“What you don’t know won’t harm you”: An interpretative phenomenological analysis of barriers and facilitators of poor early breast cancer screening uptake among black women in England

Background: Breast cancer constitutes a global public health concern. However, Black women in the United Kingdom (UK) experience disproportionately low breast cancer screening uptake despite higher risks of late-stage diagnosis and poorer outcomes. This highlights a significant gap, and the study addresses this gap by making an original contribution using interpretative phenomenological analysis (IPA) to explore the lived experiences of Black women to understand the barriers and facilitators of poor early breast cancer screening uptake in the United Kingdom. Methods: One focus group comprising 10 participants and 5 in-depth semi-structured interviews were conducted with Black women living in England, and the data were analysed using IPA. Findings: The study found that cultural modesty, stigma, fear, and fatalistic beliefs intersect to shape vulnerability and perceptions of screening. It also found that trauma, mistrust, structural disadvantages such as unequal access to healthcare and past negative healthcare experiences further serve to negotiate and sustain beliefs around screening. Conclusion: This study provides a nuanced understanding with significant policy relevance by demonstrating and recommending the need for tailored messages, trauma-informed, and psychosocially supportive screening pathways as s essential for reducing inequalities and ensuring that screening services are accessible, respectful, and emotionally safe for Black women.