Culture Is Key: Engaging Culturally and Linguistically Diverse Populations in Breast Cancer Screening in High Income Contexts: A Scoping Review

Background

Breast cancer is the most commonly diagnosed cancer in Australia and is the second highest cause of cancer mortality in Australian women. Screening in the form of mammography can significantly reduce mortality; however, research suggests that women from culturally and linguistically diverse (CALD) backgrounds are less likely to participate in mammography screening. While there is an established body of literature describing the lower engagement of CALD populations in screening and the associated challenges they face, less is known about evidence-based interventions to improve engagement.

Methods

A systematic scoping review was conducted to gain insights into best practice interventions to improve engagement of CALD populations in breast cancer screening. The search strategy followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. PUBMED, EMBASE and CINHAL databases were searched for studies published between January 2012 and October 2023.

Results

The search yielded 3249 studies; after removing duplicates, 2011 titles and abstracts were screened, and 121 papers underwent full text review. Forty-one were included in the review. Key intervention types were identified, with combination or multi-component studies being most effective at increasing mammography in CALD populations. Cultural appropriateness and tailoring are the most important considerations to be integrated into screening programs.

Conclusion

CALD populations have lower engagement and experience many challenges in accessing screening services. This review found that the integration of cultural appropriateness and tailoring is critical in the successful delivery of breast screening services to CALD populations. Individual strategies are insufficient to engage this population in screening; multicomponent strategies are the most effective.