title: Priority Setting for Improvement of Cervical Cancer Prevention in Iran.
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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Azam
authors.initials: A
authors.lastname: Majidi
authors.affiliation: Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran.|Oslo Centre for Biostatistics and Epidemiology, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway.
authors.forename: Reza
authors.initials: R
authors.lastname: Ghiasvand
authors.affiliation: Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Maryam
authors.initials: M
authors.lastname: Hadji
authors.affiliation: Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Azin
authors.initials: A
authors.lastname: Nahvijou
authors.affiliation: Department of Genecology Oncology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Azam-Sadat
authors.initials: AS
authors.lastname: Mousavi
authors.affiliation: Department of Reproductive Health, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Minoo
authors.initials: M
authors.lastname: Pakgohar
authors.affiliation: Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Nahid
authors.initials: N
authors.lastname: Khodakarami
authors.affiliation: Deputy of Public Health, Maternal Office, Ministry of Health and Medical Education, Tehran, Iran.
authors.forename: Mehrandokht
authors.initials: M
authors.lastname: Abedini
authors.affiliation: Radiotherapy Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Farnaz
authors.initials: F
authors.lastname: Amouzegar Hashemi
authors.affiliation: Central Reference Laboratory, Ministry of Health and Medical Education, Tehran, Iran.
authors.forename: Marjan
authors.initials: M
authors.lastname: Rahnamaye Farzami
authors.affiliation: Department of Pathology, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Reza
authors.initials: R
authors.lastname: Shahsiah
authors.affiliation: Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Sima
authors.initials: S
authors.lastname: Sajedinejhad
authors.affiliation: Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Mohammad Ali
authors.initials: MA
authors.lastname: Mohagheghi
authors.affiliation: Faculty of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Fatemeh
authors.initials: F
authors.lastname: Nadali
authors.affiliation: Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Arash
authors.initials: A
authors.lastname: Rashidian
authors.affiliation: Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.|Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, Tromsø, Norway.|Department of Research, Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway.|Department of Genetic Epidemiology, Folkhälsan Research Center, Helsinki, Finland.
authors.forename: Elisabete
authors.initials: E
authors.lastname: Weiderpass
authors.affiliation: Department of Gynecology and Obstetrics, Odense University Hospital, Odense, Denmark.
authors.forename: Ole
authors.initials: O
authors.lastname: Mogensen
authors.affiliation: Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran.|Cancer Model Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Kazem
authors.initials: K
authors.lastname: Zendehdel
mesh_terms: D001364:Awareness; D003362:Cost-Benefit Analysis; D055088:Early Detection of Cancer / Q000191:economics / Q000379:methods*; D005260:Female; D006291:Health Policy; D006292:Health Priorities / Q000458:organization & administration*; D006801:Humans; D015994:Incidence; D007349:Insurance, Health, Reimbursement; D007492:Iran / Q000453:epidemiology; D017410:Practice Guidelines as Topic; D062486:Public Health Surveillance; D011786:Quality Control; D012042:Registries; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000453:epidemiology
keywords: Invasive Cervical Cancer (ICC); Iran; Prevention and Control; Priority Setting; Screening