Improving early detection of breast cancer in Iran: Identifying barriers and proposing policy solutions

Abstract

Background & Aim: Delays in early breast cancer detection increase late-stage presentation, treatment burden, mortality, and costs. Barriers are systemic (access, affordability), individual (fear, awareness), and socio-cultural (stigma, beliefs). This policy brief aims to improve early detection in Iran by identifying barriers and proposing solutions.

Methods & Materials: This policy brief was developed through a multi-phase, evidence-informed study with a multidisciplinary panel. Phase 1 employed a scoping review to identify factors contributing to delayed breast cancer diagnosis globally. Phase 2 utilized semi-structured qualitative interviews with Iranian patients and healthcare providers to explore real-world barriers to early detection. Phase 3 applied an expert consensus approach to prioritize evidence-based, context-specific policy recommendations for improving early breast cancer diagnosis in Iran. The expert panel in Phase 3 comprised specialists from Radiation Oncology, Public Health, Health Education & Promotion, Medical Oncology, and Nursing.

Results: Policy recommendations were derived across five key priority areas: Enhancing equitable access to screening services; Strengthening follow-up and continuity of care systems; Improving health education and awareness; Promoting intersectoral coordination and multisectoral governance; and Ensuring sustainability of resources and digital infrastructure.

Conclusion: Initiating strategies to address these public health recommendations could substantially improve early breast cancer detection rates, reduce mortality, improve patient quality of life, and enhance the overall efficiency of the health system. Moreover, this framework may serve as a scalable model for managing non-communicable diseases in resource-limited settings.