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Barriers to Cervical Cancer Screening Among Black and Ethnic Minority Women

In recent years, black women and minority ethnic groups have been noticed to shy away from attending cervical cancer screening. Despite the government’s efforts in educating people on the benefits of screening and ensuring that every woman has undergone the process, there are still those who choose not to participate. This paper aims at finding the association between ethnicity and low attendance of cervical cancer screening.


Although cervical cancer can affect women of all ages, it has been found to be shared among women sexually active women between the ages of thirty and forty five (Patel et al., 2012). The government recommended that those between the ages of twenty-five and sixty-four undergo screening every five years. In the UK, the number of women affected by cervical cancer has significantly reduced due to the favorable outcome of the Cervical Screening Programme put in place by the NHS. The screening has made it possible for cancer cells to be detected early, thus reducing the number of severe cases of cervical cancer.

However, several hindrances prevent a specific subpopulation of women from getting the screening; black women and those belonging to minority ethnic groups, including immigrants, have the lowest number of women getting the screening. The primary purpose of this project is to explore these barriers and understand why these women choose not to undergo the screening. It will also help find better ways of enabling all women to get regular cervical cancer screening regardless of their race or ethnic group.

Critical Appraisal

According to Ekechi et al. (2014), ethnic background, migration, and religious affiliation are the major factor that determines participation in cervical cancer treatment. The researchers gave out approximately six thousand questionnaires to minority ethnic and Black beauty salons in London. It was concluded that black women who frequently attend church services had been found to avoid the screening. It was also determined that women who migrated to the country less than a decade ago were more likely to delay attending the screening process. Additionally, the barriers that hindered these women from having cervical screening services were difficulty in making appointments, skepticism of the tests, the embarrassment of the screening process, and the fear of being diagnosed with the illness.

The main weakness of this study lies in the sample size that the researchers decided to use. The challenges of using large sample sizes by Robert (2014) were used to critique the sample size used in this research. Incorporating a large sample size, in this case, six thousand, can sometimes lead to systemic prejudices, or sometimes there may be loss of significant information (Deeks et al., 2005). Most targeted participants failed to return the questionnaires, which is another disadvantage; out of the six thousand that were issued, only nine hundred and thirty-seven responded. The authors distinctly describe their sample as stratified and carried out through different boroughs with significant percentages of Black women in the area. A stratified sample can be described as sampling made up of small groups of people that have been divided according to similar features; these small groups are known as strata (Parsons, 2014). According to Sharma (2017), using stratified sampling helps researchers make statistical deductions from the population since the selection of the samples is made through the methods of probability (750).

Laura et al. (2015) found out that women belonging to different minority groups said that there was not enough awareness of the cancer; most of them were unfamiliar with the term cancer screening. Additionally, emotional barriers including, embarrassment and shame cognitive barriers like lack of signs and symptoms, were some of the reasons that all women reported to be the main barriers to getting cervical cancer screening. The study carried out interviews of forty-three women of different ethnic minority descent, White British and Black Women aged between twenty-five and sixty-four. The strength of this research is that it made sure that they collected data accurately by ensuring interviews were carried out in languages that were familiar to the subjects.

Among the main concerns of this research is the sample size used; according to Faber and Fonseca (2014), very small samples may interfere with the conclusions that are to be drawn, and researchers may end up assuming as true a false proposition. According to Khalilzadeh and Tasci (2017), larger sample sizes are encouraged since they provide statistical significance that effectively represents the entire population. However, the choice of participants in this study is appropriate for the research since it uses women from diverse backgrounds. Teherani et al. (2015) suggest that participants for any research need to be diversified to ensure that different people’s opinions with different beliefs and experiences are used to draw accurate deductions from the study.

