Knowledge, Practice, Preferences and Willingness-to-Pay for Mammographic Screening Tests among Iranian Women: A Contingent Valuation Method.

Objective: This study sought to investigate Iranian women's preferences and willingness-to-pay (WTP) based on the level of breast self-examination and mammography screening practice and knowledge, including risk factors, signs and symptoms, and early detection methods via mammography screening.

Methods: This is a descriptive, cross-sectional, population-based study conducted from October to March 2020 on over 35-year-old women living in Mashhad, selected through the convenient sampling method applied in health centers of Mashhad city. To measure the willingness to pay, the study participants were asked for their preferred choices concerning out-of-pocket payment for screening.

Results: More than one-half (58.6%) of the study's sample size had an intermediate level of knowledge regarding breast cancer's risk factors, and only 12.7% of them had an unsatisfactory level of knowledge. However, most of the participants had a poor level of practice towards breast self-examination and mammography screening. The results of measuring the willingness to pay (WTP) indicated that 11.5% of the participants were not willing to pay at all for mammography breast cancer screening, while 53.3% of the participants were willing to pay 2.27 to 3.41 $U.S, and 35.2% of the participants were willing to pay more than 3.41 $U.S for mammography breast cancer screening.

Conclusion: Any attempt to promote breast cancer screening among Iranian women should primarily focus on increasing such indices as awareness, education, health status, and household income. It should be noted that the majority of the participants possessed an average level of knowledge. Moreover, women lack appropriate information about breast cancer and its' early detection measures. However, it was found that self-employed women were more likely to practice breast self-examination than the women employed in governmental organizations, which could be attributed to the fact that self-employed women could dedicate more time to checking their breasts and practicing breast self-examination.