Perceptions of cervical cancer prevention among a group of ethnic minority women in Denmark - A qualitative study

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Background
Cervical cancer screening (CCS) and human papillomavirus vaccination (HPVV) are effective measures against cervical cancer (CC). Attendance in HPVV and CCS provides the greatest protection, while combined non-attendance in HPVV and CCS provides little to no protection. It is hence concerning that some large ethnic minority groups show considerably lower HPVV and CCS attendance than other women–especially women from Middle-Eastern and North African (MENA) countries and Pakistan. Little is, however, known about the reasons for this low combined attendance pattern.

Aim
To explore perceptions of and barriers to HPVV and CCS, among MENA and Pakistani women in Denmark.

Method
Focus group interviews were conducted. Data was transcribed verbatim, and analysed using systematic text condensation.

Findings
Seventeen long-term resident women originating from six major MENA countries and Pakistan were included. Mean age was 36 years. We found that these women, across different age groups and descent, had sparse knowledge and understanding about CC, and their perceived
relevance of disease prevention was low. Compared to HPVV, their barriers to CCS were more fixed and often linked to socio-cultural factors such as taboos related to female genitals and sexuality. Moreover, they presented unmet expectations and signs of mistrust in the healthcare system. However, at the end of the interviews, participants became more attentive toward CC prevention, particularly toward HPVV.

Conclusion
Elements of insufficient knowledge and understanding of CC and its prevention were found among a group of MENA and Pakistani women. Their socio-cultural background further represents a barrier particularly towards CCS. Additionally, negative experiences and unmet expectations lessen their trust in the healthcare system. All of which underlines the need for new tailored CC preventive strategies for this group. Based on our findings we suggest that
future studies develop and evaluate interventions aiming to improve HPVV and CCS, including user-involvement.



Original languageEnglish
Article numbere0250816
JournalPLOS ONE
Volume16
Issue6
Number of pages22
ISSN1932-6203
DOIs
Publication statusPublished - Jun 2021

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