Challenges of Providing Cervical Cancer Prevention Programs In Iran: A Qualitative Study

Background: Cervical cancer has become a major public health problem worldwide. Iran, like other developingcountries, is facing a number of challenges in managing the disease. This qualitative study documents challengesencountered in cervical cancer preventing programs in Iran. Materials and Methods: In-depth interviews wereconducted with 28 participants including eleven patients with cervical cancer, three gynecologic oncologists, fivespecialists in Obstetrics and Gynecology, five midwives, three health care managers and one epidemiologist inMashhad Iran, between May and December of 2012. The sample was selected purposively until data saturationwas achieved. Data credibility verified via allocated sufficient time for data collection, using member checkingand peer debriefing. Data analysis was carried out using conventional content analysis approach with ATLAS. tisoftware. Results: Findings from data analysis demonstrated 2 major themes and 6 categories about challenges ofproviding cervical cancer prevention programs including: individual and social challenges (cognitive/behavioralchallenges and socio/cultural challenges) and health system challenges (stewardship, financing, competency ofhealth care providers and access to services). Each category included some subcategories. Conclusions: Managingthe cervical cancer prevention programs need to include the consideration of individuals, health care providersand health system challenges. Addressing the low level of knowledge, negative attitudes, socio cultural challenges,Poor intersectional collaboration and coordination and intra-sectional management, financing and competencyof health care providers are essential steps toward significantly reducing the burdens of cervical cancer.     

Women's perceptions and social barriers determine compliance to cervical screening: results from a population based study in India

BACKGROUND: Success of cervical screening initiatives depends on high participation of the target population, which in turn is determined by the women's perceptions, health orientation and other socio-cultural issues. The present study identifies the immediate social and cultural barriers that prevent women to attend cervical screening facilities. METHODS: Women non-compliant to a community-based cervical screening program were identified. From them 500 were randomly selected for interview using a structured questionnaire that was designed on the basis of feedbacks received from several focused group discussions. Questionnaire listed 24 possible reasons for non-compliance. The women were asked to select the most pertinent reason(s) for her non-attendance or to reveal if they had any reason other than the listed ones. RESULTS: A total of 469 non-compliant women were interviewed. They had significantly lower literacy rate compared to the compliant women (OR=2.25; 95% CI: 1.23-4.13). Nearly half of the interviewed women responded that they themselves opted to stay away from the program. Most common reasons cited for non-attendance in this group were reluctance to go for medical test in the absence of any symptoms and apprehension to have a test that detects cancer. Second major group of responders comprised of women who were willing, yet could not attend due to various hurdles. Most common hurdles were inability to leave household chores, pre-occupation with family problems and lack of approval from husbands. CONCLUSIONS: Modification of health behavior through education and social empowerment of women are essential for a population based cervical screening program to succeed in India.     

Factors Associated with Delayed Diagnosis of Cervical Cancer in Iran - a Survey in Isfahan City

Background: In the absence of routine screening program for cervical cancer in Iran and high rate of diagnosedcancer in its advanced stage, recognition of sociodemographic factors related to delayed diagnosis of cancer in Irancould be helpful in reducing the burden of disease in our community. The aim of this study was to determine thestage of cervical cancer at diagnosis and factors related to delayed diagnosis of cervical cancer in Isfahan, Iran.Materials and Methods: In this cross sectional study women diagnosed with cervical cancer for the first time byhisto-pathological examination were enrolled. According to the clinical and paraclinical findings and staging ofthe cancer, they were classified into early and delayed diagnosis of cervical cancer. Sociodemographic factorswere compared in the two groups. Results: In this study of 55 women mean age was 48.3±12.0. According to ourclassification 6/55 (10.9%) and 49/55 (89.1%) of them had early and delayed diagnosis of cervical cancer. Delayeddiagnosis of the cancer was significantly higher in patients with lower degree of education, lower socioeconomicstatus, having smoker and addict husband and those who did not have a history of Pap smear test (p<0.05).Conclusions: The results of this study indicated risk factors related to delayed diagnosis of cervical cancer. Theaffected women should be targeted for implementation of specialized educational programmes for improvingknowledge and screening test.     

