Perceived barriers and facilitators influencing cervical and breast cancer screening among healthcare professionals in the Cape Coast Metropolis, Ghana: An explanatory mixed-methods study

Abstract Background Cervical and breast cancers remain major public health challenges globally and account for substantial morbidity and mortality among women, particularly in low- and middle-income countries (LMICs). Healthcare professionals play a critical role in promoting cancer prevention, early detection, and screening; however, participation in cancer screening among healthcare professionals remains suboptimal in many settings. This study explored barriers and facilitators influencing cervical and breast cancer screening among healthcare professionals in the Cape Coast Metropolis of Ghana using an explanatory mixed-methods approach. Methods An explanatory sequential mixed-methods study was conducted among healthcare professionals working in selected health facilities within the Cape Coast Metropolis. The quantitative component involved 517 healthcare professionals who completed structured questionnaires assessing health-system factors, screening intentions, recommendation behaviors, perceived barriers, and suggested interventions. Qualitative data was obtained through in-depth interviews with healthcare professionals purposively selected from different professional groups. Quantitative data were analyzed using descriptive statistics, while qualitative data were analyzed using Braun and Clarke's thematic analysis framework. Results Most participants reported the availability of onsite cervical (63.0%) and breast (61.9%) cancer screening services; however, only 23.0% indicated that their institutions provided protected work time or formal support for screening attendance. More than half (53.6%) expressed willingness to undergo screening within the next 12 months, while 56.1% regularly recommended screening to patients. The main barriers to screening were lack of time, fear of diagnosis, confidentiality concerns, and financial constraints. Qualitative analysis generated four themes: knowledge and awareness of cancer screening; attitudes, beliefs and perceptions toward screening; structural and workplace barriers; and motivators and strategies for improving screening uptake. Conclusion This mixed-methods study demonstrates that barriers and facilitators to cervical and breast cancer screening among healthcare professionals extend beyond individual knowledge and attitudes to include workplace and health-system influences. Integrated findings highlighted the importance of workload management, confidential screening pathways, affordable screening services, and institutional support in promoting screening participation.