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March 5, 2026Journal of Cancer Policy0 citationsOpen Access

“No one warned us about cancer”: Understanding barriers and facilitators to accessing and utilizing cancer prevention services among Syrian refugees in Germany

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SBSara BashirAIAbdoul-Kawihi IssakaRHRihab Hadidi

Key Points

  • This study aims to understand the barriers and facilitators affecting Syrian refugees' access to cancer prevention services in Germany.
  • Conducted semi-structured interviews with 25 Syrian refugees in Sachsenheim.
  • Participants had statutory health insurance and resided in Germany for 20 years or less.
  • Data analyzed using Levesque’s framework for healthcare access.
  • Participants identified language barriers and low cancer literacy as significant obstacles.
  • Trust in the healthcare system facilitated access to services.
  • Recommendations included the need for multilingual cancer materials and professional interpreters.

Abstract

Cancer is a leading cause of death worldwide and in Germany. While the German healthcare system provides statutory health insurance (SHI) coverage for a range of cancer prevention services, structural inclusion does not translate to access and use of services. Syrian refugees constitute one of the largest refugee populations in Germany, yet little is known about their experiences with cancer prevention in Germany. This study explores the barriers and facilitators for accessing and utilizing cancer prevention services among Syrian refugees in Sachsenheim, Baden-Württemberg, Germany. Semi-structured key-informant interviews were conducted with 25 participants in 2025 with Syrian refugees who a) have SHI, b) are aged 18 and above, and c) have been residing in Germany for 20 years or less. Data were analyzed deductively using Levesque’s framework for healthcare access. Participants reported multiple barriers to access and use of cancer prevention services, including language difficulties, limited cancer literacy, insufficient outreach and multilingual cancer prevention material. Participants also described barriers and facilitators to healthcare access and use including long waiting times which was seen as indirectly influencing engagement with cancer prevention services. Facilitators included trust in the German healthcare system and healthcare providers, SHI coverage, Arabic-speaking doctors and translators, informal support networks. Participants recommended increasing knowledge about cancer prevention services, using multilingual and digital and in-person outreach, and leveraging the pivotal role family doctors. Despite formal SHI coverage, access and utilization of cancer prevention services among Syrian refugees are shaped by structural, linguistic, and informational barriers which limit equitable engagement with preventive care. Findings underscore the need for linguistically accessible cancer prevention materials that include information clearly outlining cancer symptoms, causes, screening test names, steps, locations, and cost and insurance coverage details. Professional interpreters should also be integrated into the healthcare system in Germany. ● Syrian refugees in Germany face multiple barriers to cancer prevention services. ● Language barriers and low cancer literacy are key obstacles to cancer prevention. ● Trust in the German healthcare system facilitates access to cancer prevention. ● The legal integration of professional medical interpreters is a key recommendation.

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Cite This Study

Bashir et al. (2026) studied this question.

synapsesocial.com/papers/69a91dedd6127c7a504c1394https://doi.org/10.1016/j.jcpo.2026.100727
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