Knowledge and Practices Related to Screening for Breast Cancer among Women in Delhi,India

Background: Breast cancer is a major public health problem globally. The ongoing epidemiological, socio-cultural and demographic transition by accentuating the associated risk factors has disproportionately increased the incidence of breast cancer cases and resulting mortality in developing countries like India. Early diagnosis with rapid initiation of treatment reduces breast cancer mortality. Therefore awareness of breast cancer risk and a willingness to undergo screening are essential. The objective of the present study was to assess the knowledge and practices relating to screening for breast cancer among women in Delhi. Methods: Data were obtained from 222 adult women using a pretested self-administered questionnaire. Results: Rates for knowledge of known risk factors of breast cancer were: family history of breast cancer, 59.5%; smoking, 57.7%; old age, 56.3%; lack of physical exercise, 51.9%; lack of breastfeeding, 48.2%; late menopause, 37.4%; and early menarche, 34.7%. Women who were aged < 30 and those who were unmarried registered significantly higher knowledge scores (p ≤ 0.01). Breast self-examination (BSE) was regularly practiced at-least once a month by 41.4% of the participants. Some 48% knew mammography has a role in the early detection of breast cancer. Since almost three-fourths of the participants believed BSE could help in early diagnosis of breast cancer, which is not supported by evidence, future studies should explore the consequences of promoting BSE at the potential expense of screening mammography. Conclusion: Our findings highlight the need for awareness generation among adult women regarding risk factors and methods for early detection of breast cancer.     

Cervical Cancer Screening: Recommendations for Muslim Societies

Background: The overall cervical cancer incidence rate is low in Iran; however, because of a higher risk of death for cervical cancer, a disease that kills women in middle age, a cervical cancer control program is needed. The aim of this study was to provide consensus recommendation for cervical cancer prevention in Iran and other Muslim societies with low incidences of cervical cancer. Materials and Methods: Through a practical guideline development cycle, we developed six questions that were relevant to produce the recommendation. We reviewed 190 full text records of cervical cancer in Iran (1971 to 2013) of which 13 articles were related to the data needed to answer the recommendation questions. We also reviewed World Health Organization, IARC, GLOBOCAN report, Iran Ministry of Health cancer registry report and 8 available foreign countries guidelines. Lastly, we also evaluated the Pap smear results of 825 women who participated in the Iranian HPV survey, of whom 328 were followed-up after a 5-year interval. Results: The obtained data highlighted the burden of HPV and cervical cancer situation in Iran. Experts emphasized the necessity of a cervical cancer screening program for Iranian women, and recommended an organized screening program with a cytological evaluation (Pap smear) that would start at the age of 30 years, repeated every 5 years, and end at the age of 69 years. Meanwhile, there is no need for screening among women with a hysterectomy, and screening should be postponed to post-partum among pregnant women. Conclusions: An organized cervical cancer screening is a necessity for Iran as more than 500-900 women in middle age diagnosed with an invasive cervical cancer every year cannot be ignored. This recommendation should be taken into account by the National Health System of Iran and Muslim countries with shared culture and behavior patterns. CUBA HPV test could be consideration in countries Muslim country with appropriate budget, resources and facility.     

Knowledge,Attitudes and Practices of Sudanese Women Regarding the Pap Smear Test and Cervical Cancer

Background: Despite the established role of the Pap smear test (PST) in prevention and early detection of cervical cancer, it is still rarely practiced in Sudan. Many challenges hinder the establishment of an effective cervical cancer screening program, including socio-cultural factors. Therefore, this study aimed to investigate the knowledge, attitudes and practices (KAP) of Sudanese women with regard to the Pap smear test and cervical cancer. Materials and Methods: A total of 500 married women aged 14 to 58 years were recruited from obstetric clinics, hospitals and universities in Khartoum in 2014. Data were collected using a standardized, pretested questionnaire that inquired socio-demographic characteristics and their KAP about cervical cancer and the PST. Results: More than 52% of participating women were above 30 years of age, and the majority (78.8%) were university degree holders. A total of 486 (97.2 %) of participants were resident in urban areas of Khartoum State. However about 48% of the respondents had never heard about PST, and only 15.8% of the participants had undergone a Pap smear test previously; 46.6% (233/500) knew that the human papilloma virus (HPV) was the causative agent, but only 39.2% (196/500) had heard about HPV vaccination, and only 11.4% (57/500) had received the vaccine. However 68% of the respondents agreed to do Pap smear if properly informed about the test and 75.4% of the respondents agreed to participate in a cervical cancer screening program. Conclusions: Despite a high educational level, less than half of our participants had accurate knowledge about cervical cancer, HPV, and cervical cancer screening. Health education about cervical cancer, HPV and sexually transmitted infections and the role of PST in cervical cancer prevention are crucial when designing interventions aimed at improving cervical cancer screening for Sudanese women.     

