How social class shapes breast cancer risk perspectives and prevention practices of Australian midlife women - a qualitative study using the concept of ‘breast cancer candidacy’

Sep 21, 2026

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Rising breast cancer incidence and the associated disease burden are major public health concerns. Although up to 30% of cases could be prevented by targeting modifiable risks, misconceptions about risk limit effective primary prevention. When primary prevention is absent, secondary prevention—such as mammography—supports earlier detection, yet population screening remains suboptimal. This qualitative study examines how social class shapes Australian midlife women’s risk perceptions and prevention practices through lay epidemiology, breast cancer candidacy, and Bourdieu’s relational social class theory.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages16

Reading Time40 min

AccessFree to download

Abstract

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Background

Batchelor etal. BMC Cancer (2024) 24:1295 BMC Cancer [https://doi.org/10.1186/s12885-024-13054-3](https://doi.org/10.1186/s12885-024-13054-3) RESEARCH Open Access How social class shapes breast cancer risk perspectives and prevention practices of Australian midlife women: a qualitative study using the concept of ‘breast cancer candidacy’ Samantha Batchelor 1, Belinda Lunnay 1, Sara Macdonald2 and Paul R. Ward 1* Abstract Background The increasing incidence of breast cancer and disease burden is a significant public health concern. While 30% of breast cancers could be prevented through addressing modifiable risk factors, misconceptions among women about breast cancer risks hamper primary prevention. In the absence of primary prevention, secondary prevention such as mammography increases the early detection of breast cancer and improves health outcomes. However, current population-level screening rates indicate secondary prevention is suboptimal. More effective public health efforts to improve breast cancer prevention are required. Given breast cancer is socially patterned, this work explores how social class impacts women’s breast cancer prevention practices. This study uses the concepts of lay epidemiology and candidacy as a mechanism to understand women’s breast cancer risk perspectives. It engages Bourdieu’s relational social class theory to unpack how women’s social, cultural, and structured life contexts shape these perspectives and their considerations regarding primary and secondary prevention. Methods In this qualitative study 43 Australian midlife women (aged 45–64 years), were interviewed to explore their understandings of breast cancer risks, how they perceived their own risk, and how this shaped their prevention behaviours. A theory-informed thematic analysis applying Bourdieu’s concepts of habitus, capital, and fields to understand how women’s social class positions shapes risk perspectives and prevention practices was conducted. Results This social class analysis showed differences in how women engage in breast cancer discourse, consider risks, and participate in breast cancer prevention. Middle-class women prioritise health promoting practices and were more likely than working-class and affluent women to attend mammography screening. Working-class women experience structural factors, like low income, stress and difficult life circumstances, which hamper primary prevention practicesand for some screening is not considered or prioritised, and their decisions not to screen are less active. Affluent *Correspondence: Paul R. Ward [paul.ward@torrens.edu.au](paul.ward@torrens.edu.au) Full list of author information is available at the end of the article © The Author(s) 2024. Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit [http://](http://)[ ](http://)[creativecommons.org/l](creativecommons.org/l)icenses/by-nc-nd/4.0/. Batchelor et al. BMC Cancer (2024) 24:1295 Page 2 of 16 women often do not consider themselves at-risk due to their healthier ‘lifestyles. ’They suggest that this, and thei

FAQs

What is the focus of the study on breast cancer prevention?

The study examines how social class influences Australian midlife women’s perspectives on breast cancer risk and how those perspectives shape prevention practices, including both primary and secondary prevention.

How did the researchers collect data and analyze it?

The study interviewed 43 Australian midlife women aged 45–64 and used theory-informed thematic analysis based on Bourdieu’s concepts of habitus, capital, and fields.

What differences in prevention practices were observed across social classes?

Middle-class women prioritized health-promoting practices and were more likely to attend mammography screening, while working-class women faced structural constraints such as low income and stress that hampered primary prevention and reduced active participation in screening.

Why do the authors argue public health approaches need to address social class?

Findings suggest women interpret and respond to breast cancer risk differently depending on the opportunities and limitations of their social class positions, so prevention efforts must respond to class-based constraints and structural factors to improve equity.

Sep 21, 2026

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