breast self-examination? Asian Pac J Cancer Prev 2016;17:2229-33.  Back to cited text no. 47
    
48.
Moshki M, Taymoori P, Khodamoradi S, Roshani D. Relationship between perceived risk and physician recommendation and repeat mammography in the female population in Tehran, Iran. Asian Pac J Cancer Prev 2016;17:161-6.  Back to cited text no. 48
    
49.
Mirzaei-Alavijeh M, Heydari ST, Ahmadi-Jouybari T, Jalilian F, Gharibnavaz H, Mahboubi M. Socio-demographic and cognitive determinants of breast cancer screening. Int J Adv Biotechnol Res 2016;7:1684-90.  Back to cited text no. 49
    
50.
Naghibi A, Jamshidi P, Yazdani J, Rostami F. Identification of factors associated with breast cancer screening based on the PEN-3 model among female school teachers in Kermanshah. Iran J Health Educ Health Promot 2016;4:58-64.  Back to cited text no. 50
    
51.
Ghahramanian A, Rahmani A, Aghazadeh AM, Mehr LE. Relationships of fear of breast cancer and Fatalism with screening behavior in women referred to health centers of Tabriz in Iran. Asian Pac J Cancer Prev 2016;17:4427-32.  Back to cited text no. 51
    
52.
Aminisani N, Fattahpour R, Dastgiri S, Asghari-Jafarabadi M, Allahverdipour H. Determinants of breast cancer screening uptake in Kurdish women of Iran. Health Promot Perspect 2016;6:42-6.  Back to cited text no. 52
    
53.
Farajzadegan Z, Fathollahi-Dehkordi F, Hematti S, Sirous R, Tavakoli N, Rouzbahani R. The transtheoretical model, health belief model, and breast cancer screening among Iranian women with a family history of breast cancer. J Res Med Sci 2016;21:122.  Back to cited text no. 53
[PUBMED]  [Full text]  
54.
Shirzadi S, Nadrian H, Asghari Jafarabadi M, Allahverdipour H, Hassankhani H. Determinants of mammography adoption among Iranian women: What are the differences in the cognitive factors by the stages of test adoption? Health Care Women Int 2017;38:956-70.  Back to cited text no. 54
    
55.
Anbari K, Ahmadi SA, Baharvand P, Sahraei N. Investigation of breast cancer screening among the women of Khorramabad (west of Iran): A cross-sectional study. Epidemiol Biostat Public Health 2017;14:e12099-1.  Back to cited text no. 55
    
56.
Saadat M, Ghalehtaki R, Baikpour M, Sadeghian D, Meysamie A, Kaviani A. The participation rate and contributing factors of screening mammography among (capitalize) female faculty physicians in Tehran, Iran. Int J Cancer Manage 2017;10:e8016.  Back to cited text no. 56
    
57.
Neinavae M, Soltani HR, Soltani N. The relationship between breast self-examination (BSE) awareness and demographic factors in women health management. The Iranian Journal of Obstetrics, Gynecology and Infertility 2017;20:15-22.  Back to cited text no. 57
    
58.
Farzaneh E, Heydari H, Shekarchi AA, Kamran A. Breast and cervical cancer-screening uptake among females in Ardabil, Northwest Iran: A community-based study. Onco Targets Ther 2017;10:985-92.  Back to cited text no. 58
    
59.
Miri M, Moodi M, Miri MR, Sharifzadeh G, Eshaghi S. Breast self-examination stages of change and related factors among Iranian housewives women. J Health Sci Technol 2017;1:41-8.  Back to cited text no. 59
    
60.
Monfared A, Ghanbari A, Jansar Hosseini L, Norozi N. Status of screening by mammography and its related factors in the general population of women in Rasht. Iran J Nurs 2017;30:32-41.  Back to cited text no. 60
    
61.
Mirzaei-Alavijeh M, Ghorbani P, Jalilian F. Socio-cognitive determinants of the mammography screening uptake among Iranian women. Asian Pac J Cancer Prev 2018;19:1351-5.  Back to cited text no. 61
    
62.
Darvishpour A, Vajari SM, Noroozi S. Can health belief model predict breast cancer screening behaviors? Open Access Maced J Med Sci 2018;6:949-53.  Back to cited text no. 62
    