Opportunity for breast cancer screening in limited resource countries: a literature review and implications for Iran

Young age at occurrence and advanced tumour stage at diagnosis should urge health policy makers to focus on strategies that will help to reduce breast cancer burden in Iran. However, fundamental knowledge to select the optimal control strategy is limited. In this review paper we summarize considerations for launching a successful mass screening program in Iran using a thorough search of the literature focusing on screening activities for breast cancer in limited resource countries (LRCs). The Pubmed and Web of Knowledge databases were used for literature searches with the terms "breast neoplasm' and "screening' in combination with "limited resource countries', or "developing countries'. In addition, the bibliographies of selected references were also searched and utilized. More than 200 articles were found from 2005 to June 2011, of which 96 met the inclusion criteria. Papers were reviewed and categorized as follows: necessity and adoption of screening guidelines in LRCs (n=44); pilot implementation and barriers to screening program in LRCs (n=25); knowledge and attitudes on breast cancer and screening behaviour in LRCs (n=27). The results of the reviewed studies show that the rising trend of breast cancer incidence in LRCs has made it a health priority. Financial constraints to implement mammography screening in LRCs promote the use of alternative but less accurate screening modalities such as physical breast examination. Starting a breast cancer screening program in LRCs faces several challenges related to country's resources status, health service capacity and community awareness. Conservative attitudes toward women, fatalism and misconception on breast cancer risk factors and screening behaviour could seriously prohibit women's participation. In conclusion, given the lack of quantitative information and implementation research on breast cancer control in Iran, our ability to give a clear advice for breast cancer screening in Iran is limited. Iran should adopt a tailor-made strategy for mass screening with great emphasis on reducing the number of advanced stage tumours or "down-staging'. Combination of two approaches, clinical breast examination (CBE) and mammography would be promising given the increased competence of health care professional and public awareness. Equally important, a control plan should be started small and expanded gradually.     

Health‐care providers' perceptions,attitudes towards and recommendation practice of cervical cancer screening

In Libya, cervical cancer is ranked third as the most frequent cancer among women with early diagnosis being shown to reduce morbidity and mortality. Health‐care providers can influence women's screening behaviours, and their lack of recommendations for screening can be one of the barriers that affect women's participation in screening programmes. This study aims to assess the health‐care provider's perception around cervical cancer screening. In‐depth, face‐to‐face interviews were conducted with 16 health‐care providers, from both public and private sectors in Az‐Zawiya city, Libya, between February and July of 2014. The interviews were recorded and transcribed, then analysed using thematic analysis. Our findings suggest that health‐care providers did not provide sufficient information regarding cervical cancer screening for women who attend health‐care facilities. The results highlight the role played by health‐care professionals in motivating women to attend cervical cancer screening programs, and the need for health education of health‐care providers to offer a precious advice regarding the screening. On the other hand, health‐care providers highlighted that implementation of reminding system of cervical cancer screening will support them to improve screening attendance. In addition, health‐care providers stressed the necessity for educational and awareness campaigns of cervical cancer screening among Libyan women.     

Breast and Cervical Cancer Screening and Associated Factors among Older Adult Women in South Africa

Background: Little is known about the cancer screening prevalence and correlates in older adults fromdifferent racial backgrounds. In the context of heightened efforts for prevention and early diagnosis, we collectedinformation on screening for two major types of cancers: cervical and breast cancer in order to establish theirprevalence estimates and correlates among older South African women who participated in the Study of GlobalAgeing and Adults Health (SAGE) in 2008. Materials and Methods: We conducted a national population-basedcross-sectional study with a multi-stage stratified cluster sample of 3,840 individuals aged 50 years or older inSouth Africa in 2008. In this analysis, we only considered the female subsample of (n=2202). The measures usedincluded socio-demographic characteristics, health variables, anthropometric and blood pressure measurements.Multivariable regression analysis was performed to assess the association of socio-demographic factors,health variables and cancer screening. Results: Overall, regarding cervical cancer screening, 24.3% ever hada Papanicolaou (PAP) smear test, and regarding breast cancer screening, 15.5% ever had a mammography.In multivariate logistic regression analysis, younger age, higher education, being from the White or Colouredpopulation group, urban residence, greater wealth, and suffering from two or more chronic conditions wereassociated with cervical cancer screening, and higher education, being from the White or Indian/Asian populationgroup, greater wealth, having a health insurance, and suffering from two or more chronic condtions wereassociated with breast cancer screening. Conclusions: Cancer screening coverage remains low among elderlywomen in South Africa in spite of the national guideline recommendations for regular screening in order toreduce the risk of dying from these cancers if not detected early. There is a need to improve accessibility andaffordability of early cervical and breast cancer screening for all women to ensure effective prevention andmanagement of cervical and breast cancer.     

