کاظم زنده دل

Breast cancer is one of the most common cancers and a leading cause of death worldwide and in Iran. Mammography is commonly used in breast cancer screening and diagnosis. This study was performed with aim to evaluate the efficacy and cost-effectiveness of mammography, especially the mobile type, in breast cancer screening in Iran.

This study is an overview of reviews. After a systematic search in the databases of Cochrane Library, Trip, Pubmed, CRD and magiran, the appropriate, relevant and up-to-date reports including systematic review, health technology assessment, economic assessment and clinical guidance were found and used.

Mammography sensitivity for breast cancer screening in fixed type was reported between 84% and 96% and in mobile type between 77% and 98%. Its specificity has been reported between 50% and 100% in fixed type and between 92% and 95% in mobile type. In Iran, the use of mammography in the screening program increases the cost by about $ 37,000 per QALY (quality adjusted life years).

Due to the incidence of the disease, mammography is not cost effective in breast cancer screening, although in certain communities, for example, with a relatively high incidence may be cost effective. Mobile mammography is usually more expensive than fixed mammography and its technical performance is not much different, so it may be less cost effective than fixed mammography.

cancer has high prevalent in the world and in Iran. patients with this disease after primary diagnosis and initiation of therapeutic processes experience different problems such as employment status, income changes, change medical decisions related to costs, receiving financial help and organizational support. due to the lack of a Persian questionnaire in this area, this study aimed to design and validity and reliability assessment of change in employment status and income and supportive mechanisms in cancer survivors.

After collecting relevant articles and interviewing experts, an Initial Questionnaire containing 8 dimensions and 46 questions was designed. To standardize and validate the instrument, face validity and content validity methods were used to determine the validity and internal consistency (Cronbach's alpha) and test-retest (intra-class correlation coefficient) were used to determine the reliability. All statistical analyzes were performed by SPSS 22 software.

According to the panel of 15 experts for evaluation content validity of the instrument, based on the Lawche table, the optimal score of content validity ratio and content validity index were considered 0.49 and 0.79 respectively and all of The Questionnaire Questions Were Caught Optimal Score. Also, regarding the reliability of the tool, Cronbach's alpha was confirmed more than 0.7 and internal consistency of questions (Cronbach's alpha 0.78) showed that all Questionnaire questions were highly correlated. Finally, the reliability of the instrument by test-retest method with a correlation coefficient of ICC = 0.81 was significant at P <0.05 level.

This study provided a valid and reliable Persian-language instrument for assessing change in employment status, income and supportive mechanisms in cancer survivors that this valid instrument can be used by researchers in country.