Barriers and facilitators of breast cancer screening services amongst black African women in high income countries: a systematic review and meta-aggregation.

Background: Black African women are less likely to take up breast screening than other ethnic groups despite living in high income countries where breast screening is provided, to identify breast cancer early. Research often focus on access to breast screening in minoritised ethnic women generally, a heterogeneous group. A systematic review and a meta-aggregation were undertaken to synthesize the barriers and facilitators that influence utilization of breast screening services amongst Black African women in high income countries. Methods: Nine databases were searched- Web of Science, Scopus, Medline, CINAHL, Cochrane, British Nursing Index, PsycINFO, AMED and Embase. The review was conducted in accordance with PRISMA and ENTEREQ guidelines for systematic review and meta-aggregation. 3153 articles were imported into Covidence, 23 articles were included in the study. Results: 21 out of 23 studies took place in the United States (US), only two studies were from the United Kingdom (UK) and Australia. The findings were synthesized into three main headings- Individual level barriers, service provider barriers and health system barriers. Individual barriers include lack of awareness/poor knowledge around breast cancer and breast screening services. Also, lack of understanding of preventive services, fear of breast cancer diagnosis, cultural barriers/stigma, religious barriers and practical barriers. Provider level barriers relate to attitude of staff and racial discrimination. There were system level barriers related to access to screening. Facilitators include prompts from service provider. Conclusion: This review revealed the need for country specific studies on barriers and facilitators to breast screening in Black African women, in order to develop targeted interventions that address the barriers distinctive to this population in high-income countries like the UK. Supplementary Information: The online version contains supplementary material available at 10.1186/s12982-026-01561-6.