Noori, S., & Schouten, B. C. (2018). Perceptions of Iranian women regarding breast cancer screening behavior. Eastern Mediterranean Health Journal, 24, 1165–1171. DOI:


Background: Breast cancer is the leading cause of death among women aged 20–59 years worldwide, with 58% of deaths
occurring in less-developed countries. In the Islamic Republic of Iran, breast cancer constitutes 21% of all cancers, with an
incidence rate of 22 per 100 000 women.
Aims: Since research into breast cancer screening among Iranian women is scarce and results are contradictory, we aimed
to explore women’s’ perceptions regarding breast cancer screening behaviour and provide insights into how breast cancer
is perceived and approached. This could aid policy-makers in drafting effective interventions to stimulate women to perform regular screening.
Methods: We used the Health Belief Model as a theoretical framework. In-depth interviews with 22 women in Tehran
were performed, based on a topic-list exploring the 6 constructs of the Health Belief Model: perceived barriers, perceived
severity, perceived susceptibility, perceived benefits, self-efficacy and cues to action. Data-analysis was based on the Constructive Grounded Theory Method.
Results: The main barriers were fear, low priority and cultural values. Perceived severity was low for the majority of women, while perceived susceptibility was high for about half of them. Perceived benefit of screening was high for all women.
Women’s’ self-efficacy was low when it came to breast self-examination. Talking about breast cancer screening and having
somebody in their environment adopting screening behaviour were important cues for taking up breast cancer screening.
Conclusions: Interventions should focus on diminishing barriers and increasing women’s’ self-efficacy and interpersonal communication about breast cancer screening.

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