This course aims to inform GPs about the experiences of Black women with breast cancer. It explores the specific risk factors, challenges related to timely diagnosis, and the lived experience of Black women during the diagnosis process. The course will also address the social and cultural barriers to healthcare, using case studies to support GPs to develop culturally sensitive and effective approaches to care.

The course only takes 30 minutes and can be accessed here

The eLearning is free to any healthcare professional with an RCGP account. A free account can be created by going to non-membership access section on the RCGP website.

Why we are promoting this?

We are sharing this because we have an issue locally that reflects the national picture: that Black, Asian and minority ethnic women are getting a later diagnosis of breast cancer.

These women appear outside the range of ages for breast screening (under 50 or over 70) so present at GP practices instead. We have evidence from the National Cancer Patient Experience Survey that Black people are more likely to have to go to see their GP more often with the same health issue before being referred.

Local data

While there are significant gaps in the data, within the 467 diagnoses of minority ethnic women in Wessex 73.3% are diagnosed at early stage – slightly higher than White British women at 72.1%.

However 11.7% ethnic minority women are diagnosed at late stage compared to 9.4% of White British women. Late diagnosis rates among minority ethnic women were significantly higher in previous years and have since reduced, but they remain above the rate for White British women.

Late-stage diagnosis is most common among Black or Black British patients (23.1% diagnosed at late stage) and Asian or Asian British patients (17.1% diagnosed at late stage). These patients are also more likely to be younger as late-stage diagnosis rates increase in younger age groups (30–39 and 40–49), as well as in older age brackets (80+). There does not appear to be a relationship between late diagnosis and deprivation.

What else are we doing to support earlier diagnosis?

Over the last year we have supported ethnic minority women to raise awareness of breast cancer across our area. Through this we have been gathering other multifaceted reasons for later diagnosis, including:

• Health information, including for breast cancer, is more likely to reflect white women’s experiences and images and therefore not reach or resonate with Black, Asian and minority ethnic women
• They may not see themselves as at risk of developing the disease, or know their family history
• Black, Asian and minority ethnic women experience more barriers to breast screening, and are therefore less likely to attend
• Mistrust in health care because of experiences of racism. Black, Asian and minority ethnic women may feel ignored and unheard because of behaviours, attitudes and assumptions made by clinicians and health staff. Staff can lack awareness regarding some presentations of breast cancer e.g. skin discolouration etc.
• A wide range of cultural, religious or other beliefs can determine whether Black, Asian and minority ethnic women will seek health care advice early, including fear, stigma and taboo in discussing cancer, believing cancer is a punishment or contagious. They may put their fate in the hands of their faith.
• Deprioritising their own health for the sake of family and the household may also play a part, as well as fears about the financial, emotional and other impacts of getting a cancer diagnosis.
• Practical reasons like being able to take the time to book and go to an appointment, as well as perceptions about how easy it would be to get an appointment.

This year we will continue to work with communities to raise awareness of breast cancer, as well as work with the healthcare system and women to coproduce solutions to improve earlier diagnosis for Black, Asian and ethnic minority women.