Black women in the UK face lower uptake of NHS breast cancer screening than their white counterparts, new qualitative research from the University of Surrey suggests. The study addresses a persistent public-health gap: only 45% of Black African and Black Caribbean women attend screening compared with 63% of white women.
Researchers investigated why attendance differs by exploring barriers and decision-making processes among women aged 50–71, the age group routinely invited for screening. Using focus groups and interviews, the team gathered data from 47 participants to capture lived experiences rather than relying solely on attendance statistics.
Diagnosing breast cancer early is clinically important because it improves the likelihood of survival. Screening works by detecting abnormalities before symptoms appear, enabling timely diagnostic follow-up and treatment. However, the new findings indicate that awareness alone does not determine participation.
Participants reported uneven knowledge prior to their first invitation, particularly among women born outside the UK. For some, the concept of screening without symptoms felt unclear, raising practical and cognitive questions about why an appointment was needed.
Communication pathways also emerged as critical. Some women expected guidance from general practitioners, especially before reaching screening age, even though screening invitations are managed through national services. The study highlights how trusted relationships in primary care can support brief, preventive conversations.
Religious and cultural beliefs influenced choices in multiple ways. Some participants described concerns grounded in faith narratives about illness, while others framed screening as compatible with religious values. Among Muslim participants, the ability to request a female mammographer was also viewed as a key factor affecting confidence and attendance.
To improve uptake, the research recommends more relatable, culturally relevant materials and reassurance-focused communication. Participants called for flexible appointments and stronger, community-linked coordination between GP practices, screening services, and “community champions” who can translate information into trusted local language.
The researchers argue for co-designed interventions built with Black women rather than designed for them. This approach aims to reduce fear and uncertainty by aligning messaging with community realities, and by addressing logistical obstacles alongside educational content.
The study was published in the British Journal of Cancer. The article DOI is 10.1038/s41416-026-03551-6.
Subject of Research: Breast cancer screening uptake among Black women in the UK
Article Title: Black women’s decisions about participating in breast cancer screening in the UK: A qualitative study
Web References: https://doi.org/10.1038/s41416-026-03551-6
Keywords: breast cancer screening, NHS, Black women, qualitative study, health communication, cultural tailoring, primary care, religious beliefs, mammography uptake