63.
Hayati F, Rouhandeh R. Evaluation of the demographic factors and health beliefs associated with screening mammography in the female employees aged 35 years and more in the schools of medical sciences in Abadan, Iran. Iran J Obstet Gynecol Infertil 2018;21:52-9.  Back to cited text no. 63
    
64.
Mahmoudabadi M, Saeidifar A, Safizadeh H. Breast cancer screening behavior among nurses in Kerman teaching hospitals and its relationship with the health beliefs model scales. Iran Q J Breast Dis 2018;11:57-65.  Back to cited text no. 64
    
65.
Izanloo A, Ghaffarzadehgan K, Khoshroo F, Erfani Haghiri M, Izanloo S, Samiee M, et al. Knowledge and attitude of women regarding breast cancer screening tests in Eastern Iran. Ecancermedicalscience 2018;12:806.  Back to cited text no. 65
    
66.
Kardan-Souraki M, Moosazadeh M, Khani S, Hamzehgardeshi Z. Factors related to breast cancer screening in women in the Northern part of Iran: A cross-sectional study. Open Access Maced J Med Sci 2019;7:637-42.  Back to cited text no. 66
    
67.
Khazir Z, Morrowati Sharifabad MA, Vaezi AA, Enjezab B, Fallahzadeh H, Yari F. Predictors of mammography based on health belief model in Khorramabad women. J Educ Health Promot 2019;8:180.  Back to cited text no. 67
    
68.
Naimi E, Mirzaei-Alavijeh M, Ahmadi-Jouybari T, Ataee M, Aghaei A, Ahmadi Jouybari H. Stage of breast cancer screening adoption; the role of cognitive predictors. Asian Pac J Cancer Prev 2019;20:2373-8.  Back to cited text no. 68
    
69.
HajiKazemi ES, Mohammadi R, Nikpour S, Hosseini F, Meamarian A. Investigating effect of premarital health counseling on females' awareness towards breast and cervical cancer. Iran J Nurs 2006;19:69-76.  Back to cited text no. 69
    
70.
Yeke Fallah L, Zaree E. Effectiveness of teaching by to methods in knowledge about BSE and risk factors of breast cancer in nursing and midwifery students of Qazvin university medical science 2008. J Urmia Nurs Midwifery Fac 2007;5:1-8.  Back to cited text no. 70
    
71.
Saatsaz S, Rezai R, Nazari R, Haji Hosseini F, Seyedi Andi S. Effect of educational intervention on condition of knowledge and practice. Iran Q J Breast Dis 2009;2:28-35.  Back to cited text no. 71
    
72.
Hatefnia E, Niknami S, Mahmoudi M, Ghofranipour F, Lamyian M. The effects of health belief model education on knowledge, attitude and behavior of Tehran pharmaceutical industry employees regarding breast cancer and mammography. J Kermanshah Univ Med Sci 2010;14:42-53.  Back to cited text no. 72
    
73.
Moshfeghi K, Fani I, Bakhshayeshi A, Fani A, Mohammad Beigi A. Comparison of effectiveness of two media and powerpoint methods with review article in increasing knowledge, attitude and practices of Arak physicians about breast cancer. Daneshvar Medicine: Basic and Clinical Research Journal 2011;18:9-16.  Back to cited text no. 73
    
74.
Hajian S, Vakilian K, Najabadi KM, Hosseini J, Mirzaei HR. Effects of education based on the health belief model on screening behavior in high risk women for breast cancer, Tehran, Iran. Asian Pac J Cancer Prev 2011;12:49-54.  Back to cited text no. 74
    
75.
Rahmati Najarkolaie F, Farbod EA, Rimaz S. Effects of training breast-cancer screening on female university students' beliefs. Iran J Obstet Gynecol Infertil 2012;15:10-7.  Back to cited text no. 75
    
76.
Farma KK, Zareban I, Jalili Z, Shahraki Pour M, Lotfi B. The effect of education on condition of knowledge, attitude and preventive behaviors of breast cancer in female teachers at guidance schools in Zahedan. J Health Chimes 2013;1:65-73.  Back to cited text no. 76
    
77.
Ghasemi B, Keivani Z, Yousefifard M. The effect of breast self-examination training on knowledge, attitude and practice of women working in Shahrekord universities in 2010. J Clin Nurs Midwifery 2014;3:30-6.  Back to cited text no. 77
    
