A qualitative exploration of women's perspectives and acceptability of including new cancer awareness information in all‐clear breast or cervical screening results

Objective: This study explored women's perspectives on the acceptability of including new cancer information with an all-clear breast or cervical screening result letter (using ovarian cancer as a case study). Methods: In 2016, six focus group discussions were conducted with women aged 25–70 years old, eligible for invitation to the NHS breast or cervical screening programme and resident in England. The focus groups lasted 60–90 min and were held in community venues. Data were analysed using thematic analysis. Results: Thirty-eight women aged 25–67 years old participated in the focus groups. Data analysis yielded six descriptive themes: general cancer awareness, taking advantage of a ‘teachable moment’, a double-edge sword, barriers to accepting and using new cancer information, motivators for accepting and using new cancer information and wider strategies to increase cancer awareness in women. Women welcomed the inclusion of new cancer information in all-clear screening results but highlighted pertinent lessons to be considered to maximise the usefulness of the approach. Conclusion: While women perceived this approach as acceptable, it is pertinent to note the potential of the new cancer information to stimulate anxiety and potentially widen inequalities by excluding non-attenders at screening programmes. Specific complementary and tailored approaches are necessary to mitigate these limitations

Barriers and facilitators to accessing and utilising post-treatment psychosocial support by Black men treated for prostate cancer—a systematic review and qualitative synthesis

Purpose: To synthesise findings from published studies on barriers and facilitators to Black men accessing and utilising post-treatment psychosocial support after prostate cancer (CaP) treatment. Methods: Searches of Medline, Embase, PsycInfo, Cochrane Database of Systematic Reviews and Central, CINAHL plus and Scopus were undertaken from inception to May 2021. English language studies involving Black men aged ≥18 and reporting experiences of, or suggestions for, psychosocial support after CaP treatment were included. Low or moderate quality studies were excluded. Searches identified 4,453 articles and following deduplication, 2,325 were screened for eligibility. Two independent reviewers carried out screening, quality appraisal and data extraction. Data were analysed using thematic synthesis. Results: Ten qualitative studies involving 139 Black men were included. Data analysis identified four analytical constructs: experience of psychosocial support for dealing with treatment side effects (including impact on self-esteem and fear of recurrence); barriers to use of psychosocial support (such as perceptions of masculinity and stigma around sexual dysfunction); facilitators to use of psychosocial support (including the influence of others and self-motivation); and practical solutions for designing and delivering post-treatment psychosocial support (the need for trusted healthcare and cultural channels). Conclusions: Few intervention studies have focused on behaviours among Black CaP survivors, with existing research predominantly involving Caucasian men. There is a need for a collaborative approach to CaP care that recognises not only medical expertise but also the autonomy of Black men as experts of their illness experience, and the influence of cultural and social networks

A constructivist grounded theory study on decision-making for treatment choice among Black African and Black Caribbean prostate cancer survivors

Objective: Despite Black African (BA) and Black Caribbean (BC) men having a disproportionately high risk (1 in 4) of developing prostate cancer (CaP), there is limited understanding of their decision-making for treatment choice. This study explored decision-making for treatment choice among BA/BC men treated for CaP. Methods: Using constructivist grounded theory, face-to-face, Skype and telephone interviews were conducted with 25 Black men (8 BA, 17 BC) recruited in England between October 2016 and March 2018. Data were analysed using constant comparison until saturation was achieved. Results: Data analysis yielded three broad categories: ‘coming to terms with the prostate cancer diagnosis’, ‘getting empowerment through information-seeking’ and ‘choosing a treatment option’. Priority for survival substantially motivated BA/BC men to take up radical treatment for their CaP. However, decision-making for a particular treatment option was a more complex process which was shaped by an intersection between biological, behavioural, medical, personal and cultural factors. Conclusions: Healthcare providers need to consider the complexity of decision-making process for CaP treatment among BA/BC men and tailor cancer care services to reflect cultural sensitivity and person-centredness. This could potentially minimise treatment decision regrets and improve men's psychological wellbeing along the CaP survivorship pathway