Indirect discrimination and breast screening

Abstract

Uptake of screening services in inner-city communities has been low, particularly in older age groups, lower social classes, and ethnic minorities. In Leicester City, where up to 25% of the population belong to ethnic minorities, this may have important implications for breast screening. We randomly sampled 701 inner-city women aged 45 to 64 years, stratified by neighborhood and by women's "likely home language." Trained interviewers succeeded in interviewing 79% of those eligible, and we report here a preliminary analysis of 413 respondents. Knowledge of breast cancer and screening varied markedly and significantly by actual language: 60.4% of English-speaking and 12.5% of non-English-speaking women correctly answered 10 or more questions (of 14) about breast cancer and screening (chi 2(1) = 89.884; P = .000). Despite that, 80% or more women stated their intention to attend for screening and assessment if necessary, irrespective of neighborhood, language, age, or social class. We suggest that the difference in knowledge between language groups arose from indirect discrimination in the way in which health-related information is disseminated in British society. However, after providing appropriate screening information, we report similarly high intended acceptance rates in the two language groups.