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Table 3 Barriers to cancer screening uptake as well as follow-up and treatment in Indigenous populations

From: Australia's National Bowel Cancer Screening Program: does it work for Indigenous Australians?

Socio-cultural and behavioural barriers Structural barriers
Individual barriers Access barriers
Poor knowledge and awareness of cancer and screening services Poor coordination of services, from screening to follow-up and treatment
Low levels of health literacy Lack of transportation
Language/literacy barriers Distance barriers/rural residence
Low perceived risk Frequent moving, changing address
Negative attitude Child care commitments (family responsibilities)
Worry or fear of cancer Inflexible clinic schedules
Fatalism regarding cancer Lack of Indigenous staff
Low priority of screening Difficulties negotiating/communicating with providers and organizations due to language/literacy or cultural differences
Perceived self efficacy  
Lack of appropriate health information  
Presence of co-morbidities Lack of health promotion material in Indigenous languages
History of racism and distrust in medical institutions  
Discomfort with mainstream services/alienating hospital environment  
Absence of holistic, culturally appropriate cancer services  
  Cost of seeing a GP including transport
  Unsure of potential costs of follow-up and treatment
  Costs for travel and accommodation to hospital
  Lack of understanding of cultural needs
  Poor identification of Indigenous status
  Lack of appropriate resources