Background
Vulnerable groups face a higher risk of developing cancer due to factors such as socioeconomic disadvantage, language barriers, and limited access to healthcare. At the same time, they are less likely to participate in screening programmes, which further increases their risk. This is also seen in gastric cancer, the world’s fifth most common cancer, where incidence is substantially higher in certain migrant groups, partly due to higher H. pylori prevalence in their countries of origin.
Objectives
For TOGAS, an EU4Health project that provides evidence-based insights for developing screening approaches and recommendations for gastric cancer guidelines in the European Union, Thomas More University of Applied Sciences worked with migrant groups in the Netherlands and Belgium and the Roma population in Romania. This study aimed to gain insight into motivations, perceptions of risk, and intentions related to gastric cancer screening, with a focus on vulnerable populations.
Methods
To assess motivations, risk perceptions, and intentions regarding gastric cancer screening, Thomas More co-developed a methodology using focus group discussions on health literacy, prevention, and gastric cancer screening. These discussions were conducted in language schools in the Netherlands and Belgium and in social work centres serving the Roma population in Romania.
Results
The results of these focus groups offer valuable insight into how people with low health literacy understand health and prevention, and highlight practical ways to improve screening invitations and communication about cancer prevention and screening. Participants’ feedback on tone of voice, vocabulary, layout, contact options, and practical instructions can be directly translated into invitation strategies and routine communication by first-line healthcare staff.
Conclusions
Incorporating an equity perspective when developing screening recommendations that include the needs of specific vulnerable populations enhances the usability, credibility, and effectiveness of the gastric cancer guidelines developed within TOGAS. Moreover, by building on insights into how health, risk, and prevention are understood, these findings could inform future research on equitable screening implementation for other types of cancer. The project has received funding from the EU program EU4Health under Grant Agreement No 101101252.