78.
Khalili S, Shojaiezadeh D, Azam K, Kheirkhah Rahimabad K, Kharghani Moghadam M, Khazir Z. The effectiveness of education on the health beliefs and practices related to breast cancer screening among women referred to Shahid Behtash clinic, Lavizan Area, Tehran, using health belief model. J Health 2014;5:45-58.  Back to cited text no. 78
    
79.
Torbaghan AE, Farmanfarma KK, Moghaddam AA, Zarei Z. Improving breast cancer preventive behavior among female medical staff: The use of educational intervention based on health belief model. Malays J Med Sci 2014;21:44-50.  Back to cited text no. 79
    
80.
Rezaeian M, Sharifirad G, Mostafavi F, Moodi M, Abbasi MH. The effects of breast cancer educational intervention on knowledge and health beliefs of women 40 years and older, Isfahan, Iran. J Educ Health Promot 2014;3:43.  Back to cited text no. 80
    
81.
Sargazi M, Mohseni M, Safar-Navade M, Iran-Pour A, Mirzaee M, Jahani Y. Effect of an educational intervention based on the theory of planned behavior on behaviors leading to early diagnosis of breast cancer among women referred to health care centers in Zahedan in 2013. Iran Q J Breast Dis 2014;7:45-55.  Back to cited text no. 81
    
82.
Haghighi F, Hoseini SM, Eshaghi S, Naseh G, Tavakoli MR. The effects of education on breast self-examination knowledge, attitude, and practice among the female employees of Birjand University. Mod Care J 2015;12:47-53.  Back to cited text no. 82
    
83.
Absavaran M, Niknami S, Zareban I. Effect of training through lecture and mobile phone on breast self-examination among nurses of Zabol hospitals. Payesh 2015;14:363-73.  Back to cited text no. 83
    
84.
Taymoori P, Molina Y, Roshani D. Effects of a randomized controlled trial to increase repeat mammography screening in Iranian women. Cancer Nurs 2015;38:288-96.  Back to cited text no. 84
    
85.
Sadeghi R, Rezaeian M, Mohseni M. The effect of an educational program based on basnef model on breast self- examination practice of 20-45-year-old women in Sirjan city: A training trial study. J Rafsanjan Univ Med Sci Health Serv 2015;14:769-80.  Back to cited text no. 85
    
86.
Ghahremani L, Mousavi Z, Kaveh MH, Ghaem H. Self-care education programs based on a trans-theoretical model in women referring to health centers: Breast self-examination behavior in Iran. Asian Pac J Cancer Prev 2016;17:5133-8.  Back to cited text no. 86
    
87.
Mirzaii K, Ashkezari SN, Khadivzadeh T, Shakeri MT. Evaluation of the effects of breast cancer screening training based on the systematic comprehensive health education and promotion model on the attitudes and breast self-examination skills of women. Evid Based Care J 2016;6:7-18.  Back to cited text no. 87
    
88.
Parsa P, Mirmohammadi A, Khodakarami B, Roshanaiee G, Soltani F. Effects of breast self-examination consultation based on the health belief model on knowledge and performance of Iranian women aged over 40 years. Asian Pac J Cancer Prev 2016;17:3849-54.  Back to cited text no. 88
    
89.
Khiyali Z, Aliyan F, Kashfi SH, Mansourian M, Khani Jeihooni A. Educational intervention on breast self-examination behavior in women referred to health centers: Application of health belief model. Asian Pac J Cancer Prev 2017;18:2833-8.  Back to cited text no. 89
    
90.
Nahidi F, Dolatian M, Roozbeh N, Asadi Z, Shakeri N. Effect of health-belief-model-based training on performance of women in breast self-examination. Electron Physician 2017;9:4577-83.  Back to cited text no. 90
    
91.
Nasiriani K, Motevasselian M, Farnia F, Shiryazdi SM, Khodayarian M. The effect of telephone counseling and education on breast cancer screening in family caregivers of breast cancer patients. Int J Community Based Nurs Midwifery 2017;5:306-16.  Back to cited text no. 91
    
92.
Savabi-Esfahani M, Taleghani F, Noroozi M, Tabatabaeian M. Role playing for improving women's knowledge of breast cancer screening and performance of breast self-examination. Asian Pac J Cancer Prev 2017;18:2501-5.  Back to cited text no. 92
    
93.
Shahbazi S, Heidari M, Ghafourifard M. Comparison of direct and indirect methods of teaching breast self-examination – Influence on knowledge and attitudes of Iranian nursing and midwifery personnel. Asian Pac J Cancer Prev 2017;18:1157-62.  Back to cited text no. 93
    
