review · BMC Health Services Research
Breast and cervical cancers remain major public health concerns across Europe, where marginalised and minority populations frequently experience lower uptake of cancer screening programmes. A mixed-methods systematic review analysed thirteen studies published between 2010 and 2022 to investigate obstacles to screening participation among Black, Asian, and Minority Ethnic women throughout the United Kingdom. Using a cluster mapping approach across qualitative and quantitative evidence, thirty-four specific barriers were categorised into five central themes. These primary areas include socio-demographic characteristics, issues within health service delivery, cultural, religious, and language factors, gaps in awareness and knowledge, and challenges concerning emotional, sexual, and family support. Overcoming these identified obstacles is crucial to increasing timely screening participation and realising early detection benefits for minority ethnic women.
Cancer remains a leading cause of mortality worldwide, yet timely screening substantially reduces deaths from breast and cervical cancers. Pinpointing the exact systemic, informational, and cultural obstacles faced by Black, Asian, and Minority Ethnic women provides healthcare providers and public health authorities with clear targets for designing more inclusive, effective, and accessible screening services.
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BACKGROUND: Cancer is currently the leading cause of mortality globally, with new cancer cases estimated at 19.3 million and almost 10 million deaths in 2020. Specifically, breast and cervical cancer incidence and mortality prevalence among women of the minority group or marginalised populations in Europe have continued to be a public health concern due to the low uptake of cancer screening. Thus, this study utilised a mixed-method systematic review to identify barriers to breast and cervical screening uptake among Black, Asian, and Minority Ethnic women in the United Kingdom. METHODS: Databases including PubMed, CINAHL, British Nursing Index, Web of Science, EMBASE, and Scopus databases, were systematically searched for studies on barriers to breast and cervical screening uptake among Black, Asian, and Minority Ethnic women in the United Kingdom published in English between January 2010 to July 2022. This mixed-method systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines in reporting the included studies' results. The cluster mapping approach was used to identify and classify the barriers into themes. RESULTS: Thirteen eligible studies were included in this current review. Seven of the thirteen studies used quantitative cross-sectional research design, while six used qualitative cross-sectional research design. These studies were conducted across the United Kingdom. Five themes were developed from the cluster mapping, and thirty-four sub-theme barriers to the uptake of breast and cervical cancer screening among Black, Asian, and Minority Ethnic women in the United Kingdom were identified. The developed themes in relation to the barriers include; socio-demographic characteristics, health service delivery, cultural, religious & language, the gap in knowledge & awareness, and emotional, sexual & family support. CONCLUSION: The study concluded that barriers in socio-demographic characteristics, health service delivery, cultural, religious and language, the gap in knowledge & awareness, and emotional, sexual & family support were identified as non-uptake of breast and cervical cancer screening among Black, Asian, and Minority Ethnic women in the United Kingdom. Reducing or eliminating these barriers would improve the benefits of timely breast and cervical cancer screening in the United Kingdom.
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DOI: 10.1186/s12913-023-09410-x
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