Understanding bowel cancer screening behaviour and intention across British, Indian, and Indian-Immigrant populations: A qualitative cross-cultural comparison

Abstract

Bowel cancer screening reduces mortality, yet uptake remains suboptimal across many populations. While disparities in participation are well documented, limited qualitative research has explored how cultural and healthcare contexts shape attitudes towards screening and preventive healthcare. This study examined beliefs, experiences, and screening-related decision-making among White British individuals, Indian immigrants living in the UK, and individuals residing in India. A cross-cultural qualitative design was employed, with 30 participants taking part in semi-structured interviews. Data were analysed using reflexive thematic analysis. Four themes were identified: (1) preventive versus symptom-driven healthcare orientations; (2) making sense of screening as a preventive health practice; (3) fear and uncertainty in screening decision-making; and (4) healthcare systems as contexts for prevention. Findings suggest that attitudes towards preventive healthcare differ across cultural and healthcare settings and are shaped by an interaction between individual beliefs, emotional responses, and healthcare systems.