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Equity in breast cancer screening

For more than 20 years, the Flemish government has been informing women about the possibility of participating in the population based screening programme for breast cancer. Yet it turns out that women with a low socio-economic status (SES) participate below average in this screening: there are persistent misunderstandings about screening and people are not always aware of its importance. With this study, we want to develop a campaign together with women from the underserved group to improve accessibility to the screening programme. For this purpose, we will work together to develop and test (RCT) a reminder letter, tailored to the target group, based on the invitation letter. In this way, we want to achieve equal access to the screening programme.


From until

Supported by

Stichting tegen kanker (CPR-2022/1888)

Every year, more than 10,000 women are affected by breast cancer in Belgium (Belgian cancer registry, 2022). About 75% of women who develop breast cancer are 50 years or older. Early detection of breast cancer reduces the need for radical therapies and increases the chances of cure. Therefore, women aged 50 to 69 in Flanders are informed that they can be screened every two years.  However, women with a low socio-economic status (SES) participate much less in population screening for breast cancer.

Barrier to participation in breast cancer screening 

For women with low SES, misconceptions about breast cancer screening are the main barrier to participation. For example, people think that breast screening (mammography) is dangerous. To improve equity in the breast cancer screening programme, adapted communication is needed for this specific target group, based on a thorough understanding of their misconceptions about the programme. 

Co-creation of a tailored reminder letter 

In Flanders, there is currently no reminder letter for participation in the breast cancer screening programme. As part of this project, we are developing a tailored reminder that takes into account possible misconceptions about population screening. To identify barriers and misconceptions, we organise participatory focus groups.  We compare these results with existing international literature. Experts from different organisations, including primary care professionals, are invited to give feedback on the results, which are then incorporated into a reminder letter. However, the most important experts are women themselves. Based on the findings, we create a customised reminder letter together with women from the target group (co-creation). Such working methods, especially co-creation, are increasingly encouraged as a method where people themselves are actively involved and help shape the process.


This project is funded by the Foundation against Cancer (CPR-2022/1888).
Thomas More and the University of Antwerp are leading this project in collaboration with CVKO (centre for cancer detection) and Domus Medica.



Liesbet Van Bos

Liesbet Van Bos is a researcher in the People and Well-being Research Group, research line Prevention and empowerment. Her focus is currently on co-creative research.


Sarah Talboom

Sarah Talboom (MSc Communication Studies) joined Thomas More University of Applied Sciences in 2019. Her expertise lies in the field of inclusive communication.

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