Exploring the Barriers to Cervical Cancer Screening through the Lens of Implementers and Beneficiaries of the National Screening Program: A Multi-Contextual Study

Background: Cervical cancer is a major reason for morbidity and mortality in Low and Middle income countries. The National Programme for Prevention and Control of Cancers, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS) sets out broad national guideline to implement Cervical cancer screening. However, an implementation strategy for cervical cancer screening is not in place for districts. Although opportunistic screening takes place, implementation is hindered by psychological and physical barriers for women, as well as insufficient capacity on the part of implementers. This qualitative study aims to identify the specific barriers that prevent the uptake of cervical cancer screening. Methods: Women who could benefit from cervical cancer program were interviewed to explore the factors that influenced their uptake of the cervical screening offered. Key informant interviews were conducted with implementers of the NPCDCS and with public health staff of three States (Himachal Pradesh, Meghalaya and Karnataka), to understand their perception of determinants of the utilization of screening services. Results: The general health concern among the participants was low, and routine check-ups were considered unimportant. Poor knowledge about cervical cancer, benefits of screening service availability, as well as a general sense of well-being, embarrassment or anxiety related to the screening procedure, fear of being judged for lack of modesty, and stigma were common barriers to screening uptake. In addition to a general unawareness of cervical cancer geographical inaccessibility of screening as a barrier to participate in cervical cancer screening, in certain regions. Conclusion: It is essential to increase the knowledge on cervical cancer and on the benefits of screening among Indian women. Providing information and cues to action by health workers and professionals can facilitate the decision to participate. Implementers need to be involved to ensure context specific implementation of the National programme to overcome these barriers.     

Factors Associated with a Lack of Knowledge of Performing Breast Self-Examination and Unawareness of Cervical Cancer Screening Services: Evidence from the 2015 Egypt Health Issues Survey

Background: The incidence of breast and cervical cancers is growing rapidly among Egyptian women. In this context, we assessed the prevalence of, and factors associated with the lack of knowledge among Egyptian females of performing breast self–examination (BSE) and unawareness of cervical smear cancer screening services. Methods: Secondary data analysis was performed on a representative population-based sample of 7,518 Egyptian females aged 15–59 years from the 2015 Egypt Health Issues Survey (EHIS). Crude and adjusted odds ratios (aOR) were used to explore the relationship between sociodemographic variables and having a lack of knowledge of performing BSE or unaware of cervical smear cancer screening service amongst 6,572 and 6,942 Egyptian females aged 21–59 years, respectively. Results: Mean age of females was 36.9 years with 62% aged between 21–39 years. The proportion of women with a lack of knowledge of performing BSE or who were unaware of cervical smear cancer screening service was 87.4% and 92.3%, respectively. After adjusting for potential confounding of sociodemographic and obstetric characteristics, young women aged 21–29 years (P<0.001), primary education or below (P<0.001), residing in rural areas (aOR, 1.37 and 1.48, P=0.001), accessing different media outlets "not at all or less than once a week" (aOR, 2.81 and 1.46, P≤0.05), were associated with a greater likelihood of being with lack knowledge of performing BSE or being unaware of cervical smear cancer screening services. Conclusions: In a country burdened with breast and cervical cancers, the majority of Egyptian women have a lack of knowledge on how to perform BSE or were unaware of the available cervical smear cancer screening services. Robust health campaigns are warranted to raise public knowledge of the method of BSE and of cervical smear cancer screening services, especially amongst females aged less than 30 years, with low levels of education, or those living in rural areas.     

Enhancement of the Cervical Cancer Screening Program in Malaysia: A Qualitative Study

Introduction: Cervical cancer has long been known as a preventable disease. Yet it still is a prime women’shealth issue globally. In Malaysia, the current cervical cancer screening program, introduced in the 1960s, hasbeen found to be unsuccessful in terms of Pap smear coverage. The aim of this study is to determine providersperceptives on the program and the feasibility of practicing an organized cervical screening program in Malaysia.Methods: 11 key informant interviews were conducted with policy makers and health care providers from theMinistry of Health in Malaysia from October 2009 to May 2010. Interviewees’ perceptions were explored oncurrent and organized cervical screening program based on their expertise and experience. Results: The resultshighlighted that the existing cervical screening program in Malaysia faced flaws at all levels that failed to reducecervical cancer morbidity and mortality. The identified weaknesses were poor acceptance by women, lack ofcommitment by health care providers, nature of the program, an improper follow-up system, limited resourcesand other competing needs. Complementarily, all interviewees perceived an organized cervical screening programas an alternative approach both feasible and acceptable by women and government to practice in Malaysia.Conclusion: Better screening coverage depends on an effective screening program that incorporates a behaviourbasedstrategy. A new program should be focused in the policy-making context to improve screening coverageand to effectively combat cervical cancer.     

