In partnership with NHS England, we reviewed diagnoses of six types of cancer from 2012-2016 in England in people belonging to one of five ethnic groups, to investigate the relationship between ethnic group and late-stage diagnosis (stages 3 or 4). Cancer stage at diagnosis is a determinant of treatment options and survival.
Caribbean, African and Asian women with breast or ovarian cancer, Caribbean and African women with uterine or colon cancer, Caribbean women with non-small cell lung cancer and Caribbean men with colon cancer were more likely to be diagnosed at a late stage compared with the white British cohort.
For breast and colon cancers, non-white patients diagnosed via the same route still have increased odds of late-stage disease.
Caribbean and African women with uterine cancer were more than twice as likely to be diagnosed at a late stage than white British women.
Reasons behind increased likelihood of late diagnosis for some ethnic groups may include poorer symptom awareness, delays in seeking help and having to present to the GP multiple times before being referred for tests.
In contrast, Caribbean and African men with prostate cancer had over 20% decreased odds of late-stage cancer. Greater awareness of the risk of prostate cancer among both GPs and black men, supported by cancer charity campaigns, is likely to be driving an increase in the likelihood of black men receiving prostate-specific antigen testing.
Understanding the mechanisms of delayed diagnosis, and therefore late-stage disease, is important to reduce disparities in cancer survival by ethnic group.
Targeted intervention campaigns to help raise awareness of cancer signs and symptoms and the benefits of early diagnosis, along with removing barriers to appropriate referrals, could help to improve these inequalities.
Read the full article on the BMJ websiteAnna Fry, Becky White, Diana Nagarwalla, Jon Shelton.
If you have any comments, questions or feedback, please reach out to our team.
