Cervical Cancer Prevention, Its Challenges and Solutions in Iran and Worldwide: A Systematic Review
,
Abstract
Background: Widespread use of screening in high-income countries has led to significant reductions in mortality from cervical cancer. However, in Iran, the main reason for the late diagnosis of cervical cancer was the failure to perform a Pap smear (Papanicolaou). We aimed to investigate the status of cervical cancer prevention and its challenges and solutions in Iran.
Method: We conducted a systematic review of literature published from 1974 to 2021 in the electronic databases, including PubMed, Web of Science, Embase, Scopus, and Google Scholar, and retrieved all English-language articles. Following the application of the inclusion and exclusion criteria, full-text articles were identified and evaluated for eligibility. Finally, these publications were analyzed as part of the synthesis.
Results: Lower social-economic level, inadequate knowledge of screening tests and health centers for Pap test performance leading to worse outcomes such as lower screening participation or coverage.
Conclusion: By addressing these challenges through increasing education, increasing service accessibility, expanding screening programs, improving public awareness, improving insurance coverage, and establishing a control protocol for follow-up, it is possible to reduce cervical cancer incidence and mortality.
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11. Ahmadi R, Karimi Harouni R, Aflak Sir AA (2017). Evaluation of knowledge and attitude of women employees in Shiraz about cervical cancer and Pap smear test. The 4th International Conference on Recent Innovations in Psychology, Counseling and Behavioral Sciences, undefined,
12. Ahmadipour H, Sheikhizade S (2016). Breast and Cervical Cancer Screening in Women Referred to Urban Healthcare Centers in Kerman, Iran, 2015. Asian Pac J Cancer Prev, 17(S3):143-7.
13. Akbari H, Jedi Arani T, Gilasi H, et al (2014). Study of motivational factors and causes of nonparticipation to breast and cervical cancer screening tests among women attending health centers in Kashan city. Journal of Ilam University of Medical Sciences, 22:137-148.
14. Alam M, Mohammad Alizadeh S, Aflatonian MR, Azizzadeh Forouzi M (2007). A survey of knowledge, attitude and practice of health workers in Kerman province in the field of Pap smear test. Medical Journal of Hormozgan 10:379. [In Persian].
15. Allahverdipour H, Emami A (2008). Perceptions of cervical cancer threat, benefits, and barriers of Papanicolaou smear screening programs for women in Iran. Women Health, 47(3):23-37.
16. Amarin Z, Khader Y, Okour A, Jaddou H, Al‐Qutob R (2010). National maternal mortality ratio for Jordan, 2007–2008. Int J Gynaecol Obstet, 111(2):152-156.
17. Arrossi S, Paolino M, Sankaranarayanan R (2010). Challenges faced by cervical cancer prevention programs in developing countries: a situational analysis of program organization in Argentina. Rev Panam Salud Publica, 28(4):249-57.
18. Ashtarian HP, Mirzabeigi EB, Mahmoodi EB, Khezeli MP (2017). Knowledge about Cervical Cancer and Pap Smear and the Factors Influencing the Pap test Screening among Women. Int J Community Based Nurs Midwifery, 5(2):188-195.
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20. Bakht R, Shabairi F, ghodratollah r, Fakuri E (2016). The factors affecting cervical cancer screening among addicted women of Hamedan in 2015: On the basis of Protection Motivation Theory model. Jorjani Biomedicine Journal, 4:68-80.
21. Batson A, Meheus F, Brooke S (2006). Chapter 26: Innovative financing mechanisms to accelerate the introduction of HPV vaccines in developing countries. Vaccine, 24 Suppl 3:S3/219-25.
22. Bayrami R, Taghipour A, Ebrahimipour H (2014). Challenges of providing cervical cancer prevention programs in Iran: A qualitative study. Asian Pac J Cancer Prev, 15(23):10071-10077.
23. Bayrami R, Taghipour A, Ebrahimipour H (2015). Personal and socio-cultural barriers to cervical cancer screening in Iran, patient and provider perceptions: a qualitative study. Asian Pac J Cancer Prev, 16(9):3729-34.
24. Daryani S, Shojaeezadeh D, Batebi A, Charati JY, Naghibi A (2016). The effect of education based on a health belief model in women's practice with regard to the Pap smear test. J Cancer Policy, 8:51-56.
25. De Brouwere V, Tonglet R, Van Lerberghe W (1998). Strategies for reducing maternal mortality in developing countries: what can we learn from the history of the industrialized West? Trop Med Int Health, 3(10):771-82.
26. Dochez C, Al Awaidy S, Mohsni E, Fahmy K, Bouskraoui M (2020). Strengthening national teams of experts to support HPV vaccine introduction in Eastern Mediterranean countries: Lessons learnt and recommendations from an international workshop. Vaccine, 38:1114-1119.
27. Eghbal SB, Karimy M, Kasmaei P, Roshan ZA, Valipour R, Attari SM (2020). Evaluating the effect of an educational program on increasing cervical cancer screening behavior among rural women in Guilan, Iran. BMC Womens Health, 20(1):149.
28. Enjezab B, Faraj khoda T, Mojahed S, Bokaee M (2004). Barriers and Motivators Related to Cervical and Breast Cancer Screening. The Journal of Shahid Sadoughi University of Medical Sciences, 12:78-84.
