68 research outputs found
Economic burden of five common cancers in Iran: a systematic review of cost-of-illness with a focus on healthcare resource utilization
No full textAbstract Background According to the latest World Health Organization report, approximately half of the new cancer cases in Iran are attributed to five common cancers: gastric, breast, colorectal, lung, and prostate cancer. These cancers impose a heavy economic burden on healthcare systems and society, including direct medical costs (DMC), direct non-medical costs (DNMC), and indirect costs (IDC). This systematic review aimed to investigate the economic burden of these cancers in Iran. Methods This systematic review was conducted according to PRISMA guidelines. The search strategy was developed using MeSH terms, Emtree, and previous literature. To identify relevant studies published up until December 27, 2023, searches were conducted in both international databases (PubMed, Scopus, Web of Science, Embase, Cochrane, and the NHS Economic Evaluation Database) and national databases (SID, Magiran, and IranMedex). After removing duplicates and screening studies using Endnote software, eligible studies were selected for inclusion in the review. The costs were converted to USD 2021 using the CCEMG-EPPI-Centre cost converter. Results A total of 22 studies were included in this review. Breast and colorectal cancer each had 4 studies, while prostate, gastric, and lung cancer each had 3 studies. The remaining 5 studies covered a combination of multiple cancers. Converting the costs from different studies to USD 2021 showed that the average annual DMC per patient with breast cancer varied from 34,772. These costs ranged from 28,656 for colorectal cancer, 16,821 for prostate cancer, 17,681 for gastric cancer, and 40,682 for lung cancer. Part of these variations may be related to differences in healthcare resource utilization, while another part may be due to differences in cost calculation methodology, study perspective, and study location. Additional cost conversion findings showed that in 85% of the studies, the average annual DNMC per patient for all cancers were estimated to be less than 100,000 due to high mortality, compared to less than $30,000 for other cancers. Conclusions Given the high prevalence of these five cancers in Iran, their economic burden is significant. Policymakers should focus not only on reducing the disease burden but also on minimizing the economic burden of cancer. Strategies such as improving early detection, optimizing treatment pathways, and implementing cost-effective interventions could help reduce both healthcare costs and the overall financial strain on patients and the healthcare system
The Attitude of Women Visiting Health Centers of the Tehran University of Medical Sciences Toward Breast Cancer
No full textIntroduction: Considering changes in the structure of Iran’s population, the prevalence of cancer is increasing. Increasing social awareness about cancer and screening for common cancers are the most cost-effective approaches for breast cancer prevention and control. Studies show a significantly low rate of regular breast cancer screening behaviors. Given the importance of breast cancer and the decreasing effect of screening methods on the financial burden and disease complications, awareness about their attitude can provide appropriate information for decision- and policy-making about breast cancer screening methods in Iran. This study aimed to investigate the attitude of women over 40 years-old visiting health centers affiliated toward breast cancer screening methods.
Methods: This is a descriptive/analytical study performed cross-sectionally in the health centers affiliated with TUMS. 255 women from Imam Khomeini Hospital Complex and some health centers that were subsidiaries of the south health centers of TUMS, were enrolled. To collect the required data, we developed a questionnaire based on tools used in similar studies. We used the Chi-square test to investigate the relationship of the attitude score with demographic and socioeconomic variables. The statistical analyses in this study were performed in STATA.
Results: 14.5% of the participants had a history of breast cancer, and 18.8% of the participants had a first-degree relative with breast cancer history. About 64.7% of participants underestimated their risk for breast cancer, and 43.1% expressed their concern about breast cancer. About 77.6% of the participants agreed that breast cancers detected earlier are almost treatable. About 18.9% of the participants believed that (agree and highly agree) they will not develop breast cancer in the future, and 47.8% had no idea; 68.2% of the participants disagreed with the item “breast cancer is almost incurable even if detected in early stages;” about 22.0% of them believed that they are at higher risks for breast cancer compared to other women, and 61.3% of the participants agreed to visit a physician in case of feeling pain or a mass in the breast
Conclusion: The attitude of the women’s society toward breast cancer screening is high; this finding can be used in plans aiming to raise awareness and conduct screening in Iran
Cancer research priorities for early diagnosis in Iran: Analyses based on Multiple-Attribute Decision Making Model
No full textIntroduction
National comprehensive cancer control programs combat cancer through different measures, including primary prevention, early detection, treatment, and palliative and supportive care. Among the others, early detection programs seem to be a promising intervention and lead to lower cancer mortality. We define research priorities for the early detection of cancers in Iran.
Methods
We applied the multiple criteria decision-making (MCDM) tools using three key attributes, including "5-year prevalence", "mortality to incidence ration as severity of disease," and "economic burden," to ranked different cancers for research priorities. The priorities were ranked based on four scenarios based on the weighting of the attributes. We also used the differences in the 5-year survival between localized and advanced tumors as the effect of early detection and incorporated it as the decision rule into the priority-setting model.
