P12-5 A qualitative exploration of barriers and facilitators to breast, cervical, bowel and abdominal aortic aneurysm screening uptake among black communities in North East England, Leeds and Scotland

Background: Screening uptake remains disproportionately low among Black communities in the UK, contributing to later-stage diagnoses and poorer outcomes. Evidence indicates that community engagement and faith-based approaches may help address these inequalities. The EQUITA (Equity in Black Adult Health) study is a two-year feasibility trial co-produced with Black community members. To inform intervention development, barriers and facilitators to screening participation were explored with a Public Involvement and Community Engagement (PICE) group across national breast, cervical, bowel cancer, and abdominal aortic aneurysm (AAA) screening programmes.

Methods: A qualitative design was co-produced with the PICE group. Between March and June 2025, three focus groups were held with 15 members (six men and nine women) from North-East of England, Leeds, and Scotland. Focus groups were conducted online and facilitated by two researchers and three community recruitment leads, trusted members supporting engagement. Discussions were recorded, transcribed verbatim, and analysed using framework analysis, with findings mapped onto the Integrated Screening Action Model (I-SAM).

Results: Fear of diagnosis, fatalistic beliefs, mistrust of the healthcare system, and limited culturally relevant information reduced individuals’ capability and confidence to engage with screening. Practical barriers such as childcare, transport, and time off work limited opportunity, while accessible and familiar settings, including churches, enhanced it. Motivation was strengthened through trusted messages from Black GPs, faith leaders, and peers, along with personal testimonies and interactive activities that encouraged discussion and confidence. Improving screening uptake requires building capability through knowledge and confidence, enhancing opportunity through culturally sensitive and accessible services, and supporting motivation through trusted communication and peer encouragement.

Conclusion: This study demonstrates how social, structural, and cultural factors intersect to shape inequalities in cancer screening uptake. Community co-production offers a foundation for developing culturally appropriate and faith-centered approaches integrated into community and primary care settings to promote equitable access to early detection.