An exploration of the uptake of screening programmes for cancer in Newport West

Cancer is one of the major threats to public health and the second leading cause of death globally. In Wales, population-based cancer screening for breast cancer, bowel cancer, and cervical cancer is offered routinely to eligible population to help improve early detection and reduce mortality. Unfortunately, uptake of cancer screening is below required standards with geographical variation across Wales, highlighting the need to understand why there may be screening inequalities. Commissioned by the Newport West Neighbourhood Care Network (a primary care cluster of GP practices) in Wales, this study sought to understand cancer screening support needs from the perspectives of an eligible population in the area, which has a diverse multicultural population.

Group Concept Mapping (GCM) was used as the research method via Concept Systems GroupWisdomTM software. Three GCM studies (breast/bowel/cervical screening) were run concurrently. In total, 131 participants were recruited across three studies. More than half were from black and minority ethnic groups, of which most did not speak English. Participants completed three activities either online or offline: brainstorming to generate statements via completing a focus prompt ‘Something that would help me go for x screening is….’; sorting statements into conceptually similar categories; rating statements on a 5-point Likert scale against two criteria: perceived importance and accessibility (easy to get).

Variations in responses were found to be based on ethnicity, non-English speaking, disability, and whether a participant had missed screening. Findings from the breast screening study highlight the need to respect women, ensure they feel they can trust staff carrying out breast screening, offer reassurance about women’s experiences of breast screening, and provide practical support, especially individualised/targeted support for people with disability and those who do not speak or read English. Findings from the bowel screening study highlight the importance for GP involvement and the provision of simple instructions as part of the bowel screening test, easy-to-use testing kit, regular routine reminders, and individualised/targeted support for people especially those with disability and those from Black and Minority Ethnic communities. Findings from the cervical screening study highlight the importance of reassuring women about the safety of the cervical screening procedure and their experience of the screening, the need to take into account and respond to cultural diversity, and the provision of individualised/targeted support for people especially those with disability and those who do not speak or read English. These findings can be used in the first instance to inform the development of intervention for primary care services to enhance participation in cancer screening including future commissioning and tailored support and awareness raising initiatives.