title: Perceived barriers to flexible sigmoidoscopy screening for colorectal cancer among UK ethnic minority groups: a qualitative study.
abstract: OBJECTIVE
  Evidence from existing UK screening programmes indicates disparities in uptake rates between UK ethnic minorities and the white majority population. The aim of this study was to explore barriers to the uptake of flexible sigmoidoscopy (FS) screening among UK ethnic minority populations. Specifically, beliefs about bowel cancer, perceived barriers to the test and ideas about ways to increase uptake were investigated.
  
  
  METHODS
  Nine focus groups were conducted with a total of 53 participants from African-Caribbean, Gujarati Indian, Pakistani and white British communities. The topic guide was based on the Health Belief Model. Discussions were subject to framework analysis.
  
  
  RESULTS
  Most participants expressed limited awareness of bowel cancer and cited this as a barrier to screening attendance. Anxiety regarding the invasiveness of the test, the bowel preparation and fear of a cancer diagnosis were common barriers across all ethnic groups. Language difficulties, failure to meet religious sensitivities and the expression of culturally influenced health beliefs were all discussed as specific barriers to uptake. Ethnically tailored health promotion and general practitioner involvement were recommended as ways of overcoming such barriers.
  
  
  CONCLUSIONS
  The study was the first attempt to qualitatively explore barriers to FS bowel cancer screening in UK ethnic minorities. Most barriers were shared by all ethnic groups but health educators should supplement approaches designed for the majority to incorporate the specific needs of individual minority groups to ensure equitable access.
authors.affiliation: UCL Health Behaviour Research Centre, Department of Epidemiology and Public Health, 1-19 Torrington Place, London WC1E 6BT, UK.
authors.forename: K L
authors.initials: KL
authors.lastname: Austin
authors.forename: E
authors.initials: E
authors.lastname: Power
authors.forename: I
authors.initials: I
authors.lastname: Solarin
authors.forename: W S
authors.initials: WS
authors.lastname: Atkin
authors.forename: J
authors.initials: J
authors.lastname: Wardle
authors.forename: K A
authors.initials: KA
authors.lastname: Robb
mesh_terms: D000368:Aged; D001294:Attitude to Health; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000208:ethnology* / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008913:Minority Groups / Q000523:psychology / Q000706:statistics & numerical data*; D012812:Sigmoidoscopy / Q000706:statistics & numerical data*; D006113:United Kingdom