29. Gahremani Nasab P, Shahnazi M, Farshbaf Khalili A, Ganbari S (2014). Factors Related to Cervical Cancer Screening among Women Referring to Health Centers in Tabriz, Iran 2012. Iranina Journal of Obstetrics Gynecology and Infertility, 16:15-24.
30. Ghahramani M, Alami A, Mohammad Zade Moghaddam H, Moodi M (2018). Screening for Cervical Cancer: An Educational Intervention Based on Transtheoretical Models and Health Belief in Women of Gonabad, Iran. Iranina Journal of Obstetrics Gynecology and Infertility, 21:22-32. [In Persian].
31. Ghaoomi M, Aminimoghaddam S, Safari H, Mahmoudzadeh A (2016). Awareness and practice of cervical cancer and Pap smear testing in a teaching hospital in Tehran. Tehran University Medical Journal, 74:183-189.
32. Glanz K, Bishop DB (2010). The role of behavioral science theory in development and implementation of public health interventions. Annu Rev Public Health, 31:399-418.
33. Hajializadeh K, Ahadi H, Jomehri F, Rahgozar M (2014). The Role of Health Beliefs in Predicting Barriers to Cervical Cancer Screening. Journal of Kerman University of Medical Sciences, 21:416. [In Persian].
34. Hendry M, Lewis R, Clements A, Damery S, Wilkinson C (2013). "HPV? Never heard of it!": a systematic review of girls' and parents' information needs, views and preferences about human papillomavirus vaccination. Vaccine, 31(45):5152-67.
35. Jalalvandi M, Khodadoostan M (2005). Married Women And Pap Smear, What They Know? How They Do? Iran Journal of Nursing, 18:139-144.
36. Jumaan AO, Ghanem S, Taher J, Braikat M, Awaidy SA, Dbaibo GS (2013). Prospects and challenges in the introduction of human papillomavirus vaccines in the extended middle east and North Africa Region. Vaccine, 31 Suppl 6:G58-G64.
37. Kasmaei P, Bab Eghbal S, Atrkare Roshan Z, Estebsari F, Mehrabian F, Karimi M (2014). The effect of health belief model on rural women's Pap smear test. Nursing and Midwifery Journal, 12:401-408.
38. Keshavarz Z, Simbar M, Ramezankhani A (2011). Factors for performing breast and cervix cancer screening by Iranian female workers: a qualitative-model study. Asian Pac J Cancer Prev, 12(6):1517-22.
39. Keshavarz Z, Simbar M, Ramezankhani A, Alavi Majd H (2012). Factors influencing the behavior of female-workers in the reproductive age regarding breast and cervical cancer screening based on the Integrated Model of Planned Behavior and Self-Efficacy: A qualitative approach. Journal of School of Public Health and Institute of Public Health Research, 9:23-36.
40. Keshavarzian K, Barzegari Z (2014). Awareness and practice of women referring to Harris County Health Centers about cervical cancer and Pap smear. Med J Tabriz Uni Med Sciences Health Services, 36:70-73.
41. Khojasteh F (2004). Evaluation of knowledge, attitude and practice of women referring to health centers in Zahedan about Pap smear and cervical cancer. Jundishapur Scientific Medical Journal, -:1-9. [In Persian].
42. Levano W, Miller JW, Leonard B, et al (2014). Public education and targeted outreach to underserved women through the National Breast and Cervical Cancer Early Detection Program. Cancer, 120 Suppl 16(0 16):2591-6.
43. Luciani S, Vardy L, Paci E, Adewole I, Sasco A, Calvacante T (2009). Cancer prevention and population-based screening. Tumori, 95(5):597-609.
44. Majidi A, Ghiasvand R, Hadji M, et al (2016). Priority Setting for Improvement of Cervical Cancer Prevention in Iran. Int J Health Policy Manag, 5(4):225-32.
45. Majidi A, Majidi S, Salimzadeh S, et al (2017). Cancer Screening Awareness and Practice in a Middle Income Country; A Systematic Review from Iran. Asian Pac J Cancer Prev, 18(12):3187-3194.
46. Maseko FC, Chirwa ML, Muula AS (2015). Health systems challenges in cervical cancer prevention program in Malawi. Glob Health Action, 8:26282.
47. Moore MA, Eser S, Igisinov N, et al (2010). Cancer epidemiology and control in North-Western and Central Asia - past, present and future. Asian Pac J Cancer Prev, 11 Suppl 2:17-32.
48. Nahvijou A, Hadji M, Marnani AB, et al (2014). A systematic review of economic aspects of cervical cancer screening strategies worldwide: discrepancy between economic analysis and policymaking. Asian Pac J Cancer Prev, 15(19):8229-37.
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| Files | ||
| Issue | Vol 52 No 11 (2023) | |
| Section | Review Article(s) | |
| DOI | https://doi.org/10.18502/ijph.v52i11.14031 | |
| Keywords | ||
| Cervical cancer Prevention Challenges Systematic review Iran | ||
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Pirani N, Jafari M, Bagherzadeh R, Keikhosravi M, Pirani H. Cervical Cancer Prevention, Its Challenges and Solutions in Iran and Worldwide: A Systematic Review. Iran J Public Health. 2023;52(11):2313-2324.
