Facilitators and barriers to help-seeking for breast and cervical cancer symptoms: a qualitative study with an ethnically diverse sample in London

Psychooncology. 2014 Jul;23(7):749-57. doi: 10.1002/pon.3464. Epub 2013 Dec 19.


Objective: Earlier diagnosis of cancer has become a policy priority. There is evidence that minority ethnic groups are more likely to delay help-seeking for cancer symptoms, but few studies have explored reasons for delay in these groups. The present study explored facilitators and barriers to help-seeking for breast and cervical cancer in an ethnically diverse sample of women.

Methods: Semi-structured interviews were carried out with 54 healthy women from a range of ethnic backgrounds; Indian, Pakistani, Bangladeshi, Caribbean, African, Black British, Black other, White British and White other. Framework analysis was used to identify themes.

Results: Appraising a symptom as possibly due to cancer was an important facilitator of help-seeking, although for some the prospect of a cancer diagnosis was a deterrent. Women believed that earlier diagnosis improved the chance of survival, and this facilitated prompt help-seeking. A sympathetic GP facilitated help-seeking, and an unsympathetic GP was a deterrent. Some ethnic minority women described the use of alternative medicine and prayer as a first-line strategy that might delay help-seeking. Language barriers, racism and a tendency to 'soldier on' were also mentioned by these women.

Conclusions: Models of delay in presentation for early cancer symptoms are likely to transfer across different ethnic groups. Encouraging open discussion about cancer among minority communities could help raise awareness about the importance of early detection and promote help-seeking as a priority response to a possible cancer symptom.

Keywords: Cancer; Early Detection; Ethnicity; Oncology; Qualitative Research; Signs and Symptoms.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Awareness
  • Breast Neoplasms / diagnosis*
  • Breast Neoplasms / ethnology*
  • Breast Neoplasms / psychology
  • Delayed Diagnosis
  • Ethnicity / psychology*
  • Female
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Interviews as Topic
  • London
  • Middle Aged
  • Patient Acceptance of Health Care*
  • Qualitative Research
  • Uterine Cervical Neoplasms / diagnosis*
  • Uterine Cervical Neoplasms / ethnology*
  • Uterine Cervical Neoplasms / psychology