A Systematic Review of Barriers to Breast Cancer Screening, and of Interventions Designed to Increase Participation, Among Women of Black African and Black Caribbean Descent in the UK.

Abstract

Background: Compared with the general population, Black African and Black Caribbean women, living in the UK, are less likely to participate in breast cancer screening.

Aims: The aims of this review were to: (1) systematically describe the barriers to breast cancer screening, experienced by women of Black African and Black Caribbean descent, living in the UK and (2) identify which barriers interventions attempting to reduce inequalities have targeted, and whether they have been effective at increasing participation in breast cancer screening, among women of Black African and Black Caribbean descent.

Methods: We conducted a mixed-methods systematic review of primary research published in peer-reviewed journals. Seven databases were searched, yielding eight articles for inclusion in the review.

Results: Barriers to breast cancer screening participation were categorised into six analytical themes: 'Understanding of, and concerns about, breast screening, the procedure and the reliability of test results', 'Misconceptions about, and lack of understanding of, the causes of breast cancer and personal risk', 'Emotional responses to cancer and screening', 'General barriers to accessing healthcare services (including breast screening)', 'Beliefs about cancer as a treatable disease' and 'Religious beliefs, cultural taboos and stigma'. These findings derive largely from studies with women who were not eligible for screening. Four studies testing interventions to promote uptake among ethnic minority groups were identified. None of them targeted Black African or Black Caribbean women, specifically; however, it was possible to extract data, for these groups, from the studies.

Conclusion: Further research with women who are eligible for screening (but do not attend) is needed to verify the findings of this review. Studies targeting barriers experienced by Black women, particularly, are needed to reduce inequalities.