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Impacts of Language Barrier on Breast Cancer Screening Uptake

In the UK, most South Asian women have higher mortality rates due to breast cancer and the reason being not attending screening and mammography appointments due to poor communication between the patients and the health professionals. Most of the South Asian women cannot read or speak in English. In the UK, the data available is mostly limited to English speakers and those that are not are less likely to have a steady source of care and receive less breast cancer screening.

Disentangling the impacts of language on breast cancer screening uptake from some other factors is not easy as language acts in numerous distinct ways. People who do not speak English as their first language are not able to communicate and tell the health service providers that they need screening or even the providers cannot offer or discuss screening to the patients in an effective manner and that can lead to miscommunication.

Also, since language that people speak are closely related to their culture for instance it is said that the language that a person speaks signifies the purposeful membership to a specific cultural group. And since norms vary across different cultural groups, those that do not speak English have different values in health behaviors and perception. For example, when a non-English Speaker who attends screening and does not want to be checked by a male health officer can lack proper words to express herself and end up not showing for screening again.

Lastly, language barrier reduce breast cancer uptake as most of them cannot read and understand the letters or messages sent for screening appointments. In case, a family member is given the letter for interpretation, the information is not delivered as it was supposed to because of embarrassment. As it has been explained language and culture among South Asians relate in many ways therefore, a family member might not interpret certain health issues as required and this reduces the level of serious about the activity.

The main aim of conducting this research is to analyze the literature by exploring how language barrier correlates to breast cancer screening in women. Also, it aims at implementing a methodology that can be used as a reminder to the women to ensure they usually attend breast screening after a given period even though they do not speak English fluently (Genof et al. 2016). They are to be educated using translators in their local language about the importance and usefulness of screening.

There are a wide range of objectives for conducting this research and they include;

  • To check if the study can offer any kind of improvement to the services if the differences are known, can they be changed, and can the way of inviting people to screen be changed.
  • To educate society about the importance of breast screening.
  • To design a methodology that encourages those with a language barrier to still attend a screening for quick diagnosis and early prevention to improve the survival rates.
  • To ensure a good understanding of breast cancer the women to motivate to conduct screening irrespective of their ethnicity or race.
  • To investigate to what extent of awareness breast cancer has influenced breast screening among women who do not speak English as their first language.

This chapter explains some of the relevant literature reviews on the influence of language barrier, awareness, perception, accessibility, and attitude on the acceptance of breast cancer transmission among women. It also features the theoretic view whose opinion forms this work and the abstract context of the study.

According to the National Institute for Health and Care Research, the South Asian women have been identified to need help to overcome language and cultural barriers for them to take part completely in breast cancer screening plan. South Asians being keen followers of culture and traditions have a problem in welcoming news about breast cancer. Some of them do not prefer monitoring by male health officials and also fear the impacts of the screening program as the results could be the complete opposite of what is expected.

Challenges of Communication and Cultural Values in Health Behaviors and Perception

Due to culture, there are certain things which these women cannot talk about frankly, for instance in cases where the children are literate and can read the appointment letters to their parents, certain information can be assumed and thus make the appointment letter seem less important.

The women who does not speak English have the fear of attending screening and having a third party while discussing about their health issues and researches has shown that the third parties can also not be reliable to deliver the information as it is communicated. A journal on Public Health highlights that the aspect had an influence on the decision on the flow of communication from health officials to the individual about screening and its prospective benefits as well as harms. According to the SAGE journal most Pakistani women face challenges in the uptake of screening services, need for translation and optimization on screening materials disseminate knowledge including that of the environment where screening is done with the context of culture encouraging the informed choice on turnout.

A proportional study carried out by (De Cuevas et al. 2016) revealed that African women have the lowermost engagement in the screening facilities and searched for the root cause of the issues that resulted in their lower interest in breast screening programs. Focused group discussion which is considered qualitative research was used and from the discussion, the key subjects identified appropriately are understanding the principles around breast cancer, attentiveness to the NHS breast screening package, a lower interest in the NHS breast screening facility, and endorsements for enlightening information on the NHS breast cancer screening program (Genof et al. 2016).

