Socio-Cultural Beliefs and Health System Structures Influencing Delayed Colorectal Cancer Screening Among Indian Migrant Communities in Developed Countries: A Scoping Review Protocol

Mayur  Savsaiya; Kamal Singh; Apil Gurung

doi:10.17605/OSF.IO/N8TGA

Colorectal cancer (CRC) is one of the leading causes of cancer morbidity and mortality globally. The likelihood of developing this cancer rises with age, with the majority cases occurring in individuals above 50 years. However, recent trend indicate increasing number of diagnoses in Younger adult. In many developed countries such as Australia, New Zealand, organized population-based screening programs which include fecal immunochemical testing (FIT), fecal occult blood testing (FOBT), and colonoscopy screening programs offered through primary care systems. Indian migrants constitute one of the largest and fastest-growing diaspora communities globally. Evidence suggests that migrant populations may experience lower participation in preventive screening services due to intersecting socio-cultural, linguistic, structural, and systemic barriers (Rajan, 2025) which may lead to delayed screening. Such delays may result in diagnosis at more advanced stages, reduced survival outcomes, and increased healthcare costs. The aim of study is to systematically map and synthesise existing literature on how socio-cultural beliefs and health system structures influence patterns of delayed colorectal cancer screening among Indian migrant communities in developed countries and the objectives are to identify socio-cultural beliefs, norms, and values, examine structural and systemic health system factors associated with delayed CRC screening among Indian migrants and identify intervention strategies that have been implemented to address screening delays and highlight gaps in evidence and propose directions for future research. Searches will be limited to English-language publications from 2000 onwards to capture contemporary screening program contexts. Data analysis will be conducted using a narrative synthesis approach. Findings will be organised thematically under two primary domains: (1) Socio-cultural factors and (2) health system structures. As this study involves secondary analysis of published literature, ethical approval is not required. However, ethical principles of transparency, rigor, and accurate reporting will be maintained. The expected outcomes of the study are to Identify under-researched area, provide an evidence map of socio-cultural and structural determinants of delayed CRC screening, inform policy modifications, and support health system redesign initiatives aimed at improving equity in cancer prevention. Understanding delayed colorectal cancer screening among Indian migrant communities requires attention to both cultural belief systems and the structural realities of host healthcare systems. By systematically mapping this intersection, the proposed scoping review will help reduce screening disparities, enhance culturally safe healthcare delivery, and inform evidence-based public health strategies in developed countries.

Socio-Cultural Beliefs and Health System Structures Influencing Delayed Colorectal Cancer Screening Among Indian Migrant Communities in Developed Countries: A Scoping Review Protocol

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