Exploring breast cancer inequalities v.01
Research type
Research Study
Full title
Exploring inequalities in breast cancer outcomes through the lens of intersectionality: A qualitative study
IRAS ID
325406
Contact name
Mar Estupiñán Fdez. Mesa
Contact email
Sponsor organisation
University of Surrey
Clinicaltrials.gov Identifier
SPON-2023-15, SPON-2023-15
Duration of Study in the UK
1 years, 0 months, 29 days
Research summary
This research forms the second part of the applicant’s PhD, aiming at understanding socioeconomic inequalities in breast cancer outcomes across the cancer pathway. There is evidence that women from minority ethnic groups with breast cancer, particularly from Black African/Caribbean and Asian communities, persistently report less favourable cancer care experiences than White patients. Although some hypotheses have been proposed; it remains unclear what exactly influences these differences. Understanding patients’ views in relation to their care experience is key to inform and improve NHS cancer services. This qualitative research aims to understand what factors shape the unique care experiences of Black African/Caribbean and Asian women with breast cancer, and to understand how systems of oppression (e.g., racism) may play a role in influencing breast cancer inequalities in the UK.
This research is a multiple-site study including 2 NHS Trusts (Guy’s and St Thomas’, London, and Royal Surrey Hospital, Guildford) where patients attend breast cancer services. At each clinic, potential eligible patients will be identified and invited to participate in the study. Data will be collected from interviews, and analysed to identify common themes that will help us understand the unique experiences of Black African/Caribbean and Asian women across the breast cancer care pathway, what influences the decisions they make about their treatment and their interactions with the healthcare system. Research findings will help us explain what factors influence inequalities among Black African/Caribbean and Asian women with breast cancer in the UK and make recommendations to inform policy and practice. This research is funded by the University of Surrey as a studentship awarded to Mar Estupiñán Fernández de Mesa (PhD student).Lay summary of study results: In England, minority ethnic women with breast cancer consistently feedback that they have less favourable experiences with NHS cancer services than White women. We wanted to understand what factors may explain these unique care experience. We also wanted to understand how the interactions between women from minority ethnic and their social networks (e.g., family members, friends) and the healthcare system may influence their experience of breast cancer care.
We recruited 20 women aged 31-60 years with breast cancer (Asian (n=7), Black (n=9), and of mixed ethnicity (n=4)) and invited them to participate in an interview to discuss their breast cancer care experience. We used a tool (called Framework Analysis) to analyse the interviews.
We developed four themes that explained the difference in care experienced by minority ethnic women with breast cancer in England. These themes included women feeling stereotyped by health care professionals and social networks; the influence of healthcare professionals’ knowledge, attitudes, and behaviours; barriers in the healthcare system; and the influence of cultural beliefs. We created a figure to illustrate how these factors interact with each other to influence differences in care experienced by minority ethnic women.
We concluded that the are many factors that consistently disadvantage minority ethnic women with breast cancer. We observed they deal with many circumstances that influence how they cope and manage their disease, and how they access and navigate NHS cancer services. Our findings indicate that policymakers and healthcare professionals should review and improve policies and cancer services to ensure all women receive the same quality of breast cancer care.REC name
Yorkshire & The Humber - Leeds West Research Ethics Committee
REC reference
23/YH/0153
Date of REC Opinion
21 Jul 2023
REC opinion
Favourable Opinion