National and Sub-national Burden of Breast Cancer in Iran; 1990- 2013

Estimating the burden of diseases، injuries and major risk factors is necessary for adopting appropriate health policies in every country، and this paper aims to explain the study protocol of national and sub-national burden of breast cancer in Iran from 1990 to 2013. We will perform a systematic review of the confirmed databases and literature to gather data on breast cancer epidemiology in Iran. The definitions، data sources، organizing the team، methods of data gathering and data generating will be explained in this paper. The methodology of estimating the trend of prevalence، years of life lost due to premature death (YLLs)، years of life lost due to disability (YLDs) and disability-adjusted life years lost (DALYs) of breast cancer by age groups، provinces and probable inequalities will be explained. We will tackle possible data problems due to the lack of data points on provinces and years and also geographical misalignment by using two advanced statistical methods، namely Bayesian autoregressive multilevel and Spatio-temporal models. Trend estimation will be reported using these two models together with uncertainty intervals. This study provides a comprehensive assessment of breast cancer and its specific pattern in Iran. The results will help policy makers to know the trend of prevalence، the distribution، and the inequalities of breast cancer in Iran to allocate resources in a better way.