Back to Top Nursing Next - The Ottawa Hospital
Nursing Next banner Nursing Next banner

Barriers to cancer screening are tough to break down

Cancer Screening Barriers

By Wanda Doyle, RN, Cancer Screening and Prevention Team

Evidence shows that cancer screening – such as mammograms, Pap tests, and fecal occult blood tests – helps to decrease mortality rates. So, why is there such a large percentage of people in the Champlain LHIN who are eligible for the ‘big three’ cancer screening programs but who don’t get screened?

When I started my health-promotion role with the Champlain Integrated Cancer Screening team, I didn’t hesitate to immediately get involved with promoting and evaluating cancer screening because of its importance to public health. Our team is responsible for managing, educating and promoting screening for breast, colorectal and cervical cancer for the approximately 1.2 million people in our LHIN. In this position, I am supported by colleagues who have been involved with the Ontario Breast Screening Program for more than 20 years, and by the regional, provincial and primary care medical leads in cancer screening.

I quickly learned that working in a public-health role was very different from my previous work with patients in a hospital setting. I experienced greater challenges than I anticipated, because connecting with the public about cancer screening, increasing awareness, and promoting participation required a different approach than I was familiar with. I now find myself engaging in conversations about a difficult subject that is often unexpected. The non-clinical environment requires approaching people with more open-ended questions, and actively listening for teachable moments while we talk.

The cultural diversity of the LHIN and its large geographic area – consisting of urban and rural communities – presents challenges to health education and access to cancer screening programs. The varying levels of education and economic status require us to regularly modify information to meet patients’ needs. We use a multipronged approach to reach our patients, including formal presentations in workplaces and conferences, community-organized events, booths in retail outlets, conventional mass media and social media. Some of the locations where we’ve had an information booth include the 2015 International Plowing Match in Finch, Ontario, local women’s shows, home and garden shows, malls, mosques and The Ottawa Hospital’s Nursing Skills Fairs. If you visited one our displays, you were one of approximately 6,400 people we reached in 2015!

My engagement with the public has given me and the entire team the insight and information to better identify the barriers to cancer screening. I look forward to providing more information sessions in the coming year, and we will use our past experiences to continue improving the promotion of cancer screening programs. By providing information targeted to specific demographics, we were able to reach groups who typically may not have been aware of cancer screening, its benefits or the programs we offer.

7 common cancer-screening barriers

  1. Stigma. The stigma associated with the word ‘cancer’ is a major barrier to getting people screened. Talking about cancer is uncomfortable and often avoided.
  2. Fear. A fear of diagnosis is a deterrent to scheduling and completing the screening tests.
  3. Misunderstanding. The lack of clarity around the meaning of the word ‘screening’ and what that entails often prevent people from accessing these services.
  4. Confusion. The types of tests required and how often they should be performed for proper screening and diagnosis are often confusing.
  5. Awareness. A common misconception about screening is that if there is no family history of cancer, then the importance of screening decreases. However, family history is only one of many indicators in assessing the risk of getting cancer.
  6. Education. Public education about the need and benefits of cancer screening is lacking. For example, many people do not know that early detection leads to lower mortality rates.
  7. Misperceptions. The belief that you won’t get cancer because you eat well, exercise and don’t smoke is wrong! Cancer does not discriminate based solely on our activities or diet.
Martin Town Movember

Wanda Doyle, RN, Cancer Screening and Prevention Team, connects with the public about cancer screening awareness across our LHIN.

Are you at risk? Complete your cancer risk assessment online at