Table 1.
Observational studies of breast cancer screening
| First author/city/year of publication | Study design | Study population | Sample size | Mean age (SD) | Instrument | The most important findings |
|---|---|---|---|---|---|---|
| Valizadeh, Tabriz, 2006[19] | Cross-sectional | Nurses in 21 therapeutic centers | 420 | NA | QNR | BSE: 70.2% Frequency of BSE: 39% every 2 months and more |
| Aghababaii, Hamedan, 2006[20] | Cross-sectional | Female nursing and midwifery students | 68 | NA | QNR | BSE (total: 79.4%, regular: 29.4%) |
| Abbaszadeh, Kerman, 2007[21] | Cross-sectional | Females >35 years | 296 | NA | QNR | Total HBM scores in mammography group >the group without mammography |
| Heidari, Zahedan, 2008[22] | Cross-sectional | Females referred to Qouds maternity hospital in Zahedan | 384 | 28.8 (8.4) | INTVW with purposed QNR | BSE (regular: 4.5%, occasionally: 18.7%, never: 76.8%) CBE history: 4.1% Mammography history: 1.3% |
| Simi, Shiraz, 2009[10] | Cross-sectional | Females 25-54 years referred to Shiraz Oil company polyclinic | 300 | Median: 38.5 (14) | QNR | BSE (total: 53.3%, find an abnormal examination: 5.6%, positive finding: 3.8%, did not know how to do: 52.9%, do it incorrect method and time: 3%) |
| Khalili, Tabriz, 2009[23] | Cross-sectional | Females referred to HCCs | 400 | 30.1 (7.4) | QNR, C/L | BSE: 18.8% CBE: 19.1% Mammography: 3.3% |
| Salimi Pormehr, Ardebil, 2010[24] | Cross-sectional | Females referred to HCCs | 300 | 29 (8) | QNR | BSE: 4% CBE: 4.7% Mammography: 3.7% |
| Alavi, Mashhad, 2010[25] | Cross-sectional | Gynecologic specialists and residents | 124 | 43.1 | QNR | BSE: Normal group (regular: 33%, irregular: 44%, never: 23%) High-risk group (regular: 46.7%, irregular: 53.3%) Mammography (normal group: 11.8%, high risk group: 27.1%) |
| Sultan Ahmadi, Kerman, 2010[26] | Cross-sectional | Females referred to HCCs | 200 | 30.60 (7.89) | QNR | BSE: 22.5% CBE: 21.5% |
| Noroozi, Bushehr, 2011[27] | Cross-sectional | Females working in public places of Bushehr | 388 | 34.32 (10.66) | QNR | BSE (total: 37.1%, regular: 7.5%) Mammography: 14.3% CBE: 5.9% |
| Hasani, Bandarabas, 2011[28] | Cross-sectional | Females referred to HCCs | 240 | 37.2 (6.1) | QNR | BSE (total: 31.7%, regular: 7.1%) |
| Yadollahie, 11 cities of Iran, 2011[11] | Cross-sectional | Females referred to HCCs | 3030 | Median: 40 (14) | INTVW, QNR | BSE (total: 49.4%, incorrect method and time: 9.6%, did not know how to do: 30.9%) |
| Samah, Tehran, 2012[29] | Cross-sectional | Asymptomatic females 35-69 years | 400 | NA | QNR | Mammography: 21.5% |
| Harirchi, Semnan and Khorasan, 2012[30] | Cross-sectional | Females >30 years | 770 | 46.91 (13.3) | QNR | The risk of not performing BSE, CBE, mammography for illiterate females were respectively 4.56, 2.51, 3.14, times more than literate females |
| Aflakseir, Shiraz, 2012[31] | Cross-sectional | Female staff at SUMS and SU | 113 | 48 (8.02) | QNR | BSE: 51% Mammography: 21% |
| Moodi, Isfahan, 2012[32] | Survey | Females >40 years | 384 | 52.24 (8.2) | INTVW, QNR | Mammography history: 44.3% |
| Kadivar, Tehran, 2012[33] | Cross-sectional | Female physicians and female nonhealthcare personnel | 196 | Physicians: 46.06 (8.0) Nonhealthcare personnel: 36.97 (9.38) |
QNR | BSE (physicians: 37.6%, nonhealthcare personnel: 26.1%) CBE (physicians: 31.25%, nonhealthcare personnel: 27.59%) mammography (physicians: 18.75%, nonhealthcare personnel: 17.24%) |
| Fouladi, Ardabil, 2013[34] | Cross-sectional | Females referred to HCCs | 380 | 38.12 (6.7) | QNR | BSE: 27% Mammography: 6.8% |
| Pirasteh, Tehran, 2013[35] | Cross-sectional | Married females referring to HCCs | 302 | NA | QNR | BSE in females with high self-efficacy was 1.17 times more than other females |
| Asgharnia, Rasht, 2013[36] | Cross-sectional | Females referring to Al-Zahra hospital | 400 | 48.07 (6.44) | QNR | BSE: 43.8% Mammography: 23.2% |
| Akhtari-Zavare, Hamedan, 2014[37] | Cross-sectional | Females referring to HCCs | 384 | 30 (9.1) | INTVW, QNR | BSE (total: 26%, didn’t know how to do: 72.1%) |
