Abstract
BackgroundWomen from ethnic minority backgrounds are less likely to attend cervical screening, but further understanding of ethnic inequalities in cervical screening uptake is yet to be established. This study aimed to explore the socio-demographic and ethnicity-related predictors of cervical cancer knowledge, cervical screening attendance and reasons for non-attendance among Black women in London.MethodsA questionnaire was completed by women attending Black and ethnic hair and beauty specialists in London between February and April 2013. A stratified sampling frame was used to identify Black hair specialists in London subdivisions with >10% Black population (including UK and foreign-born). Fifty-nine salons participated. Knowledge of cervical cancer risk factors and symptoms, self-reported screening attendance and reasons for non-attendance at cervical screening were assessed.ResultsQuestionnaires were completed by 937 Black women aged 18–78, describing themselves as being predominantly from African or Caribbean backgrounds (response rate 26.5%). Higher educational qualifications (p < .001) and being born in the UK (p = .011) were associated with greater risk factor knowledge. Older age was associated with greater symptom knowledge (p < .001). Being younger, single, African (compared to Caribbean) and attending religious services more frequently were associated with being overdue for screening. Women who had migrated to the UK more than 10 years ago were less likely to be overdue than those born in the UK. Of those overdue for screening who endorsed a barrier (67/133), ‘I meant to go but didn’t get round to it’ (28%), fear of the test procedure (18%) and low risk perception (18%) were the most common barriers.ConclusionsEthnicity, migration and religiosity play a role in predicting cervical screening attendance among women from Black backgrounds. African women, those born in the UK and those who regularly attend church are most likely to put off attending. Additional research is needed to explore the attitudes, experiences and beliefs that explain why these groups might differ.Electronic supplementary materialThe online version of this article (doi:10.1186/1471-2458-14-1096) contains supplementary material, which is available to authorized users.
Highlights
Women from ethnic minority backgrounds are less likely to attend cervical screening, but further understanding of ethnic inequalities in cervical screening uptake is yet to be established
Our objectives were i) to explore socio-demographic and ethnicity-related factors associated with cervical cancer knowledge and non-attendance at cervical screening and ii) consider self-reported reasons for non-attendance at screening
We have reported the means for these scores, but because the data were highly skewed participants were recoded into two groups, those who ‘cited’ vs ‘did not cite’ at least 1 correct risk factor/symptom
Summary
Women from ethnic minority backgrounds are less likely to attend cervical screening, but further understanding of ethnic inequalities in cervical screening uptake is yet to be established. This study aimed to explore the socio-demographic and ethnicity-related predictors of cervical cancer knowledge, cervical screening attendance and reasons for non-attendance among Black women in London. Cervical cancer is the fourth most common cancer in women worldwide with a significant burden of mortality, in developing countries [1]. In developed countries such as the US and UK incidence of cervical cancer is much lower, but disparities by socio-economic status, race and ethnicity remain [2,3,4,5]. Qualitative studies suggest lower knowledge of cervical cancer among minority groups could explain low engagement with cancer prevention services, [10] but this has not been explored quantitatively
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