Barriers to screening amongst first-degree female relatives of patients with breast cancer: a qualitative study

PURPOSE: To explore the underlying reasons and external factors influencing non‑participation or willingness to undergo screening among female first‑degree relatives of breast cancer patients, and to provide a basis for developing intervention programs through qualitative interviews. METHODS: A descriptive qualitative design was adopted. From the perspective of the Health Ecological Model, semi‑structured in‑depth interviews were conducted with 18 female first‑degree relatives of breast cancer patients. Thematic analysis was used to analyze the interview data. RESULTS: Participants ranged in age from 25 to 67 years and included daughters, sisters, and mothers of patients. Three themes and seven sub‑themes were identified: Microsystem (Emotional and trust barriers, Perceived imbalance of risk and cost); Mesosystem (Lack of family support, Insufficient interpersonal and information support, Poor advice from healthcare professionals); Macrosystem (Insufficient policy coverage, Cultural taboos and fatalism). CONCLUSION: Female first‑degree relatives of breast cancer patients face multi‑level barriers to screening. Healthcare providers should implement targeted interventions addressing these factors to improve their screening behaviors.