title: Barriers to Breast and Cervical Cancer Screening in Singapore: a Mixed Methods Analysis.
abstract: BACKGROUND
  In order to increase breast and cervical cancer screening uptake in Singapore, women's perceived barriers to screening need to be identified and overcome. Using data from both focus groups and surveys, we aimed to assess perceived barriers and motivations for breast and cervical cancer screening.
  
  
  METHODS
  We conducted 8 focus groups with 64 women, using thematic analysis to identify overarching themes related to women's attitudes towards screening. Based on recurring themes from focus groups, several hypotheses regarding potential barriers and motivations to screen were generated and tested through a national survey of 801 women aged 25-64.
  
  
  RESULTS
  Focus group participants had misconceptions related to screening, believing that the procedures were painful. Cost was an issue, as well as efficacy and fatalism.
  
  
  CONCLUSIONS
  By identifying barriers to and motivators for screening through a mixed-method design that has both nuance and external validity, this study offers valuable suggestions to policymakers to improve breast and cervical cancer screening uptake in Singapore.
authors.affiliation: Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore E-mail : chetna.malhotra@duke-nus.edu.sg.
authors.forename: Chetna
authors.initials: C
authors.lastname: Malhotra
authors.forename: Marcel
authors.initials: M
authors.lastname: Bilger
authors.forename: Joy
authors.initials: J
authors.lastname: Liu
authors.forename: Eric
authors.initials: E
authors.lastname: Finkelstein
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000523:psychology*; D055088:Early Detection of Cancer / Q000523:psychology*; D005260:Female; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008327:Mammography / Q000523:psychology; D008403:Mass Screening / Q000523:psychology*; D008875:Middle Aged; D009042:Motivation / Q000502:physiology; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000523:psychology; D065006:Papanicolaou Test / Q000523:psychology; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D012846:Singapore; D011795:Surveys and Questionnaires; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000523:psychology*