As one of the most common diseases, out of seven, at least one woman will suffer a breast cancer analysis in her lifespan (Research, 2014). Health literacy has grown to be a multidimensional perception and it involves a wide range of skills and resources that is used in the involvement of information exchange between the healthcare providers and the patient. Women with no dependable breast cancer screening info or support from health care providers are always vulnerable to barriers like fear, discomfort, and embarrassment. Such factors discourages women from attending the screening appointments.

As the chance of development of breast cancer surges, almost every female in the United Kingdom listed or rolled up with a General Practitioner from age 50 to 70 is summoned for breast screening after every three years (Ibrahim Mohammed, 2012). Despite the very significant task that the screening can do in breast cancer exposure, most women fail to attend their appointments. Institute of the global health innovation (IGHI) clinical exploration, a new research project in North West London by Dr. Amish Acharya comprehends how more females can be motivated to attend discourse (De Cuevas et al. 2016). The women are invited to attend their screening appointments through phone calls or letters by using the language they understand best and in cases where the recipient cannot understand the concept in the letter, she opts to miss out on the appointment.

Factors Contributing to Poor Breast Cancer Screening Uptake in South Asian Women

In 2016-2017, roughly 71% of women found in England parted from their breast screening appointments to go for a study done by NHS Digital. The digital learning involves the use of English since it entails people from different background and that discourages most women who don’t understand English making them loose interest in learning about cancer screening (Genof et al. 2016). Most women don’t attend their screening appointments due to the time allocations with a reasoning that most of them work during the day therefore appointment is an inconvinience.

Research shows that the barricades could vary across diverse racial groups. For instance, most British-Pakistani women underlined the requirement to translate reading resources into innate languages, this can improve their access to information on screening. Another research by MDPI steered to the turnout of  African females exposed that aspects such as the fright of a lethal cancer finding can avert them from availing themselves of the engagements. Concern and negative expectations like concern of disrespect from the screening providers and the feeling of being embarrassed (Ibrahim Mohammed, 2012).

The Journal on South Birmingham Breast Screening service discloses that the physical discomforts caused during the previous mammograms conducted have contributed greatly to the reduced number of women taking up screening. Most women lack the literacy on the risks associated with breast cancer and the belief of misinformation like screening is painful and harmful or that cancer has no treatment. Structural barriers are everyday challenges related to booking appointments, getting access to the screening services, and handling priorities like family obligations

The call and reminiscence information technology structure (BS Select) may grab information on particulars of a woman’s preference language. It may also specify if a translator is required on the same, which could be vital for those women attending the valuation camp (Edgar et al. 2016). This study is interested in the inhabitant’s catalog just in a similar manner as the demographic data and can also be included or revised manually by the breast screening service. Information kept at the breast screening (BS) Service concerning favored language is not spontaneously relocated to the National breast screening system. A comma detached data (.csv) file could be downloaded for a consignment within Breast Screening Select and the information can be keyed in manually into the national breast screening system.

Breast screening facilities issue a programmed translator during valuation engagements when demanded for women whose purposeful language is not English. This is reinforced with appropriately transcribed facts. Where this cannot be realized, a comprehensive translation service must be available. A transcriber service is not offered for mundane screening summon (Edgar et al. 2016). Wherever breast screening facilities have recognized a crowd of the population where English is not their mother language, they might contemplate if any resident community could be supportive in the process of snowballing cognizance of breast screening and also to back up personalities in enhancing the accessibility to the screening services(Ibrahim Mohammed, 2012).

Consideration are given concerning how mammographies will be in a position to back up non-English speakers during the breast screening procedure when they avail themselves for the same. Providers can give preference to using images in a storyboard to discuss the process or accessing a video explanation of the process for places with facilities. The host organization might have access to amenities such as Linguistic Line where interpretation amenities can be retrieved by phone and in an understandable language (Genof et al. 2016).

