https://orcid.org/0000-0003-4295-0824
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ABSTRACT
Background
Gastrointestinal cancers in Iran are among the major non-communicable diseases with a considerable burden on the health system. Changes in lifestyles as well as environmental factors have resulted in the emergence of these cancers.
Objective
To elicit and quantitatively verify experts’ opinions regarding the potential public health impact, feasibility, economic impact, and budgetary impact of gastrointestinal cancer prevention policies in Iran.
Methods
Sixteen experts from Iran were recruited in an email-based, two-round Delphi study. In each round, a questionnaire of policy options for preventing gastrointestinal cancers, which adhered to the new policy framework of the World Cancer Research Fund International, was given to participants. In the first round, experts were asked to provide opinions for and against the policy options. The second round evaluated the policy options for their public health impact, feasibility, economic impact, and budgetary impact.
Results
A total of 32 policy options were organized based on three domains: health-enhancing environments, system changes, and behavior change communications. Of the 32 policy options, there were consensus in 31 (96%) and 30 (93%) options for public health impact and feasibility, respectively. On study completion, experts reached a consensus in 29 of 32 (90%) policy options for economic impact; only on 26 (81%) of these policy options did participants reached consensus for budgetary impact.
Conclusion
Findings indicated that although nearly all policy options reached a consensus for their public health impact, some options are not feasible or do not appear to have an economic rationale for being implemented. Moreover, it is crucial to take into account the inter-sectoral collaboration between health and non-health sectors. Findings from this study can be helpful for health policymakers in identifying support for evidence-informed approaches regarding gastrointestinal cancer prevention.
Responsible Editor
Julia Schr..oders
Responsible Editor
Julia Schr..oders
Acknowledgments
This study was part of NK’s Ph.D. dissertation supervised by AJ and approved and supported financially by Tabriz University of Medical Sciences, Tabriz, Iran. The approval code is IR.TBZMED.REC.1397.618.
Authors’ contributions
AJ designed the study. NK and RK gathered the data and analyzed the data. NK drafted the manuscript. AK provided critical feedback and reviewed and revised the manuscript. MK, AG, and AJ revised the manuscript technically. All authors read and approved the final manuscript.
Disclosure statement
None of the authors have any competing interest
Ethics approval and consent to participate
Ethical approval was gained through Tabriz University of Medical Sciences Ethics Committee (approval number: IR.TBZMED.REC.1397.618). Informed consent was obtained from all individual participants included in the study.
Paper context
Gastrointestinal cancers are one of the deadliest cancers in the world. The current study developed a multifaceted policy package containing 32 policy options to prevent gastrointestinal cancers. Policymakers in Iran and contextually similar countries may use this policy package in preventing these cancers.