| Hajian-Tilaki, Babol, 2014[38] | Cross-sectional | Females aged 18-64 years | 500 | 31.2 (9.4) | INTVW, QNR | BSE: 38.4% CBE: 25.2% Mammography: 12% |
| Mokhtary, Tabriz, 2014[39] | Cross-sectional | Female HCP of tabriz health centers | 196 | 37.01 (7.54) | QNR | BSE: 73.2% CBE: 10.7% Mammography: 26.9% |
| Nojomi, Tehran, 2014[40] | Cross-sectional | Females referring to HCCs | 1012 | 38.2 | QNR | CBE (history: 22%, intention for doing in future: 75.8%) Mammography (history: 7%, intention for doing in future: 72.1%) |
| Shiryazdi, Yazd, 2014[41] | Cross-sectional | Female health care workers | 441 | 34.7 (13.7) | QNR | BSE (total: 41.9%, regular: 14.9%) Mammography: 10.6% |
| Ghodsi, Hamedan, 2014[42] | Cross-sectional | Females >35 years | 358 | NA | QNR, C/L | Performance: BSE (14.8%, 9.4% regularly), mammography 25.84% |
| Taymoori, Sanandaj, 2014[43] | Cross-sectional | Females >40 years referring to HCCs | 593 | 56.84 (5.04) | QNR | Mammography: 10.5% Most effective factors on Mammography: Self-efficacy and perceived susceptibility |
| Momenyan, Qom, 2014[44] | Cross-sectional | Nursing and midwifery students | 113 | 22.5 (3.7) | QNR | BSE: 63.2% Increasing perceived susceptibility and self-efficacy scores increases the likelihood of BSE |
| Bahrami, Sanandaj, 2015[14] | Cross-sectional | Females >20 years referring to the HCCs | 250 | 36 | QNR | BSE: 13.6% CBE: 4.8% Mammography: 9.6% Main information resources (physician: 62.4%, healthcare team: 16%) |
| Ahmadipour, Kerman, 2016[45] | Cross-sectional | Females referring to urban HCCs | 240 | 31.7 (7) | QNR | BSE (monthly: 25.6%, irregular: 21.8%, never: 52.6%) CBE (every year: 8.5%, irregular: 24.8%, never: 66.7%) Mammography (every year: 5.4%, irregular: 21.6%, never: 73%) |
| Vahedian Shahroodi, Mashhad, 2015[17] | Cross-sectional | Females health volunteer | 410 | 34.7 (9.4) | QNR | Sig relationship between the stages of the change model and BSE (P<0.001) Main information resource: physician and health care staff |
| Tavakoliyan, Kazeroon, 2015[16] | Cross-sectional | Females 20-65 years referring to HCCs | 300 | 39.55 (11.08) | QNR | BSE (regular: 12.7%, never: 48.3%) CBE (more than 5 times: 1.3%, never: 56.3%) Mammography (more than 5 times: 3%, never: 82.3%) Main information resource: Healthcare team and TV |
| Jouybari, Kermanshah, 2016[46] | Cross-sectional | Females referring to urban HCCs | 116 | NA | QNR | Mammography: 12.1% Predicators to undergoing Mammography: Educational level, positive BC_FH, family support, self-efficacy |
| Tahmasebi, Bushehr, 2016[47] | Cross-sectional | Females 20-50 years referred to HCCs | 400 | 27.3 (8.08) | QNR | BSE: 10.9% Predictive factors for BSE: Self-efficacy directly, awareness |
| Moshki, Tehran, 2016[48] | Cross-sectional | Females >50 years referred to mammography centers | 601 | 58.9 (6.4) | QNR | BSE (regular: 15%, irregular: 69.4%, never: 15.6%) CBE (regular: 29.5%, irregular: 54.5%, never: 20%) Mammography (repeated one time: 38%) Effective factors in repeat Mammography: Physician recommendation and BSE |
| Mirzaei-Alavijeh, Abadan, 2016[49] | Cross-sectional | Females 35-50 years referred to HCCs | 385 | 39.12 | QNR | BSE: 19.1% Mammography: 7.5% Predictive factors BC screening: Age, education, BC_FH, perceived severity, self-efficacy |
| Naghibi, Kermanshah, 2016[50] | Cross-sectional | Female high school teachers | 258 | 38.9 (8) | QNR | BSE: 48.1% CBE: 24.8% Mammography: 9.3% |
| Ghahramanian, Tabriz, 2016[51] | Cross-sectional | Females referred to HCCs | 370 | NA | QNR | BSE: 43% CBE: 23% Mammography: 38.2% |
| Aminisani, Baneh, 2016[52] | Cross-sectional | Females >40 years referred to HCCs | 561 | 43.64 (5.17) | QNR | Mammography: 22% |
| Farajzadegan, Isfahan, 2016[53] | Cross-sectional | Females with a BC_FH | 162 | 37.6 (11.16) | QNR | One-third of the participants were in the action/maintenance stages of TTM |