94.
Matlabi M, Khajavi A, Askari F, Saberi M. Breast self-examination and the role of education based on stages of change model in changing women's decision. Iran J Obstet Gynecol Infertil 2018;21:42-51.  Back to cited text no. 94
    
95.
Ghaffari M, Esfahani SN, Rakhshanderou S, Koukamari PH. Evaluation of health belief model-based intervention on breast cancer screening behaviors among health volunteers. J Cancer Educ 2019;34:904-12.  Back to cited text no. 95
    
96.
Ghaffari M, Rad TN, Mohammadi S, Rakhshanderou S. Effect of an intervention on the breast cancer screening behavior in women: Application of integrated behavioral model. Int J preve med 2018;9:99.  Back to cited text no. 96
    
97.
Masoudiyekta L, Rezaei-Bayatiyani H, Dashtbozorgi B, Gheibizadeh M, Malehi AS, Moradi M. Effect of education based on health belief model on the behavior of breast cancer screening in women. Asia Pac J Oncol Nurs 2018;5:114-20.  Back to cited text no. 97
[PUBMED]  [Full text]  
98.
Mirmoammadi A, Parsa P, Khodakarami B, Roshanaei G. Effect of consultation on adherence to clinical breast examination and mammography in Iranian women: A randomized control trial. Asian Pac J Cancer Prev 2018;19:3443-9.  Back to cited text no. 98
    
99.
Naserian N, Ansari S, Abedi P. Comparison of training via short messages and group training on level of knowledge and practice of middle-aged women about breast cancer screening tests. J Cancer Educ 2018;33:1036-42.  Back to cited text no. 99
    
100.
Mashhod KN, Jalili Z, Mahmoudi MF. Effectiveness of a theory-based educational intervention on breast self-exam behavior in women who referred to health care centers. Payesh 2018;17:53-6.  Back to cited text no. 100
    
101.
Fathollahi-Dehkordi F, Farajzadegan Z. Health education models application by peer group for improving breast cancer screening among Iranian women with a family history of breast cancer: A randomized control trial. Med J Islam Repub Iran 2018;32:51.  Back to cited text no. 101
    
102.
Alizadeh Sabeg P, Mehrabi E, Nourizadeh R, Poursharifi H, Mousavi S. The effect of counseling on breast cancer awareness in rural Iranian women: A randomized controlled clinical trial. J Cancer Educ 2019;34:1083-91.  Back to cited text no. 102
    
103.
Termeh Zonouzy V, Niknami S, Ghofranipour F, Montazeri A. An educational intervention based on the extended parallel process model to improve attitude, behavioral intention, and early breast cancer diagnosis: A randomized trial. Int J Womens Health 2019;11:1-10.  Back to cited text no. 103
    
104.
Rokhforouz F, Nasirzadeh M, Asadpour M. The effect of educational intervention based on trans-theoretical model on the correct behavior of breast self-examination among health volunteers in rafsanjan city, Iran. J Zanjan Univ Med Sci Health Serv 2019;27:32-9.  Back to cited text no. 104
    
105.
Molaei-Zardanjani M, Savabi-Esfahani M, Taleghani F. Comparing individual and peer education on the constructs of theory of planned behavior in mammography. J Cell Biochem 2019;8:20.  Back to cited text no. 105
    
106.
Miller AB, Harirchi I, Lotfi MH, Noori M, Mirzaei M, Jafarizadea M, et al. Yazd breast cancer project profile; a community based trial for the evaluation of self-examination and physical examination of the breast cancer disease. Iran J Med Sci 2015;40:531-6.  Back to cited text no. 106
    
107.
Saghatchi F, Jafari F, Alizadeh SF, Khatibi F, Bigdeli A. Study of screening mammography frequency and related variables in women referring to the mammography center, Mousavi Hospital, Zanjan. Journal of Human Environment and Health Promotion 2015;1:49-55.  Back to cited text no. 107
    
108.
Alikhassi A, Rahmani M, Ahmadinejad N, Akbari S, Roozafzai F, Habibabadi ZA. Recall rate of opportunistic screening mammography in a university referral breast center in Iran. Iran Red Crescent Med J 2017;19(10).  Back to cited text no. 108
    
