Barreras y facilitadores para la participación en el cribado de cáncer colorrectal de la población migrante y gitana

Abstract

Objective

To identify barriers and facilitators to participation in the colorectal cancer screening program (CCSP) in the Basque Country among migrant and Roma populations (aged 50-69), and to explore the differential elements of these factors compared with the general population.

Method

We conducted an explanatory–interpretative qualitative study from a socioconstructivist perspective. Data was collected through four focus groups and five triangular groups, with a total of 42 participants, between October 2023 and May 2024, in the Basque Country. A reflexive thematic analysis was done.

Results

Barriers identified among migrant and Roma participants differ from hegemonic population’ ones, including educational, linguistic, sociocultural (beliefs about health and prevention), and gender-related factors (care responsibilities, constructions of masculinity). Personalized and in-person care, along with awareness raising by trusted community figures, emerged as key facilitators. While family history and previous health issues acted as facilitators among the hegemonic population, those did not have the same effect among migrant and Roma populations.

Conclusions

Participation in the CCSP is constrained by educational, linguistic, sociocultural, and gender-related barriers, manifested in care responsibilities and models of masculinity. An intersectional perspective is essential to understanding how gender, socioeconomic status, and race or ethnicity influence participation in screening programs. The barriers and facilitators identified can guide the development of targeted outreach strategies to engage these communities, such as in-person care and awareness raising through community figures.