Building bridges to equitable breast cancer care for South Asian women
Professor Daksha Trivedi’s research is helping to break down cultural and systemic barriers to cancer services for South Asian women – informed, in part, by her own cancer journey.
Breast cancer is the most common cancer in the UK, accounting for 30 per cent of all new cancer cases in women. But while early detection and treatment have improved survival rates overall, these benefits are not shared equally.
Women from ethnic backgrounds – particularly Black and South Asian women – are less likely to be aware of breast cancer symptoms or to attend screenings, contributing to later-stage diagnoses and poorer outcomes. Three-year survival rates for South Asian and Black women are lower than for white women.
Evidence shows that women from some ethnic groups also experience higher levels of depression, anxiety, and poorer quality of life following a diagnosis. The reasons are complex: cultural taboos, language barriers, and a lack of trust in, or understanding of, the healthcare system.
Addressing these challenges is the focus of research by Daksha Trivedi, Professor of Applied Health Research at the University of Hertfordshire. Collaborating with the Asian Women Cancer Group and the East of England Cancer Alliance, Trivedi’s team explored the experiences and perceptions of South Asian women throughout their cancer journeys.
“It’s so important to listen to those directly affected,” says Professor Trivedi. “Their voices help us understand what really works – and where the barriers still are – to accessing cancer care.”
The study is part of a wider NIHR Applied Research Collaboration East of England programme on prevention and early detection. South Asian women aged 46 to 81, all either breast cancer survivors or undergoing treatment, took part. They shared their views on breast screening, the referral process and the support they received before, during and after treatment.
What emerged was a picture of avoidable barriers and missed opportunities. Many women spoke of limited understanding of screening and what it involved. Language barriers were common, and clinical communications often failed to account for the emotional shock of a diagnosis or the unfamiliarity of medical terminology. One key frustration was receiving critical information by letter, rather than in conversation with a clinical nurse.
The study also revealed gaps in awareness of available treatments and support services and highlighted the importance of culturally sensitive care. For many South Asian women, social stigma around cancer can create further isolation – something Professor Trivedi understands first-hand.
In late 2017, just six months after losing her twin brother to primary oesophageal cancer, Professor Trivedi was diagnosed with the same disease. Raised in a traditional South Asian family, she was acutely aware of how a cancer diagnosis is often seen as taboo within the community.
My own cancer journey showed me how crucial it is to provide holistic support that meets patients’ cultural and individual needs. It has been so rewarding to work with, and relate to, the Asian Women Cancer Group, who are from the same culture as me. This research is an important step towards ensuring cancer care meets the needs of South Asian families.
Professor Daksha Trivedi,
Professor of Applied Health Research
The study offers practical recommendations to improve care. These include recruiting Community Champions to raise awareness and address cultural barriers, ensuring a Cancer Clinical Nurse is present at diagnosis, and promoting diverse representation in educational materials. It also calls for stronger referral pathways to community support groups and tailored training for clinicians in using existing clinical tools to communicate effectively across cultures.
Discussions are now underway with the East of England Cancer Alliance on how to implement these recommendations. The project forms part of Professor Trivedi’s broader commitment to research that tackles health inequalities across marginalised communities.
Another current initiative is a feasibility study of a culturally adapted, faith-based mental health programme for young Muslim women. In partnership with the charity Inspirited Minds, the IM-Adapted Project aims to improve engagement and outcomes for a group who face additional barriers in accessing conventional mental health support.
"If we want to reduce health inequalities, we need to design services that reflect the cultural and social realities of the people they serve. That means working in partnership with communities to move beyond a one-size-fits-all approach, listening to lived experience, and embedding inclusivity into healthcare systems at every level". Professor Daksha Trivedi
Professor Trivedi
Professor of Applied Health Research
Professor Daksha Trivedi trained as a scientist and obtained her Ph.D (King’s College, London) and M.Sc, Faculty of Medicine, University of London and an M. Phil in Epidemiology at the University of Cambridge.
She has an established strong record of conducting interdisciplinary research which spans across various public health areas including mental health. Her expertise in Applied Health Research includes Evidence Based Practice (systematic reviews & evidence synthesis), Quantitative and qualitative designs, Mixed Methods, Clinical Trials, evaluation of complex interventions and co-production, leading stakeholder events with community engagement. Daksha’s work includes mental health, prevention and early detection and health inequalities, leading research in Health, experience and care of marginalised, disadvantaged and ethnically diverse groups. She collaborates with the National Institute for Health and Care Research (NIHR) Applied Research Collaboration East of England (EoE) and is the University’s lead for applied mental health and care research and implementation with the NIHR ARC, EoE.