This research paper addresses language barrier as a limitation to conducting screening on women. From the literature reviews provided above, it is easy and appropriate to conclude that the issue of speaking another language apart from English is significant and associable with receipt of breast screening in unadjusted models. Although this reasoning is reduced in adjusted models, not speaking well remained to be negatively linked with receipt of cancer screening. The language barrier, therefore, is a contributing factor to health disproportions by delaying enough health communication.

It is known that women who do not read or speak English at all are less likely to be receiving breast cancers screening than women of the same race and ethnicity but speak English well (Edgar et al. 2016). The question that was asked on the objectives if communication barrier is a contributing factor to the number of women who go for screening is answered in the literature review by different studies that confirm that women with poor English speaking ability tend not to go for screening at required intervals making it easy for them to be attacked by Cancer (Anastasia et al, 2019). The research explored greatly the relationship between communication barriers, breast screening, and cultural practice. 


Anastasi, N. and Lusher, J., (2019). The impact of breast cancer awareness interventions on breast screening uptake among women in the United Kingdom: A systematic review. Journal of Health Psychology, 24(1), pp.113-124.

Crawford, J., Ahmad, F., Beaton, D. and Bierman, A.S., (2016). Cancer screening behaviours among S outh A sian immigrants in the UK, US and C anada: a scoping study. Health & social care in the community, 24(2), pp.123-153.

De Cuevas, R.M.A., Saini, P., Roberts, D., Beaver, K., Chandrashekar, M., Jain, A., Kotas, E., Tahir, N., Ahmed, S. and Brown, S.L., (2018). A systematic review of barriers and enablers to South Asian women’s attendance for asymptomatic screening of breast and cervical cancers in emigrant countries. BMJ open, 8(7), p.e020892.

Dhabi, A (2016) Cervical and Breast Cancer Screening Uptake among Women with illness. Create Space Independent Publishing: Wales.

Dunn, S.F., Lofters, A.K., Ginsburg, O.M., Meaney, C.A., Ahmad, F., Moravac, M.C., Nguyen, C.T.J. and Arisz, A.M., (2017). Cervical and breast cancer screening after CARES: a community program for immigrant and marginalized women. American Journal of Preventive Medicine, 52(5), pp.589-597.

Edgar, L., Glackin, M., Hughes, C. and Ann Rogers, K.M., (2013). Factors influencing participation in breast cancer screening. British Journal of Nursing, 22(17), pp.1021-1026.

Gele, A.A., Qureshi, S.A., Kour, P., Kumar, B. and Diaz, E.,(2017). Barriers and facilitators to cervical cancer screening among Pakistani and Somali immigrant women in Oslo: a qualitative study. International journal of women's health, 9, p.487.

Genoff, M.C., Zaballa, A., Gany, F., Gonzalez, J., Ramirez, J., Jewell, S.T. and Diamond, L.C., (2016). Navigating language barriers: a systematic review of patient navigators’ impact on cancer screening for limited English proficient patients. Journal of general internal medicine, 31(4), pp.426-434.

Ibrahim Mohammed, A (2012) Thematic Analysis: A critical Review of its Process and Evaluation: a literature review. Journal of Social Sciences 1st ed. pp 39-41.

Jones, C.E., Maben, J., Jack, R.H., Davies, E.A., Forbes, L.J., Lucas, G. and Ream, E., 2014. A systematic review of barriers to early presentation and diagnosis with breast cancer among black women. BMJ open, 4(2), p.e004076.

Jun, J. and Nan, X., (2018). Determinants of cancer screening disparities among Asian Americans: a systematic review of public health surveys. Journal of Cancer Education, 33(4), pp.757-768.

Lu, M., Moritz, S., Lorenzetti, D., Sykes, L., Straus, S. and Quan, H., (2012). A systematic review of interventions to increase breast and cervical cancer screening uptake among Asian women. BMC public health, 12(1), pp.1-16.

Sokal, R(2015) A Critical Review of the Literature on the Uptake of Cervical and Breast Cancer Screening in South Asian Women. British Journal of Nursing, 18(4), pp. 34-68

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