Methodological Approach

Cervical cancer has been a concern throughout the years. Many researchers have dedicated their time to understanding the causes, symptoms, treatment plans, and prevention measures that can enable people to understand it better. Since it was discovered in the 1970s, several articles and books have been written to help create awareness of the diseases. Additionally, governments and other health organizations have been at the forefront to ensure that women get an early screening of cervical cancer to prevent the risk associated with late detection of the disease. However, some people choose not to go for the screening despite being made available for everyone due to particular circumstances. Studies have been carried out in the past to determine the reasons for this reluctance. I believe that enough books and scholarly articles could be applied to this project. For this reason, to answer the research question, I plan to use different written sources; several scholarly articles and survey books contain analytical assessments and explanations relevant to my research question. In as much as several sources provide information in relation to the research, not all contain information that is credibly backed up by valid evidence. Since the written sources are so many, the most challenging issue about using literature review to answer the research question is the discernment of which articles to use and which ones to ignore. It is essential to choose a source that is well structured and contains supporting data to the hypothesis being tested; this will reduce the chances of getting false deductions from the study.


To conduct this research, I would search for literature reviews consistent with my research question. Understanding cervical cancer, the screening process, and its relation to ethnicity is the main focus of this project. Despite so many benefits that have been outlined concerning early cervical cancer screening, there are still a specific group of women who choose not to undertake the screening. The National Health Service has put up a program that provides free cervical cancer screening to women every three to five years; however, not all eligible fortis screening women are willing to participate (Labeit et al., 2013). Since the main aim of the research is to understand how ethnicity and race affect early cervical cancer screening, my research would be based on this topic. Some of the keywords I would be looking for include cervical cancer screening, awareness, minority ethnic groups, and black women. The articles must also contain a study that uses a sample population from the United Kingdom. Articles that have collected data from different boroughs to make sure that the accumulated data is not biased and that accuracy is ultimately achieved.

Ethical Issues

One of the main ethical concerns in carrying out this research is the issue of informed authorization. It is crucial that when conducting research, all the parties involved must be educated on the purpose of the study and the course of action that will be followed if they agree to participate in the survey (Orb et al., 2001). Informing them of the risk and benefits involved will help them participate voluntarily in the research. At no point during the collection of data should an individual feel coerced in any way; this consists of persuasion and trickery to gain the trust of the subject. Researchers must ensure that their participants completely trust them out of their own free will and ensure that they assure them of the confidentiality of the entire process.

Another ethical issue regarding confidentiality; the identification of the participant must never be linked with the distinctive replies in the study. In extreme cases involving sensitive information, a certificate of confidentiality may be issued to protect the subject against any legal action the researcher may undertake. Additionally, when an individual is perceived to be in danger during a research process, one is morally obligated to report such cases to relevant authorities, which might entail giving out confidential information. Patients’ records and other sensitive information to be used in any research are to be kept confidential at all times (Iman and Ghafarinasab, 2011).

Additionally, there are ethical concerns when using vulnerable groups to collect data during the research (Whitehead, 2007). Children, prisoners, sedated individuals, the poor, chronically ill individuals, older people, and mentally challenged individuals are among the groups of people who can be categorized as vulnerable. It is critical that they are not used during the research as this would be considered taking advantage of the vulnerable, and the study results will not be a precise depiction of the entire population. Ensuring that all the individuals participating in the research are of sane mind, legal age, and healthy is essential in ensuring accuracy and avoiding the challenge of being biased.


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Ekechi, C., Olaitan, A., Ellis, R., Koris, J., Amajuoyi, A., & Marlow, L. A. (2014). Knowledge of cervical cancer and attendance at cervical cancer screening: a survey of Black women in London. BMC public health14(1), 1-9.

Faber, J., & Fonseca, L. M. (2014). How sample size influences research outcomes. Dental press journal of orthodontics19, 27-29.

Iman, M. T., & Ghafarinasab, E. (2011). Ethical standards in human sciences researches.

Kaplan, R. M., Chambers, D. A., & Glasgow, R. E. (2014). Big data and large sample size: a cautionary note on the potential for bias. Clinical and translational science7(4), 342–346.

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Patel, A., Galaal, K., Burnley, C., Faulkner, K., Martin-Hirsch, P., Bland, M. J., … & Naik, R. (2012). Cervical cancer incidence in young women: a historical and geographic controlled UK regional population study. British journal of cancer106(11), 1753-1759.

Sharma, G. (2017). Pros and cons of different sampling techniques. International journal of applied research3(7), 749-752.

Whitehead, L. C. (2007). Methodological and ethical issues in Internet-mediated research in the field of health: An integrated review of the literature. Social science & medicine65(4), 782-791.


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