Barriers to Breast Cancer-Screening Adherence in Vulnerable Populations

SIMPLE SUMMARY: Breast cancer is the most prevalent cancer in the world. Early diagnosis can prevent cancer growth and therefore saving lives. Breast cancer screening through periodic mammography has been effective in decreasing mortality. However, adherence to screening does not meet the desired expectations in all population groups. The objective of this review is to identify the barriers that affect adherence to breast cancer–screening programs in an ethnically diverse group of women in order to propose public health measures to increase adherence. Although the dissemination of breast cancer–screening programs is still lacking in most of the vulnerable populations, we observed important favorable changes in those cases in which the population undergoes health education sessions, they are informed about cancer-screening programs or they seek medical attention. Therefore, implementing awareness campaigns focused on these populations should be promoted, as well as working on healthcare professional cultural competence to improve breast cancer–screening adherence worldwide. ABSTRACT: Breast cancer screening through periodic mammography has been effective in decreasing mortality and reducing the impact of this disease. However, adherence to screening does not meet the desired expectations from all populations. The main objective of this review is to explore the barriers that affect adherence to breast cancer–screening programs in vulnerable populations according to race and/or ethnicity in order to propose measures to reduce the lack of adherence. We conducted a search of publications in the PubMed Central and Scopus databases. The eligible criteria for the articles were as follows: original quantitative studies appearing in SJR- and/or JCR-indexed journals from 2016 to 2021 in English or Spanish. Most of them present common barriers, such as race/ethnicity (47%), low socioeconomic (35.3%) and educational levels (29.4%), no family history of cancer and being single (29.4%), medical mistrust and a health information gap (23.5%), lack of private health insurance (17.6%) and not having annual health checks (17.6%). The target populations with the lowest adherence were Black, Asian, Hispanic and foreign women. Implementing awareness campaigns focused on these populations should be promoted, as well as working on diversity, cultural acceptance and respect with healthcare workers, in order to improve breast cancer–screening adherence worldwide.