Exploring women’s perspectives on barriers and facilitators to breast cancer screening among Malaysians: a qualitative study

Breast cancer is the most prevalent cancer in Malaysia, accounting for 17.6% of all cancer diagnoses and 32.4% of all cancers among women (2017–2021). However, according to a nationwide survey, mammography uptake has declined to 12.8% among women aged 40 and above by 2023. This study explored barriers and facilitators to breast cancer screening among Malaysian women. Methods: A qualitative study was conducted with purposive sampling of women aged 40 and above in the urban Klang Valley, selected based on ethnicity, education, and screening history. In-depth interviews continued until data saturation, with transcripts analysed through descriptive coding and thematic analysis. Results: A total of 41 women participated, of whom 19 were aged 50 and above. Participants comprised Malay ( n = 14), Chinese ( n = 15), and Indian ( n = 12) women. Fewer than half were up-to-date with breast cancer screening and slightly more than half held tertiary education. Barriers were grouped into eight themes: limited awareness and knowledge, psychosocial barriers, cultural influences, attitudinal factors, perceived susceptibility, competing responsibilities, perceived costs, and healthcare access. Six themes for facilitators emerged: healthcare provider influence, accessible and incentivised services, supportive reminders, social support, individual motivation, and health education and promotional channels. Mapped onto the Health Belief Model, barriers concentrated under perceived barriers while facilitators concentrated under cues to action. Conclusions: Findings highlight the multifaceted barriers and facilitators to screening uptake. Interventions addressing individual and systemic factors, including intensifying education, enhancing accessibility, and fostering supportive communities are essential to strengthen participation.