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Priority Setting for Improvement of Cervical Cancer Prevention in Iran Publisher Pubmed



Majidi A1 ; Ghiasvand R1, 2 ; Hadji M1 ; Nahvijou A1 ; Mousavi AS3 ; Pakgohar M4 ; Khodakarami N5 ; Abedini M6 ; Hashemi FA7 ; Farzami MR8 ; Shahsiah R9 ; Sajedinejhad S10 ; Mohagheghi MA1 ; Nadali F11 Show All Authors
Authors
  1. Majidi A1
  2. Ghiasvand R1, 2
  3. Hadji M1
  4. Nahvijou A1
  5. Mousavi AS3
  6. Pakgohar M4
  7. Khodakarami N5
  8. Abedini M6
  9. Hashemi FA7
  10. Farzami MR8
  11. Shahsiah R9
  12. Sajedinejhad S10
  13. Mohagheghi MA1
  14. Nadali F11
  15. Rashidian A12
  16. Weiderpass E13, 14, 15, 16
  17. Mogensen O17
  18. Zendehdel K1, 18
Show Affiliations
Authors Affiliations
  1. 1. Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran
  2. 2. Oslo Centre for Biostatistics and Epidemiology, Institute of Basic Medical, Sciences, University of Oslo, Oslo, Norway
  3. 3. Department of Genecology Oncology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
  4. 4. Department of Reproductive Health, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
  5. 5. Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  6. 6. Deputy of Public Health, Maternal Office, Ministry of Health and Medical Education, Tehran, Iran
  7. 7. Radiotherapy Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran
  8. 8. Central Reference Laboratory, Ministry of Health and Medical Education, Tehran, Iran
  9. 9. Department of Pathology, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
  10. 10. Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
  11. 11. Faculty of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran
  12. 12. Department of Health Management and Economics, School of Public Health, University of Medical Sciences, Tehran, Iran
  13. 13. Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
  14. 14. Department of Community Medicine, Faculty of Health Sciences, University of Tromso, The Arctic University of Norway, Tromso, Norway
  15. 15. Department of Research, Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway
  16. 16. Department of Genetic Epidemiology, Folkhalsan Research Center, Helsinki, Finland
  17. 17. Department of Gynecology and Obstetrics, Odense University Hospital, Odense, Denmark
  18. 18. Cancer Model Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran

Source: International Journal of Health Policy and Management Published:2016


Abstract

Background: Cervical cancer is the fourth most common cancer among women worldwide. Organized cervical screening and vaccination against human papilloma virus (HPV) have been successful interventions for prevention of invasive cervical cancer (ICC). Because of cultural and religious considerations, ICC has low incidence in Iran and many other Muslim countries. There is no organized cervical screening in these countries. Therefore, ICC is usually diagnosed in advanced stages with poor prognosis in these countries. We performed a priority setting exercise and suggested priorities for prevention of ICC in this setting. Methods: We invited experts and researchers to a workshop and asked them to list important suggestions for ICC prevention in Iran. After merging similar items and removing the duplicates, we asked the experts to rank the list of suggested items. We used a strategy grid and Go-zone analysis to determine final list of priorities for ICC prevention in Iran. Results: From 26 final items suggested as priorities for prevention of ICC, the most important priorities were developing national guidelines for cervical screening and quality control protocol for patient follow-up and management of precancerous lesions. In addition, we emphasized considering insurance coverage for cervical screening, public awareness, and research priorities, and establishment of a cervical screening registry. Conclusion: A comprehensive approach and implementation of organized cervical screening program is necessary for prevention of ICC in Iran and other low incidence Muslim countries. Because of high cost for vaccination and low incidence of cervical cancer, we do not recommend HPV vaccination for the time being in Iran. © 2016 by Kerman University of Medical Sciences.
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