Barriers to and discourses about breast cancer prevention among immigrant women in Spain: a qualitative study

Abstract

ObjectivesTo identify knowledge, barriers and discourses about breast cancer screening in Spain among female immigrants from low-income countries and native Spanish women from a low socioeconomic class.DesignQualitative interview study with thematic analysis interpreted using cultural mediators.SettingMallorca, Spain.ParticipantsThirty-six in-depth interviews, using cultural mediators, of immigrant women living in Mallorca who were 50–69 years old and were from Maghreb, Sub-Saharan Africa, Eastern Europe, Latin America, China or were native to Spain and from a low socioeconomic class.ResultsWe analysed the interviews to assess breast cancer perceptions and beliefs, discourses about breast cancer prevention and barriers to accessing breast cancer prevention programmes. Although the women reported an association of breast cancer with death, they acknowledged the effectiveness of early detection. They also exhibited reluctance to talk about cancer. Discourses about cancer prevention tended to be proactive or fatalistic, depending on the woman’s country of origin. For all women, fear of results and lack of time were barriers that limited participation in breast cancer prevention programmes. Language barriers, frequent changes of residence and fear due to status as an irregular (undocumented) immigrant were barriers specific to immigrant women.ConclusionsThe culture of origin affects whether an immigrant has a fatalistic or proactive approach toward breast cancer screening. Immigrants from low-income countries and Spanish natives from a low socioeconomic class experience barriers in access to breast cancer screening. Frequently changing homes is also a barrier for immigrant women.

Factors Influencing Physical Activity Participation among Midlife Immigrant Women: A Systematic Review

“…Other studies also show consistent findings; it has been observed that a lack of time due to work responsibilities is a barrier associated with preventative breast cancer screening among populations of immigrant women in Spain. This is due to the fact that these immigrant women had strict job schedules with job security concerns, resulting in a reluctance to take time off work [ 47 ]. Due to these time constraints among immigrant women, it is imperative that future interventions consider the work schedules and availability of this target population.…”

Breast cancer screening and immigrant women—A scoping review of attendance, knowledge, barriers and facilitators

“…Some women expressed that women from their native countries sometimes are dependent on their husbands to accompany them to the screening centre and it can be difficult for these women to coordinate their screening appointments with their husbands’ schedules (Bhargava, Hofvind, & Moen, 2019). Women expressed prioritizing work, worrying about money and job security and having difficulties taking time off for appointments (March et al, 2018; Suwankhong & Liamputtong, 2018). A fear of discovering that they developed cancer and had to stop working and would not be able to provide for their families was also expressed (March et al, 2018).…”

“…Women expressed prioritizing work, worrying about money and job security and having difficulties taking time off for appointments (March et al, 2018; Suwankhong & Liamputtong, 2018). A fear of discovering that they developed cancer and had to stop working and would not be able to provide for their families was also expressed (March et al, 2018). Some women expressed that mammography is a very expensive procedure in their native country and therefore they never went, other women had their mammograms performed in their native countries when they went back to visit (March et al, 2018).…”

“…The word cancer created fear in some women, and they did not want to talk about it; it was expressed that ‘talking about it might cause it’. Breast cancer was also described as connected with death, lack of effective treatment and being incurable (March et al, 2018). Factors that could increase the risk of developing breast cancer were described by some women as genes, smoking, no exercise, stress and unhealthy diets (Tatari et al, 2020).…”

Challenges of paediatric palliative care in Romania: a focus groups study

“…At the same time, however, we should not ignore the possible persisting cultural stigma around the word “cancer” and “palliative care” in specific. Although cancer, thanks to the many medical improvements, is becoming a chronic disease which can be managed over time, and is thus less stigmatized; studies seem to suggest that in Eastern Europe the word is often still avoided because it is considered as a source of a certain disgrace [ 19 , 31 ]. Unlike for cancer, the stigma surrounding PC seems to be a more global phenomenon which has been frequently reported in previous studies.…”