In Guildford, Surrey, 47 women sat down with researchers from the University of Surrey and shared something that could save lives. These Black African and Caribbean women, all between ages 50 and 71, talked about why going for breast cancer screening felt difficult — or even frightening. Their answers, published in the British Journal of Cancer, reveal a gap that researchers now want to close.
Right now, only 45% of Black women in the UK attend breast cancer screening, compared with 63% of white women. That 18-point gap means Black women are more likely to have cancer found late, when it has spread and become harder to treat. Early detection through screening dramatically improves someone's chances of surviving breast cancer — but only if people actually go.
The study found that many Black women, especially those born outside the UK, simply did not know breast screening existed until they received their first invitation letter in the mail. Others wondered why they should get screened when they felt perfectly healthy. Some expected their family doctor to explain screening to them before they reached the age when invitations arrive.
Faith also played a role for some women. Certain Black African Christian women believed that illness was not permitted by God in their bodies. Muslim women said they needed to indicate their religion on medical forms so they could be matched with a female mammographer — someone of the same gender to perform the scan. These details matter because they show that one-size-fits-all health messages do not reach everyone equally.
The women in the study also said that invitation letters felt cold and formal. The pamphlets and images used to promote screening rarely showed anyone who looked like them. When health information does not feel relatable, it is easier to ignore.
But the researchers did not just document the problem — they heard solutions directly from the women themselves. Participants suggested building stronger links between family doctors, screening services, and trusted community members — people who could answer questions, reassure nervous women, and spread the word in languages and styles that feel familiar. One participant put it plainly: women need to feel seen before they will show up.
Lead researcher Anietie Aliu, a registered nurse and postgraduate researcher at the University of Surrey, said the findings show that improving attendance means more than just raising awareness. "Women need relatable screening information, reassurance, flexible appointments and services that are accessible within their communities," she explained. Her colleague Dr. Afrodita Marcu added that solutions will only work if Black women help design them: "We need a more collaborative approach, where primary care, screening services and community voices work together to support women before, during and after the invitation."
The researchers are calling for health materials developed in genuine partnership with Black communities — resources that use familiar language, show diverse faces, and respect different beliefs. It is a practical vision: not fixing people, but building systems that actually reach them. And that, researchers say, could help close the gap and save more lives.