The Prevalence of Breast Self-Examination Practice Among Women in Iran: A Systematic Review and Meta-Analysis

Breast cancer is one of the leading causes of cancer-related deaths, yet it can be effectively treated if detected early. Various studies investigating the prevalence of breast self-examination (BSE) among women in Iran have yielded varying findings. Thus, this systematic review and meta-analysis aimed to determine the pooled prevalence of BSE practice in Iran.

Scopus, PubMed, EMBASE, Web of Science, Google Scholar, Scientific Information Database (SID), and MagIran databases were systematically searched from June 2023. Two independent authors screened, extracted data, and assessed the quality of articles. Discrepancies were resolved through discussion or consultation with a third reviewer. Heterogeneity was evaluated with the I² index and Cochran Q test. Subgroup analysis was conducted by separating the target population and the region of the country, and meta-regression was performed to explore the relationship between the prevalence of BSE, the year of publication of articles, and the age of women. Meta-regression was used to assess trends over time and age. Publication bias was assessed using a funnel plot and Egger’s test. The random effects meta-analysis was conducted using STATA 17 software.

Eighty-eight studies with 76,453 participants were included to estimate the pooled prevalence of BSE practice. The pooled prevalence of ever and regular BSE practice was 43.4% (95% confidence interval [CI]: 38.6–48.1) and 16.5% (95% CI: 13–20), respectively. The highest prevalence of ever BSE was observed among healthcare workers (57.6%), while the lowest was among women attending health centers (37.1%). Similarly, the highest prevalence of regular BSE was reported among students (21.2%), whereas the lowest prevalence was among women attending health centers (13.7%). From 2000 to 2022, the pooled prevalence of ever BSE practice showed an increasing trend, as determined through meta-regression (p = 0.018). Additionally, there was a significant upward trend in the prevalence of regular BSE practice with the increasing age of women (p = 0.022). Publication bias was insignificant for the ever BSE (p = 0.413).

Despite nearly half (43.4%) of Iranian women reporting ever practicing BSE, the prevalence of regular BSE practice was only 16.5%, which is insufficient given the importance of regular self-examinations in the early detection of breast cancer. These findings highlight the need for implementing programs to enhance awareness about breast cancer and encouraging women to adopt regular BSE as a preventive measure against breast cancer.