Experiences of cervical screening participation and non‐participation in women from minority ethnic populations in Scotland

Abstract

Background The introduction of screening in the UK and other high‐income countries led to a significant decrease in the incidence of cervical cancer and increase in survival rates. Minority ethnic groups are often underrepresented in screening participation for reasons that are poorly understood. Objective To explore experiences of cervical screening participation and non‐participation of women from minority ethnic populations in Scotland and gain insights to support the development of interventions that could potentially support screening participation and thereby reduce inequalities. Design Qualitative comparison group study using in‐depth, semi‐structured individual interviews that were thematically analysed. Setting and participants This study took place in Scotland. Fifty women were purposively sampled from four ethnic minority groups: South Asian; East European; Chinese; and Black African or Caribbean. White Scottish women were also interviewed. Results Many experiences described were common regardless of ethnicity, such as difficulties managing competing priorities, including work and care responsibilities. However, important differences existed across the groups. These included going abroad for more frequent screening, delayed introduction to screening and not accessing primary care services, language difficulties in health‐care settings despite proficiency in English and not being sexually active at screening commencement. Experiences of racism, ignorance and feeling shamed were also reported. Conclusions Key differences exist in the experience of minority ethnic groups in Scotland. These offer potential opportunities to reduce disparity and support screening participation including maximizing co‐incidental interactions and developing outreach work.

Barriers to breast and cervical cancer screening uptake among Black, Asian, and Minority Ethnic women in the United Kingdom: evidence from a mixed-methods systematic review

“…The characteristics of the 13 studies included in the systematic review, such as the study aim, country where the research was conducted, study design, and participant characteristics, were illustrated in Table 3 . In relation to this study focus, out of the 13 studies in this review, 8 studies focused on the range of barriers to breast cancer screening among Black Asian and Minority Ethnic women in the United Kingdom [ 62 – 69 ], whilst 5 studies focused on the barriers to cervical cancer screening among Black Asian and Minority Ethnic women in the United Kingdom [ 29 , 30 , 70 – 72 ].…”

“…In relation to this study focus, out of the 13 studies in this review, 8 studies focused on the range of barriers to breast cancer screening among Black Asian and Minority Ethnic women in the United Kingdom [ 62 – 69 ], whilst 5 studies focused on the barriers to cervical cancer screening among Black Asian and Minority Ethnic women in the United Kingdom [ 29 , 30 , 70 – 72 ].…”

“…Accelerating the uptake of these screenings would require identifying the barriers influencing the non-utilisation of these screening services and providing requisites programmes and plans to overcome the barriers [ 26 – 28 ]. Nevertheless, previous studies conducted on the barriers to the uptake of breast and cervical cancer screenings among Black, Asian, and Minority Ethnic group women in the United Kingdom using either primary or secondary data source; however, to the best of our knowledge, no study has been able to synthesise all the barriers for the last 12 years using a systematic review [ 29 , 30 ].…”

Race-based Versus Race-conscious Medicine in Obstetrics and Gynecology

“…Black and Hispanic individuals in the United States are more likely to die from cervical cancer than all other races. In the United Kingdom, Black and Asian individuals, and those of other ethnic minoritized groups log lower uptakes of cervical screening, which can lead to greater incidences of cervical cancer that may progress to severe disease 21. Although there has been an overall decrease in the incidence and mortality associated with cervical cancer, marked disparities in vaccination, screening, treatment, and overall mortality exist among racial and ethnic minoritized groups, the socioeconomically disadvantaged, and those residing in rural and isolated areas, all of whom are the most vulnerable 22.…”

“…In the United Kingdom, Black and Asian individuals, and those of other ethnic minoritized groups log lower uptakes of cervical screening, which can lead to greater incidences of cervical cancer that may progress to severe disease. 21 Although there has been an overall decrease in the incidence and mortality associated with cervical cancer, marked disparities in vaccination, screening, treatment, and overall mortality exist among racial and ethnic minoritized groups, the socioeconomically disadvantaged, and those residing in rural and isolated areas, all of whom are the most vulnerable. 22 According to the SEER database, between 2012 and 2016, the mortality rate of cervical cancer for Black individuals was 3.5 per 100,000 versus 2.2 per 100,000 for White individuals.…”