Women’s Cancers in Developing Countries: From Research to an Integrated Health Systems Approach

The article focuses on two women’s cancers, breast and cervical cancer, that are much more deadly indeveloping countries than in developed countries. Early detection can make a significant difference for thetreatment outcome of these two cancers and there are now cost-effective tools for prevention and screening. Theauthors propose a new public health approach to these two cancers in developing countries where resources foreffective cancer control are very limited and offer a framework for putting women’s cancers in developingcountries on the global public health agenda. The key areas are: 1. Proposals for a new, integrated public healthapproach to women’s cancers (breast and cervical) in resource poor settings; 2. Reviews of the evidence forcost-effective screening and early detection of breast and cervical cancer, and discussion of some of the lessonslearned from HIV/AIDS on an integrated health systems approach; 3. Outlines of ways to make a priority ofwomen’s cancers in developing countries on the political agenda of international agencies.     

Health Damaged Context: Barriers to Breast Cancer Screening from Viewpoint of Iranian Health Volunteers

Background: Breast cancer is common among cancer diseases and the second leading cause of death among womenworldwide. The breast cancer-caused death is directly associated with diagnosis time of the disease. Screening is one ofthe major methods for health promotion in human societies. However, many women still refuse to do the periodicscreening. The present study is aimed to analyze the experiences of health volunteers in order to understand the barriers tobreast cancer screening among women at southeast of Iran. Methods: Data collection was performed through focusgroups. Using the purposive sampling method, 24 participants were selected and then were allocated to 6-membergroups. The data were analysed using Lundman and Graneheim qualitative content analysis. Results: The main theme of“Health Damage Context” was extracted with four main categories, including: family barriers, cultural and social barriers,personal barriers and organizational barriers. Conclusion: Based on the results of the present study, there are numerousbarriers to regular breast cancer screening, and for the same reasons, the willingness to screening is sometimes notsatisfactory. Therefore, in case of the women’s referral to health centers, nurses and other health-care professionalsshould inform them about the role of different screening methods in early diagnosis and rapid treatment of breast cancer.     

Cervical Cancer Screening in Iranian Women: Healthcare Practitioner Perceptions and Views

Background: Although regular screening for cervical cancer with the Papanicolaou test is an important element for reducing the incidence and mortality of cervical cancer, the actual screening program in Iranian women is not sufficiently comprehensive at present. The purpose of this study was to explore healthcare provider perceptions of factors affecting cervical cancer screening in Iranian women. Methods: In this qualitative study performed from September 2015 to August 2016 in Hamadan, Iran, we conducted semi-structured in depth interviews with 14 healthcare providers selected purposefully. All interviews were recorded, transcribed and analyzed according to a conventional thematic analysis approach. MAXQDA10 software was employed for data analysis. Results: Four themes were extracted from data: "Inefficient management of cervical cancer screening process, Personal and professional characteristics of health care providers, Individual barriers and facilitators, Need for health system authorities to pay attention". Conclusion: Increased official attention to screening, and identifying challenges and providing strategies based on these challenges will help in achieving a successful screening program. It is necessary to attend to professional features of medical science students and increase the skills of interaction with clients in addition to academic training. Efforts should be made to increase trust in healthcare providers regarding the Pap test and receptiveness of society to this screening modality through informing the public, with encouragement through the media.     