Results
Gastric cancer and cancers of the brain and nervous system ranked first in all the proposed scenarios. The most and least 5-year survival differences between localized and advanced cancers were observed for the kidney (80.5%) and the brain (3.3%) cancers. The top 10 priorities for early cancer detection in Iran were gastric, prostate, breast, lung, colorectal, ovarian, kidney, bladder, and cervical cancers.
Conclusion
We used a quantitative method and demonstrated the priority areas for research in the early detection of cancer in Iran. Researchers and government may use these results to optimize their research strategies for cancer prevention in Iran.
Cost-effectiveness of different cervical screening strategies in Islamic Republic of Iran: A middle-income country with a low incidence rate of cervical cancer
No full textObjective: Invasive cervical cancer (ICC) is the fourth most common cancer among women worldwide. Cervical screening programs have reduced the incidence and mortality rates of ICC. We studied the cost-effectiveness of different cervical screening strategies in the Islamic Republic of Iran, a Muslim country with a low incidence rate of ICC. Methods: We constructed an 11-state Markov model, in which the parameters included regression and progression probabilities, test characteristics, costs, and utilities; these were extracted from primary data and the literature. Our strategies included Pap smear screening and human papillomavirus (HPV) DNA testing plus Pap smear triaging with different starting ages and screening intervals. Model outcomes included lifetime costs, life years gained, quality-adjusted life years (QALY), and incremental cost-effectiveness ratios (ICERs). One-way sensitivity analysis was performed to examine the stability of the results. Results: We found that the prevented mortalities for the 11 strategies compared with no screening varied from 26 to 64. The most cost-effective strategy was HPV screening, starting at age 35 years and repeated every 10 years. The ICER of this strategy was 8,875 per QALY compared with no screening. We found that screening at 5-year intervals was also cost-effective based on GDP per capita in Iran. Conclusion: We recommend organized cervical screening with HPV DNA testing for women in Iran, beginning at age 35 and repeated every 10 or 5 years. The results of this study could be generalized to other countries with low incidence rates of cervical cancer. � 2016 Nahvijou et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited
Survey of awareness and beliefs about cancer (ABC) in Tehran Province, Iran
No full textIntroduction: Knowledge, attitudes, and practices are essential measures for planning and evaluating cancer control programs. Little is known about these in Iran.
Methods: We conducted a population-based interview survey of adults aged 30–70 using the Farsi version of the Awareness and Beliefs about Cancer questionnaire in the capital province of Tehran, Iran, 2019. We calculated weighted estimates of levels of cancer knowledge, attitudes, and practices to allow for different selection probabilities and nonresponse. We used multivariate logistic regression to understand demographic factors associated with bowel, cervix, and breast screening practices.
Results: We interviewed 736 men and 744 women. The mean number of recalled cancer warning signs was less than one; 57.7% could not recall any cancer warning signs. Participants recognized 5.6 out of 11 early cancer warning signs and 8.8 of 13 cancer risk factors. Most (82.7%) did not know that HPV infection was a cancer risk factor. Approximately, half had negative attitudes towards cancer treatment, but over 80% had positive attitudes towards the effectiveness of screening for improving survival. Colorectal, breast, and cervical screening rates were 24%, 42%, and 49%, respectively. Higher socioeconomic status increased the odds of taking up screening for cancer. Women aged 60–70 were less likely to report taking up breast and cervical screening than younger women.
Discussion: The Iranian population has poor awareness and negative attitudes about cancer, and participation in screening programs is low. Public awareness and early detection of cancer should be promoted in Iran
Mothers’ preferences and willingness-to-pay for human papillomavirus vaccines in Iran: A discrete choice experiment study
No full textThis study aimed to identify mothers’ preferences and willingness-to-pay (WTP) for human papillomavirus (HPV) vaccines (in this case, bivalent and quadrivalent) in Iran. We used a discrete choice experiment (DCE) method to present mothers with choices between two hypothetical profiles of vaccines, described by combinations of five attributes, each with two or three levels. We analyzed the DCE results using conditional logistic regression and measured WTP estimates for each attribute. Our response rate was 53.96%, while the completion rate for questioner was 93.57%. We identified protection against cervical cancer, protection against genital warts, protection duration, serious side effects, and cost to influence mothers’ preferences for HPV vaccination. The relative importance for serious side effects was the highest among all attributes. Mothers’ WTP for bivalent and quadrivalent HPV vaccines was in US 1 = IRR 42,000) and US $ 380, respectively. Quadrivalent vaccination could be the most suitable candidate for implementing the national immunization schedule. The reason is that mothers express more WTP for the quadrivalent vaccine than bivalent due to its protection against genital warts
Additional file 1 of Use of sentiment analysis for capturing hospitalized cancer patients' experience from free-text comments in the Persian language
No full textAdditional file 1. Some parts of the codes
Application of E75 peptide vaccine in breast cancer patients: A systematic review and meta-analysis
No full textEconomic Evaluation of Treatments for Patients with Esophageal Cancer: A Systematic Review
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