Barriers to Breast and Cervical Cancer Screening in Singapore: a Mixed Methods Analysis

  • Malhotra, Chetna (Lien Centre for Palliative Care, Duke-NUS Medical School) ;
  • Bilger, Marcel (Program in Health Services and Systems Research, Duke-NUS Medical School) ;
  • Liu, Joy (Lien Centre for Palliative Care, Duke-NUS Medical School) ;
  • Finkelstein, Eric (Lien Centre for Palliative Care, Duke-NUS Medical School)
  • Published : 2016.08.01


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. Materials and 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.


Supported by : Singapore Ministry of Health


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