The first national study of its kind in Ireland has been conducted to assess cancer awareness, attitudes, screening participation, and access to healthcare among the Traveller community.
Social determinants of health have a significant impact on Traveller health, while stigma and discrimination can significantly hinder Travellers’ ability to adopt risk-reducing lifestyle behaviours, participate in screening, and access healthcare.
Findings reveal a high level of awareness of cancer risks among the Traveller community, while the development of the role of the Traveller healthcare worker was viewed positively and identified as a means to improve Traveller health.
The HSE’s National Cancer Control Programme commissioned the co-designed study led by University College Dublin (UCD) in partnership with Pavee Point Traveller and Roma Centre on Cancer Awareness and Attitudes among the Traveller Community in Ireland.
The research aimed to understand Travellers’ awareness of cancer risk factors and signs and symptoms; identify barriers and enablers to cancer risk reduction and early diagnosis of cancer – including access to health services and engagement with cancer prevention/risk-reducing behaviours; and assess the impact of the social determinants of health on health-related behaviours.
The study also looked at healthcare professionals’ views regarding the barriers and enablers for Travellers concerning healthy lifestyle behaviours, cancer screening participation, and timely reporting of cancer symptoms.
Traveller community health workers across Ireland coordinated and collected data from 483 surveys and assisted in recruitment for the qualitative interviews with Travellers and health professionals.
Dr Una Kennedy, GP Advisor to the HSE’s National Cancer Control Programme, said, “We are delighted to publish this research report on cancer awareness and attitudes amongst the Traveller community in Ireland. The research provides an understanding of cancer awareness and attitudes among the Traveller community in Ireland as well as barriers and enablers for Travellers engaging with the health system.
“This is the first study of its kind to be undertaken in Ireland. The research provides baseline data to inform the development and delivery of effective cancer prevention and early diagnosis initiatives, monitor the impact of these initiatives, and support better understanding of policy priorities.”
The majority of respondents agreed that there are actions they can take to reduce their cancer risk, particularly smoking, with a total of 88 per cent of respondents spontaneously citing it as a risk factor.
“There was also strong recognition of ultraviolet radiation from the sun and sunbeds as a risk factor, with 92 per cent identifying sunbed use and 78 per cent citing sunburn as a risk factor.
Most Travellers knew that a lump or a bump, or a changing mole, could be a sign of cancer. Other common signs and symptoms of cancer such as an ongoing cough or losing weight were less well recognised.
The key enablers for accessing cancer screening were speaking with the local Traveller primary healthcare worker (28%), and receiving an invitation to attend screening helps to improve screening uptake (27%).
Barriers to acting on a potential sign or symptom of cancer include not wishing to discuss their symptoms with a doctor’s receptionist (37%), fearing the potential diagnosis (32%), and the possibility of needing additional tests (31%).
Dr Patricia Fox, principal investigator on the project and Assistant Professor, UCD School of Nursing, Midwifery, and Health Systems, said: “Our findings reveal a ‘whole of government’ approach is required to address the underlying social determinants of health, which negatively impact Travellers in the context of cancer prevention, screening, and early detection.
“There needs to be continued partnership with Traveller organisations and primary healthcare for Travellers projects on all initiatives related to the Traveller community and particularly with reference to increasing knowledge of cancer risk factors and targeted and mainstreaming support for cancer prevention, screening, and early detection.
“Trusted relationships with culturally sensitive, well-resourced healthcare professionals and health services are also key, as is employing flexible, innovative approaches in this context.”
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