Effects of Group Counseling Based on Health Belief Model on Cervical Cancer Screening Beliefs and Performance of Rural Women in Kaboudrahang,Iran

Objective: Pap smear test is an appropriate screening method for early diagnosis of cervical cancer and reduction of mortality. This study targeted effects of group counseling based on the Health Belief Model on cervical cancer screening practices of Iranian rural women. Method: This quasi-experimental study was conducted on 80 rural women under coverage of the health care centers in rural areas in the city of Kabudrahang, Iran, in 2015. The data collection tool was a researcher-made questionnaire covering demographic information, Health Belief Model (HBM) constructs and screening performance. Data were collected using a multi-stage sampling method. Group counseling was conducted based on the Health Belief Model and the GATHER steps in three sessions for the intervention group. Counseling included an introduction to cervical cancer, disease symptoms, warning signs and prevention approaches. Pap smear testing in both intervention and control groups was evaluated two months after the group counseling. Results: Before the intervention, there was no significant difference between both groups in the HBM constructs and performance. After the intervention, a significant difference was seen in the perceived susceptibility (P<0.001), severity (P=006), benefits (P=012), barriers (P<0.001), and self-efficacy (P=002). Two months after the intervention, 17 patients (42.5%) in the intervention group, and 4 patients (10%) in the control group had undergone a Pap smear test (P<0.001). Conclusion: Design and implementation of counseling programs based on the HBM can modify the beliefs of rural women regarding cervical cancer screening and increase their performance.     

Role of Print and Audiovisual Media in Cervical Cancer Prevention in Bangladesh

Background: Visual inspection of cervix with acetic acid (VIA) is offered at 252 centers in 64 districts ofBangladesh. VIA+ve women are managed at colposcopy clinics of Bangabandhu Sheikh Mujib Medical University(BSMMU) and 14 Medical College Hospitals (MCHs). This research work has been supported by ‘UICC CancerPrevention Campaign’ programme. Objectives: This study explored the role of print materials and electronicmedia to improve cervical cancer screening in the present socio-cultural context of Bangladesh. Methods: Thisstudy was performed from January to August 2011 at two upazilas of Bangladesh (Singair with screening facilityand Sonargaon without screening facility). Data were collected by focus group discussion (FGD) with women,husbands and community people before and after intervention. Information on cervical cancer screening and VIAcamps was disseminated using advertisement through local cable line of the television, microphone announcement,service providers and leaflet throughout the week prior to a VIA camp. Three-day VIA camps were organized atthe upazila health complex (UHC) of both upazilas. Quantitative data was gathered from women at the campson source of information on VIA and the best method of awareness creation. Results: The population was awareof “cancer” and a notable number knew about cervical cancer. Baseline awareness on prevention and VIA waslow and it was negligible where screening services were unavailable. Awareness was increased fourfold in bothupazilas after interventions and half of the women and the majority of the community people became aware ofscreening and available facilities. Cable line advertisement (25.5%), microphone announcement (21.4%), anddiscussion sessions (20.4%) were effective for awareness creation on VIA. Television was mentioned as the bestmethod (37.4%) of awareness creation. Conclusion: Television should be used for nation-wide awareness creation.For local awareness creation, cable line advertisement, microphone announcements and health education atUthan Baithaks/ EPI sessions can easily be adopted by the government.     

Cancer Screening Awareness and Practice in a Middle Income Country; A Systematic Review from Iran

Objective: Ageing population and noticeable changes in lifestyle in developing countries like Iran caused an increase in cancer incidence. This requires organized cancer prevention and screening programs in population level, but most importantly community should be aware of these programs and willing to use them. This study explored existing evidence on public awareness and practice, as well as, adherence to cancer screening in Iranian population. Methods: Major English databases including Web of Science, PubMed, Scopus, and domestic Persian databases i.e., SID, Magiran, and Barakat search engines were searched. All publications with focus on Iranian public awareness about cancer prevention, screening, and early detection programs which were published until August 2015, were explored in this systematic review. For this purpose, we used sensitive Persian phrases/key terms and English keywords which were extracted from medical subject headings (MeSH). Taking PRISMA guidelines into considerations eligible documents, were evaluated and abstracted by two separate reviewers. Results: We found 72 articles relevant to this topic. Screening tests were known to, or being utilized by only a limited number of Iranians. Most Iranian women relied on physical examination particularly self-examination, instead of taking mammogram, as the most standard test to find breast tumors. Less than half of the average-risk adult populations were familiar with colorectal cancer risk factors and its screening tests, and only very limited number of studies reported taking at least one time colonoscopy or FOBT, at most 5.0% and 15.0%, respectively. Around half of women were familiar with cervical cancer and Pap-smear test with less than 45% having completed at least one lifetime test. The lack of health insurance coverage was a barrier to participate in screening tests. Furthermore some people would not select to be screened only because they do not know how or where they can receive these services. Conclusion: Low awareness and suboptimal use of screening tests in Iran calls for effective programs to enhance intention and compliance to screening, improving the patient-physician communication, identifying barriers for screening and providing tailored public awareness and screening programs.