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Barriers to cervical cancer screening among ethnic minority women: A qualitative study

Marlow, L; Waller, J; Wardle, J; (2015) Barriers to cervical cancer screening among ethnic minority women: A qualitative study. Journal of Family Planning and Reproductive Health Care , 41 (4) pp. 248-254. 10.1136/jfprhc-2014-101082. Green open access

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Abstract

BACKGROUND: Ethnic minority women are less likely to attend cervical screening. AIM: To explore self-perceived barriers to cervical screening attendance among ethnic minority women compared to white British women. DESIGN: Qualitative interview study. SETTING: Community groups in ethnically diverse London boroughs. METHODS: Interviews were carried out with 43 women from a range of ethnic minority backgrounds (Indian, Pakistani, Bangladeshi, Caribbean, African, Black British, Black other, white other) and 11 white British women. Interviews were recorded, transcribed verbatim and analysed using Framework analysis. RESULTS: Fifteen women had delayed screening/never been screened. Ethnic minority women felt there was a lack of awareness about cervical cancer in their community, and several did not recognise the terms ‘cervical screening’ or ‘smear test’. Barriers to cervical screening raised by all women were emotional (fear, embarrassment, shame), practical (lack of time) and cognitive (low perceived risk, absence of symptoms). Emotional barriers seemed to be more prominent among Asian women. Low perceived risk of cervical cancer was influenced by beliefs about having sex outside of marriage and some women felt a diagnosis of cervical cancer might be considered shameful. Negative experiences were well remembered by all women and could be a barrier to repeat attendance. CONCLUSIONS: Emotional barriers (fear, embarrassment and anticipated shame) and low perceived risk might contribute to explaining lower cervical screening coverage for some ethnic groups. Interventions to improve knowledge and understanding of cervical cancer are needed in ethnic minority communities and investment in training for health-professionals may improve experiences and encourage repeat attendance for all women.

Type: Article
Title: Barriers to cervical cancer screening among ethnic minority women: A qualitative study
Open access status: An open access version is available from UCL Discovery
DOI: 10.1136/jfprhc-2014-101082
Publisher version: http://dx.doi.org/10.1136/jfprhc-2014-101082
Language: English
Additional information: This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/
Keywords: Cervical screening, race, ethnicity, inequalities, barriers
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health > Epidemiology and Public Health
URI: https://discovery.ucl.ac.uk/id/eprint/1458583
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