Experiences of cervical screening participation and non-participation in women from minority ethnic populations in Scotland

Background
The introduction of screening in the UK and other high-income countries led to a significant decrease in the
incidence of cervical cancer and increase in survival rates. Minority ethnic groups are often underrepresented in
screening participation for reasons that are poorly understood.
Objective
To explore experiences of cervical screening participation and non-participation of women from minority ethnic
populations in Scotland and gain insights to support the development of interventions that could potentially
support screening participation and thereby reduce inequalities.
Design
Qualitative comparison group study using in-depth, semi-structured individual interviews that were thematically
analysed.
Setting and participants
This study took place in Scotland. Fifty women were purposively sampled from four ethnic minority groups: South
Asian; East European; Chinese; and Black African or Caribbean. White Scottish women were also interviewed.
Results
Many experiences described were common regardless of ethnicity, such as difficulties managing competing
priorities, including work and care responsibilities. However, important differences existed across the groups.
These included going abroad for more frequent screening, delayed introduction to screening
and not accessing primary care services, language difficulties in healthcare settings despite proficiency in
English, and not being sexually active at screening commencement. Experiences of racism, ignorance, and
feeling shamed were also reported.
Conclusions
Key differences exist in the experience of minority ethnic groups in Scotland. These offer potential opportunities
to reduce disparity and support screening participation including maximising co-incidental interactions and
developing outreach work.