Singaporean Women's Perceptions and Barriers to Breast and Cervical Cancer Screening

Abstract

Objectives: To understand the key factors guiding women's decision of whether or not to use breast and cervical cancer screening services (in order to determine how to cost effectively increase screening uptake in following conjoint).Methods: We conducted eight focus groups, with Singaporean women aged between 40 and 64 for breast cancer screening, and between 25 and 64 years for cervical cancer screening, to identify the key factors that drive cancer screening. Using the Health Belief Model to guide our focus group questions, we analyzed the responses and compared similarities and differences among screeners and non-screeners. Results: Singaporean women understand the severity of both breast and cervical cancer and fear the associated lifestyle challenges that come with a cancer diagnosis. With the exception of several non-screeners in the breast cancer group, all women reported they believed they were at risk of developing cancer. All women reported the benefits of early detection and accuracy of preventative screening. Both screeners and non-screeners feared cancer detection during screening and saw the screening clinic as a place of possible cancer diagnosis. Conclusion: How women perceive their cancer diagnosis, accepting the cancer reality or succumbing to fatalist beliefs, greatly impacts their decision to screen. Screeners were more likely to report that they had recommendations from friends, referrals from doctors, and influences from promotion campaigns. Non-screeners were more likely to have perceive fatalistic views (lack of control over a diagnosis (fatalism) was a unique barrier reported by non-screeners.