| Shirzadi, Tabriz, 2017[54] | Cross-sectional | Females from three Iranian cities | 1131 | 50.28 (7.93) | QNR | Mammography history: 28% Mammography adoption: 5.6% Predictors for mammography adoption: Perceived barriers, perceived benefits |
| Anbari, khoramabad, 2017[55] | Cross-sectional | Females 20-65 years referred to HCCs | 457 | 35.9 (9.7) | QNR | BSE: 10.3% CBE: 6% Mammography: 2.4% |
| Saadat, Tehran, 2017[56] | Survey | Female academics of TUMS | 99 | 47.79 (8.19) | QNR | BSE: 47.5% Mammography (regular: 7%, once in 2 past years: 24.4%) |
| Neinavae, Karaj, 2017[57] | Cross-sectional | Females referred to Karaj HCCs | 200 | 35.5 (9.7) | QNR | BSE (aware and performed correctly: 48.5%) |
| Farzaneh, Ardabil, 2017[58] | Cross-sectional | Females aged 20-60 years | 1134 | NA | QNR | BSE: 36.7% CBE: 5.6% Mammography: 16.5% |
| Miri, Birjand, 2017[59] | Cross-sectional | Females referred to HCCs | 450 | 30.7 (5.2) | QNR | BSE (preaction: 75.8%, precontemplation: 32.9%, contemplation: 19.6%, preparation: 23.3%, no experience of BSE) |
| Monfared, Rasht, 2017[60] | Cross-sectional | Females residing in Rasht | 1000 | 49.43 (10.18) | QNR | Mammography history: 45% Cause of screening: 68.4% checking health status Cause of not doing screening: 65.3% had no problem, and 3.4% had not enough information |
| Mirzaei-Alavijeh, Kermanshah, 2018[61] | Cross-sectional | Females who referred to HCCs | 408 | 39.61 (8.28) | QNR | Mammography history: 13% |
| Moghaddam Tabrizi, Urmia, 2018[15] | Cross-sectional | Females referred to HCCs | 348 | 43.25 (5.36) | QNR, C/L | Mammography history (never: 12%, at least one: 88%) Main source of information: Doctors |
| Pirzadeh, Isfahan, 2018[9] | Cross-sectional | Female medical students of MUI | 384 | 20.92 (1.26) | QNR | BSE (precontemplation: 42.8%, contemplation: 22%, preparation: 12.8%, action: 13.2%, maintenance: 19%) Didn’t have skills for BSE: 60% |
| Darvishpour, Guilan, 2018[62] | Cross-sectional | Females 20-65 years living in East Guilan cities | 304 | NA | QNR | BSE predictors: perceived benefits, self-efficacy, and perceived barriers Mammography predictors: perceived benefits and perceived barriers |
| Hayati, Abadan, 2018[63] | Cross-sectional | Females >35 years employees of Abadan School of Medical Sciences | 90 | 42.9 (5.8) | QNR | Mammography) total: 24.4%, once: 17.7%, twice or more: 6.7%) |
| Mahmoudabadi, Kerman, 2018[64] | Cross-sectional | Female nurses from Kerman educational hospitals | 209 | 35.53 (8.01) | QNR | BSE: 9.1% CBE: 26.3% Mammography: 15.8% |
| Izanloo, Mashhad, 2018[65] | Cross-sectional | Patients referred to outpatient clinics and people >14 years in public urban areas | 1469 | 38.8 (11.69) | QNR | Main screening methods (self-assessment: 41.6%, ultrasound: 46.4%) |
| Kardan-Souraki, Mazandaran, 2019[66] | Cross-sectional | Females participating in BC screening programs | 1165 | 37.15 (8.84) | QNR | BSE: 62% CBE: 41.1% Mammography: 21.7% |
| Khazir, Khorramabad, 2019[67] | Cross-sectional | Females referred to HCCs | 262 | 49.62 (7.79) | QNR | Mammography: 30.85% Significant relationship between HBM component and mammography behavior |
| Naimi, Kermanshah, 2019[68] | Cross-sectional | Married females clients of eight HCCs | 334 | 39.75 (7.73) | QNR | BC screening adoption (precontemplation: 58.4%, contemplation: 26.9%, preparation: 3%, action: 9.6%, maintenance: 2.1%) |
| Nikpour, Babol, 2019[18] | Cross-sectional | Urban population under the coverage of HCCs | 800 | 47.63 (10.46) | QNR | BSE: 17.5% CBE: 15.3% Mammography: 21.6% Mean 5-year and lifetime risk: 0.89±0.89 and 8.87±3.84 Predicting mammography performance: The high 5-year calculated risk |
HCC=Health Care Center; BC=Breast cancer; MUI=Isfahan University of Medical sciences; TUMS=Tehran University of Medical Sciences; BC_FH=Family history of breast cancer; SUMS=Shiraz University of Medical sciences; HCP=Health care provider; SU=Shiraz University; NA=Not available; QNR=Questionnaire; INTVW=Interview; C/ L=Checklist; BSE=Breast self-examination; CBE=Clinical breast examination; HBM=Health belief model; TTM=Transtheoretical model; SD=Standard deviation; TV=Television