Risky shifts or shifting risk: African and African-Caribbean women's narratives on delay in seeking help for breast cancer

Research in USA and the UK has revealed that whilst the incidence of breast cancer is lower in women from black and ethnic minority groups, African and African-American women delay seeking help, have a worse prognosis, and a higher mortality rate. A variety of reasons has been suggested for this: from system delay, to delay by the women arising from educational and socio-economic disadvantage or religious beliefs. Building on this in the UK, from a study conducted in a South London Screening Clinic, a sub-sample of African and African-Caribbean women were interviewed to obtain their narratives of action in delay in seeking help for late-stage breast cancer. The findings suggest that the women were aware of the services offered, were expecting a diagnosis of cancer, but offered a model of fearing extrusion from their community rather than fear of death from the disease, leading to delay in seeking help. The reasons for this are explored and a risk trajectory in biomedicine compared with the African and African-Caribbean women's world is described.