Exploring breast cancer screening barriers among Barbadian women: a focus group study of mammography in a resource-constrained setting

Non-communicable chronic diseases and timely breast cancer screening among women of the Eastern Caribbean Health Outcomes Research Network (ECHORN) Cohort Study

“…Moreover, in Trinidad and Tobago, the use of mammography services is primarily for diagnostics purposes [41, 42]. A study conducted in Barbados demonstrated that women have negative perceptions about mammography, and this may lower screening rates in spite of the accessibility and availability [43]. Future research will need to examine each island context to elucidate factors that may contribute to women’s receipt of timely screening mammography.…”

What do people fear about cancer? A systematic review and meta‐synthesis of cancer fears in the general population

“…Fears about the emotional and physical consequences of a cancer diagnosis were mentioned in more than half of included studies. In a quarter of included studies, participants mentioned fears about how to emotionally ‘handle’ a cancer diagnosis, expecting to feel devastated, anxious, sad, and depressed and having their world fall apart: ‘You can go in there [ie, screening] thinking nothing is wrong and come out with your whole life being changed’ . …”

“…Some were afraid of cancer's spread and feared that it would be too late to stop it by the time it was detected, but fears associated with cancer treatments such as pain, suffering, and bodily changes (including hair loss and resection scars) were more prevalent and were mentioned in more than 40 studies. Chemotherapy and surgery were particularly fearful, partly stemming from cancer encounters in others (see also theme 2). Fear of surgery was also expressed as a fear of having body parts cut off and deformed, particularly if this would be visible to others: ‘[…] I would prefer to die and be buried in one piece than being cut and sold by kilo’ .…”

“…In the context of breast and cervical screening, some women expressed fears of losing intimate body parts. The breasts (and to a lesser extent the cervix) were widely considered to be symbols of femininity and motherhood, and losing these body parts was likened to being ‘less of a woman’:

For many of our informants, the breast was not simply an organ, but a symbol of femininity. Therefore they saw breast cancer as not only threatening their lives, but also their womanhood, since most believed that breast cancer would always lead to the removal of the breasts.

…”

“…Cervical and breast cancer were associated with promiscuous behaviour, provoking fears of social rejection and gossip: ‘[Women] are worried about what will people say, […] questions will be raised and I will have to feel ashamed’ . Some therefore preferred to avoid screening to avoid being diagnosed …”