Abstract
BackgroundThe 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.ObjectiveTo 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.DesignQualitative comparison group study using in‐depth, semi‐structured individual interviews that were thematically analysed.Setting and participantsThis 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.ResultsMany 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.ConclusionsKey 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.
Highlights
Cervical cancer is a leading cause of morbidity and mortality in women, with an estimated 570 000 new cases and 311 000 deaths worldwide in 2018.1 cervical cancer is one of the most successfully prevented and treated forms of cancer
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
The decrease in incidence in these countries has not been universal with minority ethnic groups underrepresented in screening uptake and over-represented in cancer incidence compared with the majority White populations in some contexts.6-9 In Canada, access of cancer screening is markedly lower among members of visible minority populations than the White population.[7]
Summary
Cervical cancer is a leading cause of morbidity and mortality in women, with an estimated 570 000 new cases and 311 000 deaths worldwide in 2018.1 cervical cancer is one of the most successfully prevented and treated forms of cancer. The relationship between non-attendance and such barriers is complex with the same barriers reported among individuals who do regularly attend screening.[15,16] Reducing health inequalities, in cancer, is a priority in the UK with screening and early diagnosis key foci.[17,18] Previous studies exploring barriers in cervical screening have been conducted with individual minority and ethnically diverse populations; limited comparisons can be made across the studies to understand how experiences of minority populations differ due to contextual differences. We aimed to gain insights to support the development of interventions to reduce potential inequalities and support screening participation in minority ethnic populations in this region. 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. Conclusions: Key differences exist in the experience of minority ethnic groups in Scotland These offer potential opportunities to reduce disparity and support
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