Research on cancer screening disparities among racially minoritised populations in Europe has largely relied on migration-focused frameworks, overlooking how racialisation itself structures engagement with preventive care. This study examines how prior healthcare experiences, including experiences of racism, shape breast and cervical cancer screening engagement among Black women of African descent in Flanders, Belgium. Semi-structured interviews were conducted with 36 women (aged 25-68). Three themes emerged: Naming racism captured a spectrum from overt discrimination to ambiguous microaggressions; (Il)legitimacy captured how first-generation women internalised hierarchies of deservingness; Divergent coping described persistent covert coping strategies including switching providers, alongside cumulative withdrawal from healthcare. Findings demonstrate that screening disparities cannot be understood through migration-related factors alone — centring racialisation makes visible structural dynamics that cultural or linguistic explanations obscure, arguing for institutional accountability over individual adaptation.