109.
Barfar E, Rashidian A, Hosseini H, Nosratnejad S, Barooti E, Zendehdel K. Cost-effectiveness of mammography screening for breast cancer in a low socioeconomic group of Iranian women. Arch Iran Med 2014;17:241-5.  Back to cited text no. 109
    
110.
Shafaie FS, Nagizadeh S, Valizadeh S. Breast cancer screening tests in Tabriz Behbood hospital. Int J Womens Health Reprod Sci 2016;4:134-40.  Back to cited text no. 110
    
111.
Saei Ghare Naz M, Darooneh T, Salmani F, Badr K, Ozgoli G. Relationship of health locus of control with breast cancer screening belief of Iranian women. Asian Pac J Cancer Prev 2019;20:699-703.  Back to cited text no. 111
    
112.
Taymoori P, Berry T. The validity and reliability of Champion's Health Belief Model Scale for breast cancer screening behaviors among Iranian women. Cancer Nurs 2009;32:465-72.  Back to cited text no. 112
    
113.
Khazaee-Pool M, Majlessi F, Montazeri A, Pashaei T, Gholami A, Ponnet K. Development and psychometric testing of a new instrument to measure factors influencing women's breast cancer prevention behaviors (ASSISTS). BMC Womens Health 2016;16:40.  Back to cited text no. 113
    
114.
Moshki M, Shahgheibi S, Taymoori P, Moradi A, Roshani D, Holt CL. Psychometric properties of the mammography self-efficacy and fear of breast cancer scales in Iranian women. BMC Public Health 2017;17:534.  Back to cited text no. 114
    
115.
Poorolajal J, Akbari ME, Ziaee F, Karami M, Ghoncheh M. Breast cancer screening (BCS) chart: A basic and preliminary model for making screening mammography more productive and efficient. J Public Health (Oxf) 2018;40:e118-25.  Back to cited text no. 115
    
116.
Khazaee-Pool M, Bahrami M, Luque JS, Pashaei T, Taymoori P, Roshani D. Validation of the Farsi version of the medical outcomes study-social support survey for mammography. BMC Public Health 2018;18:1280.  Back to cited text no. 116
    
117.
Pourhaji F, Ghofranipour F. Designing and psychometric evaluation of Breast Self-Examination Behavior Predicting Scale (BSEBPS). Int J Cancer Manage 2018;11.  Back to cited text no. 117
    
118.
Heidari Z, Feizi A. Transcultural adaptation and validation of the Persian version of the breast cancer awareness measure (BCAM) questionnaire. Cancer Med 2018;7:5237-51.  Back to cited text no. 118
    
119.
Khazaee-Pool M, Pashaei T, Alizadeh R, Ponnet K. New educational model to promote breast cancer-preventive behaviors (ASSISTS): Development and first evaluation. Cancer Nurs 2019;42:E44-51.  Back to cited text no. 119
    
120.
Akhtar SS, Nadrah HM, Al-Habdan MA, El Gabbani SA, El Farouk GM, Abdelgadir MH, et al. First organized screening mammography programme in Saudi Arabia: Preliminary analysis of pilot round. East Mediterr Health J 2010;16:1025-31.  Back to cited text no. 120
    
121.
Al-Zalabani AH, Alharbi KD, Fallatah NI, Alqabshawi RI, Al-Zalabani AA, Alghamdi SM. Breast cancer knowledge and screening practice and barriers among women in Madinah, Saudi Arabia. J Cancer Educ 2018;33:201-7.  Back to cited text no. 121
    
122.
Asgari P, Bahramnezhad F, Shiri M, Fathi A, Afsharipour G. The effect of group training and e-learning on self-perception in diabetes adolescents. Iran J Nur 2016;29:33-40.  Back to cited text no. 122
    
123.
Canadian Partnership Against Cancer. Report from the Evaluation Indicators Working Group. Guidelines for Monitoring Breast Cancer Screening Program Performance. Canadian Partnership Against Cancer Toronto; 2013.  Back to cited text no. 123
    
124.
Lee EH, Kim KW, Kim YJ, Shin DR, Park YM, Lim HS, et al. Performance of screening mammography: A report of the alliance for breast cancer screening in Korea. Korean J Radiol 2016;17:489-96.  Back to cited text no. 124
    
125.
Yankaskas BC, Klabunde CN, Ancelle-Park R, Renner G, Wang H, Fracheboud J, et al. International comparison of performance measures for screening mammography: can it be done? J Med Screen 2004;11:187-93.  Back to cited text no. 125
    



 
 
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