Attitudes towards a programme of risk assessment and stratified management for ovarian cancer: a focus group study of UK South Asians’ perspectives

Abstract

ObjectivePopulation-based risk assessment, using genetic testing and the provision of appropriate risk management, could lead to prevention, early detection and improved clinical management of ovarian cancer (OC). Previous research with mostly white British participants found positive attitudes towards such a programme. The current study aimed to explore the attitudes of South Asian (SA) women and men in the UK with the aim of identifying how best to implement such a programme to minimise distress and maximise uptake.DesignSemistructured qualitative focus group discussions.SettingCommunity centres across North London and Luton.Participants49 women and 13 men who identified as SA (Indian, Pakistani or Bangladeshi), which constitutes the largest non-European ethnic minority group in the UK.MethodsSeven community-based focus groups were held. Group discussions were transcribed verbatim, coded and analysed thematically.ResultsAwareness and knowledge of OC symptoms and specific risk factors was low. The programme was acceptable to most participants and attitudes to it were generally positive. Participants’ main concerns related to receiving a high-risk result following the genetic test. Younger women may be more cautious of genetic testing, screening or risk-reducing surgery due to the importance of marriage and childbearing in their SA cultures.ConclusionsA crucial first step to enable implementation of population-based genetic risk assessment and management in OC is to raise awareness of OC within SA communities. It will be important to engage with the SA community early on in programme implementation to address their specific concerns and to ensure culturally tailored decision support.

Acceptability of risk stratification within population-based cancer screening from the perspective of healthcare professionals: A mixed methods systematic review and recommendations to support implementation

“…The attitudes of HCPs reported in this review are broadly consistent with the attitudes of the general public towards risk stratification of population-based cancer screening. Overall, risk stratification was seen as acceptable in principle, which is congruent with numerous studies reporting that the public are largely optimistic about risk stratification [7,10,[37][38][39][40][41][42][43][44][45][46][47][48][49][50]. We found that HCPs had some concerns about the evidence for reducing screening for those at low-risk and the psychological and physical implications of reduced or no screening.…”

British South Asian male nurses' views on the barriers and enablers to entering and progressing in nursing careers

“…However, it is critical to note that these findings point to a number of enablers within the intersectional experience of BSA men and nursing. Contrary to the current understanding of ‘traditional South Asian masculinity’ (Everitt‐Penhale & Ratele, 2015; Hann et al, 2018; Kalra, 2009), it may be that BSA men's constructions of masculinity could be seen as an enabler for them being well suited to the nursing profession. As masculinities are constructed differently across different ethnicities (Swami, 2016), BSA masculinity may include aspects such as caring, demonstrating commitment and contributing to one's community which could be seen as aligning with key qualities needed of a good nurse.…”

Systemic Barriers to Risk-Reducing Interventions for Hereditary Cancer Syndromes: Implications for Health Care Inequities

“…81,82 Inclusion of patient stakeholders may also help ensure that interventions are culturally competent and thus effective at influencing risk-reducing behavior. 70,71 Such stakeholder approaches have been successful in designing tailored screening interventions for sporadic CRC in Hispanic populations and hold promise for improving equity of hereditary cancer prevention. 109,110 In conclusion, to narrow health care inequities in genomic medicine, it is critical to reduce barriers to cancer riskreducing interventions, especially in underserved populations.…”

“…Sociocultural attitudes and values about hereditary cancer syndrome interventions may vary by region or by ethnic or racial subpopulation in a given area-especially when it comes to care that affects reproductive organs or secondary sex organs. [70][71][72] This can be the result of cultural stigma surrounding cancer or cultural values around childbearing or the affected organs. 70,[72][73][74] Additional stigma surrounding breast cancer risk exists for men, which may affect their adherence to screening recommendations.…”

“…[70][71][72] This can be the result of cultural stigma surrounding cancer or cultural values around childbearing or the affected organs. 70,[72][73][74] Additional stigma surrounding breast cancer risk exists for men, which may affect their adherence to screening recommendations. 75 The cultural value of traditional medicine may also affect uptake and adherence to Western medical interventions in some populations.…”