Barriers to Breast Cancer-Screening Adherence in Vulnerable Populations

Abstract

Breast cancer screening through periodic mammography has been effective in decreasing mortality and reducing the impact of this disease. However, adherence to screening does not meet the desired expectations from all populations. The main objective of this review is to explore the barriers that affect adherence to breast cancer–screening programs in vulnerable populations according to race and/or ethnicity in order to propose measures to reduce the lack of adherence. We conducted a search of publications in the PubMed Central and Scopus databases. The eligible criteria for the articles were as follows: original quantitative studies appearing in SJR- and/or JCR-indexed journals from 2016 to 2021 in English or Spanish. Most of them present common barriers, such as race/ethnicity (47%), low socioeconomic (35.3%) and educational levels (29.4%), no family history of cancer and being single (29.4%), medical mistrust and a health information gap (23.5%), lack of private health insurance (17.6%) and not having annual health checks (17.6%). The target populations with the lowest adherence were Black, Asian, Hispanic and foreign women. Implementing awareness campaigns focused on these populations should be promoted, as well as working on diversity, cultural acceptance and respect with healthcare workers, in order to improve breast cancer–screening adherence worldwide.

Factors Affecting Breast Cancer Screening Behavior Among Women in Saudi Arabia: A Retrospective Cross-Sectional Study

“…Ponce-Blandón et al highlighted the challenges faced by healthcare workers in handling cultural differences and suggested strategies to educate them about diversity and respect [28]. Ensuring medical confidence in healthcare professionals and systems is crucial for strengthening doctor-patient interactions, increasing satisfaction and adherence to screening, and emphasizing diversity and cultural integration [26][27][28].…”

“…Serral et al emphasized the importance of educating the population, especially susceptible women, about the benefits and risks of breast cancer screening programs so that they could make informed decisions [ 26 ]. Furthermore, to minimize adherence to screening programs, it is advised that women who often ignore screening get yearly health checkups [ 27 ]. Collaborating with healthcare providers is critical for enrolling individuals who satisfy eligibility requirements.…”

“…Collaborating with healthcare providers is critical for enrolling individuals who satisfy eligibility requirements. Addressing the health information gap and building confidence in healthcare organizations are also critical [ 27 ]. Ponce-Blandón et al highlighted the challenges faced by healthcare workers in handling cultural differences and suggested strategies to educate them about diversity and respect [ 28 ].…”

What are the barriers towards cervical cancer screening for vulnerable women? A qualitative comparative analysis of stakeholder perspectives in seven European countries

“…The latter was similarly identified as a barrier within breast cancer screening in vulnerable populations. 43 In Denmark, Estonia, France, Italy and Portugal, which have higher GDP, the common barriers are related to providers’ insufficient cultural and relational competencies in encounters with vulnerable women. According to McCormack et al , 44 the need to integrate person-centred approach in healthcare has long been recognised.…”

Multicancer Early Detection Tests: An Overview of Early Results From Prospective Clinical Studies and Opportunities for Oncologists

“…Barriers to optimal implementation and support of these screening programs in the primary care setting are well-documented. [21][22][23] Evidence suggests that PCPs generally feel inadequately supported by staff and electronic systems while feeling uncertain about their responsibility, with less than half of surveyed PCPs reporting that they were very satisfied with the process of managing abnormal screening results for any cancer type. 24 A recent survey revealed that an overwhelming majority of PCPs support patient participation in MCED clinical trials while the majority also have concerns related to management of positive results.…”