Understanding barriers and facilitators to breast cancer screening: insights from South Asian women and general practitioners in Victoria, Australia

Résumé fourni par la source

BACKGROUND: South Asian women, like many other culturally and linguistically diverse populations in Australia, remain under-represented in breast cancer screening, perpetuating inequities in early detection and treatment. To explore perspectives of South Asian women and general practitioners (GPs) to identify barriers, facilitators and strategies to improve breast screening participation. METHODS: A qualitative study using semi-structured interviews was conducted with South Asian women (aged 35-65 years) and GPs in Victoria, Australia. Data were analysed using inductive and deductive reflexive thematic analysis, with findings mapped to the individual, interpersonal, organisational, community and policy levels of the Socio-Ecological Model, and interpreted using the Consolidated Framework for Implementation Research. Reporting followed the COREQ checklist. RESULTS: Thirty-four participants (25 South Asian women and nine GPs) were interviewed. At the individual level, barriers included fear of pain or cancer diagnosis, modesty and competing priorities that reduced breast screening participation; whereas facilitators included preventive attitudes, awareness of the benefits of early detection and autonomy. Interpersonally, limited GP prompting and spousal permission restricted participation, whereas proactive GP communication, shared decision-making and family support encouraged it. Organisational barriers included difficulties navigating screening pathways and long waiting times, whereas cultural sensitivity and availability of female staff facilitated engagement. Community-level barriers included stigma around discussing breast health and language difficulties, whereas trusted translators and leveraging community networks promoted participation. Recommendations from participants for health policy level included proactive GP-patient communication, family-inclusive messaging, promoting awareness of female staff and policy reforms, such as automated, multilingual text reminders. CONCLUSIONS: Breast screening participation is shaped by interacting individual, interpersonal, organisational, community and policy-level factors. Primary care has an important role in improving screening awareness and participation through culturally sensitive communication, proactive screening discussions and community-based outreach strategies.

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