Identifying barriers and facilitators to participation in cancer screening among Irish travellers, a minority ethnic group in Ireland, using a codesigned approach.

Abstract

IntroductionThis study sought to determine participation by eligible Irish Travellers, a minority ethnic group, in the cancer screening programmes in Ireland (bowel, breast and cervical screening) and to determine barriers/facilitators to screening.MethodologyThis study was co-designed with the National Cancer Control Programme (NCCP) and Pavee Point Traveller and Roma Centre, Ireland. A survey questionnaire, adapted from the NCCP's 2022 National Survey on Cancer Awareness, was disseminated to Travellers via Traveller Community Health Workers (TCHWs).ResultsA total of 574 survey questionnaires were distributed across 12 different Primary Health Care Traveller Projects in the Republic of Ireland and 483 (84%) were returned completed; 148 (30.6%) were from men and 306 (63.1%) from women (6.3%, missing data). High proportions had ever attended breast (72.6%) and cervical (65.4%) screening. Bowel screening uptake was low in both men (12.5%) and women (19.2%). Low proportions recalled receiving an invitation to programmes. The faecal immunochemical test test used in the BowelScreen programme prompted embarrassment as a barrier in eligible men (62.5%); embarrassment was lower in women for bowel (38.5%), breast (32.9%) and cervical (30.4%) screening. Fear was the second highest barrier. The main facilitators of screening attendance were talking to TCHW and an invitation respectively, particularly in women eligible for bowel (50%; 53.8%), breast (49.3%; 50.7%) and cervical screening (47.6%; 48.2%), but lower in men (25%; 37.5%); 25% cited the family doctor as facilitator.ConclusionTravellers face barriers accessing mainstream health services; easy access to screening must be ensured. The TCHW is a key facilitator. There is a need for universal ethnic identifiers to facilitate routine monitoring of participation and outcomes for Travellers in screening.