Breast cancer is the most common cancer diagnosed in women globally. But, in part thanks to screening programmes, over 75% of those diagnosed with breast cancer in England now survive for ten years or more .
Author
- Anietie Aliu
Postgraduate Researcher, Health and Medical Sciences, University of Surrey
However, due to a complex combination of racial disparities in the quality of healthcare patients receive, social factors such as poverty, and differences in tumour biology, Black women in the UK are more likely to die from the disease than women from other ethnicities.
Breast screening improves breast cancer survival by identifying cancer at an earlier stage when it is easier to treat. In the UK, breast screening by mammography is offered free to women who are between the ages of 50 and 71 through the National Health Service Breast Screening Programme .
Research shows that Black women in the UK are less likely to take part in breast screening programmes but are more likely to die from the disease from late diagnosis. So, why are Black women less likely to attend breast screenings when it could help save their lives?
I was part of a team that reviewed all the studies which examined the barriers to breast cancer screening which Black women in the UK experience.
The review found significant gaps in existing research on breast cancer in the Black community and barriers preventing Black African and Black Caribbean women in the UK in partaking in potentially life-saving breast cancer screenings. We reviewed nearly 1,000 papers, but only eight articles included Black women.
The review found that previous research often grouped Black women from diverse backgrounds together, including Black African and Black Caribbean, masking important cultural nuances and different experiences. Additionally, the limited research available primarily focused on women who either attend screenings or who are ineligible, overlooking the crucial perspectives of those who are eligible but do not participate.
As part of our research, we also wanted to identify any effective interventions to improve screening uptake for Black women - but we found no interventions that exclusively targeted Black women.
Our study found that barriers were physical, emotional, cultural and related to healthcare. Black women who believed breast cancer could be treated if caught early were more likely to attend screening. Some of the key barriers, though, seem applicable to women from all ethnic groups. For example, fear of positive diagnosis .
Cancer diagnosis is often seen as a death sentence but we found that Black women, in particular, are less likely to discuss breast cancer. Our review found that fear, stigma and negative perceptions of cancer contributed to a strong culture of silence which hindered responses to screening.
Our review also found that many Black women who participated in the studies placed a high value on family relationships. Some Black African women, for example, were worried that if they were diagnosed and treated for breast cancer their partner might leave them or that their marriage prospects could be negatively affected because potential partners might think that cancer runs in their family.
Barriers from healthcare structure were also flagged. Black women reported difficulties in attending screening appointments during work hours and lack of evening or weekend appointments prevented some women in full-time employment from attending screening.
The review found that knowledge and awareness of breast cancer could be low, especially among some women born outside the UK, some of whom believed they weren't vulnerable to breast cancer because they weren't familiar with it in their country of birth. This shows a need for more culturally sensitive research on breast cancer screening in the Black communities.
To reduce health disparities, then, and to enhance awareness of breast cancer screening, we recommend tailored community health programs and outreach initiatives that resonate with the people they are targeting.
Anietie Aliu is affiliated with University of Surrey Aliu, A.E., Kerrison, R.S. and Marcu, A. (2025), A Systematic Review of Barriers to Breast Cancer Screening, and of Interventions Designed to Increase Participation, Among Women of Black African and Black Caribbean Descent in the UK. Psycho-Oncology, 34: e70093. https://doi-org.surrey.idm.oclc.org/10.1002/pon.70093
