Breaking down barriers to cancer screening

Jayshree Jhala's breast cancer was detected early through screening, but people from ethnic minorities are generally less likely to take up the tests

Cancer screening saves lives, and in the UK we benefit from national screening programmes for breast, cervical and bowel cancer. But the success of screening depends on actually getting people to take up the offer of testing.

But researchers have found that some ethnic minorities are less likely to take up screening than the white population – meaning that their cancers are often diagnosed at a later stage, when they’re harder to treat.

So far there hasn’t been much research in the UK into the reasons why people from ethnic minority groups are less likely to take up screening, or go to the doctor with cancer symptoms. A few small studies, mainly from the US, suggest that fatalism (the belief that cancer is predetermined) plays a part.

And there are also pervading attitudes that cancer is a taboo subject, with significant stigma attached to the disease. But there are almost certainly other factors at play, such as language and cultural barriers, and gender roles.

To investigate this further, we’re funding Dr Laura Marlow from our Health Behaviour Research Centre at University College London to look at why this happens, with the hope of finding ways to reduce this inequality.

Investigating beliefs about cancer

For this project, Dr Marlow will be interviewing a total of 55 Indian, Caribbean and white British women, to discuss their views about cancer symptoms and screening. The women in the study will be recruited from community and faith groups, and range in age from 30 to 60, to get a spread across those eligible for cervical and breast screening.

Dr Marlow plans to probe these women’s beliefs about cancer and find out how they affect their views on cancer screening or other preventative or early detection measures. This will give the research team an idea of some of the main issues to investigate in larger groups.

Casting her net wider, the next step is to survey another 300 women – 100 from each ethnic group – to discover their beliefs about cancer, and how they shape their behaviour with respect to screening and symptoms. And then the study will extend even further, interviewing 500 women from a wider range of ethnic groups (including Indian, Pakistani, Bangladeshi, African and Caribbean) about their views on cancer, screening, stigma and fatalism.

Spotting cancer early, saving lives

Two of our key goals are to see cancer diagnosed earlier by 2020, and to tackle cancer in low income and minority communities. It’s only through research like this that we can understand some of the barriers that prevent people in ethnic minority groups from taking up screening, or going to the GP with symptoms.

If we can find out exactly how people in different groups perceive cancer and cancer screening, then together with other organisations, we can produce more effective, targeted health information that addresses these concerns. And by increasing the uptake of screening – and encouraging symptom awareness and prompt appearance at the GP surgery – then we will help to reduce inequalities in cancer survival, and ultimately save lives.

Kat