Barriers to Cancer Screening in Immigrant Communities

First in our Cancer Series

“When I was told I had stage II gastric cancer, I was shocked and disbelief was my first reaction. I had always lived a healthy lifestyle, visited my doctor routinely, exercised regularly, and ate well — especially after losing my daughter to leukemia. I never imagined cancer would be part of my story.” — Gastric cancer survivor

Introduction

Cancer screenings save lives. Detecting malignancies such as breast, cervical, or colorectal in their early stage, treatment is more effective, survival rates increase, and reduces the overall burden on healthcare systems.

However, many immigrants living in the U.S., especially African immigrants, are facing significant barriers, and access to life-saving screenings is far from guaranteed.

Despite advances in diagnostics and national screening guidelines, cancer is often detected at advanced stages in immigrant communities — and the consequences are dire.

Why Screening Matters

“I first felt a lump in my breast nearly eight years ago, but I chose not to undergo a mammogram because my previous experience was so painful. The hesitation delayed my diagnosis for years. Reflecting, I was fortunate enough that the cancer hadn’t advanced further. If I had waited any longer, I might not have survived. My advice to others is simple: do not delay — get screened early!”— Breast cancer survivor.

Cancer doesn’t happen overnight. It develops over time, often starting with precancerous lesions that can be identified and treated before symptoms ever appear.

Screening works - the evidence is profound and the data tell a compelling story: here’s what the data shows:

• Breast cancer deaths have dropped by 39% among U.S. women.

• Colorectal cancer mortality is down 47% in men and 44% in women.

• Cervical cancer deaths have declined by over 80% following the widespread use of Pap smear testing (Sources: Loud et al., 2014; Habbema et al., 2012)

Yet these gains haven’t reached everyone.

“I had symptoms of dyspepsia for months and was treated for H. pylori, but my symptoms persisted, and the discomfort remains unresolved. Only after an endoscopy and biopsy did I learn it was stage II gastric cancer. I was frustrated — with my doctors for not investigating earlier, and with myself for not demanding answers sooner, especially knowing my father's history of esophageal cancer.”— Gastric cancer survivor.

The Reality for Immigrant Communities - “The elephant in the room”

One out of seven people in the US is a foreign-born individual, but they are much less likely to receive timely cancer screenings.  Why? Due to known common barriers such as:

• Language barriers and low health literacy—difficulties accessing, understanding, and using health information.

• Cultural beliefs, stigma, profound fears, and misconceptions towards cancer.

• Lack of health insurance coverage.

• Persistent mistrust of the healthcare system.

• Limited access to culturally sensitive care.

  
  

These challenges are not abstract — they affect real lives.

Understanding the Bigger Picture

“ A close friend of mine was diagnosed with breast cancer and advised to undergo a mastectomy. She refused, due to fears of losing her feminine attractiveness to her partner and her capacity to breastfeed. And feminine, she returned to Eritrea seeking traditional treatment instead. A year later, she came back, but her cancer had spread, and she passed away only a few months afterward.”— Gastric cancer survivor.

Health isn’t only shaped by a single factor; it emerges from the intersection of systems, environments, and beliefs. The National Institute on Minority Health and Health Disparities (NIMHD) breaks this down into four domains of influence:.

• Individual: beliefs, language proficiency, and health knowledge• Interpersonal: family or peer dynamics.

• Community: access to care and social norms.

• Societal: healthcare policy, and immigration laws (Source: Fang et al., 2017)

Each layer can either support or block access to cancer screenings.

Spotlight: African Immigrant Communities

African immigrants face distinct challenges compared to U.S.-born Black Americans. Despite often possessing higher education and income, they are:

• Less likely to have a consistent healthcare provider

• More likely to lack health insurance

• More likely to experience discrimination or bias in seeking medical care(Source: Venters & Gany, 2011)

In addition, women from certain African countries, such as Nigeria, face a higher risk of triple-negative breast cancer, a particularly aggressive and hard-to-treat form, due to inherited BRCA1 and BRCA2 mutations (Oluwagbemiga et al., 2021).

These realities make targeted outreach and screening programs not only necessary but urgent.

“In my community, many people remain passive in their healthcare interactions. They trust the doctor without voicing questions and concerns, and silent behavior can be dangerous, potentially compromising timely interventions. I want to encourage others, especially African immigrants, to speak up, ask about their options, make informed decisions, and take ownership of their health.”— Breast cancer survivor.

What Can Be Done

Prevention should be a right, not a privilege. Here are some ways we can begin to mitigate the barriers:

• Create culturally tailored screening programs.

• Employ community health navigators who speak the language fluently and know the culture comprehensively.

• Provide free or low-cost screenings with necessary logistical support..

• Collaborate actively with faith-based organizations and community leaders.

Call To Action

Cancer screening saves lives. The voices of survivors remind us of what is at stake when fear, pain, or silence delay care. Together, we can break down these barriers and ensure that every immigrant community has access to the care they deserve.

References

1. Loud, J. T., & Murphy, J. (2014). Cancer Screening and Early Detection. Seminars in Oncology Nursing, 30(3), 150–159.

2. Habbema, J. D. F., et al. (2012). Impact of Screening on Cervical Cancer Mortality in the United States. Cancer Epidemiology, Biomarkers & Prevention, 21(11), 1706–1713.

3. Fang, C. Y., et al. (2017). Social and Cultural Barriers to Cancer Screening Among Immigrants. Journal of Health Disparities Research and Practice, 10(4), 1–16.

4. Venters, H., & Gany, F. (2011). African Immigrant Health. Journal of Immigrant and Minority Health, 13(2), 333–339.

5. Oluwagbemiga, L. A., et al. (2021). BRCA Mutations and Breast Cancer in African Women. BMC Cancer, 21, 1234.