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Relationship between ethnicity and stage at diagnosis in England: a national analysis of six cancer sites

Fry, A; White, B; Nagarwalla, D; Shelton, J; Jack, RH; (2023) Relationship between ethnicity and stage at diagnosis in England: a national analysis of six cancer sites. BMJ Open , 13 (1) , Article e062079. 10.1136/bmjopen-2022-062079. Green open access

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Abstract

Objectives Cancer stage at diagnosis is a determinant of treatment options and survival. Previous research has shown differences in barriers to presentation with cancer between ethnic groups. The completeness and quality of cancer stage and ethnicity data has improved markedly over recent years in England, allowing for comparison of stage distributions at diagnosis between ethnic groups. This study aimed to assess relationships between ethnic group and two outcomes: unknown stage cancer and late stage (stages 3 and 4) cancer, after adjustment for confounders. Design and setting A retrospective secondary data analysis using data from NHS Digital's National Cancer Registration and Analysis Service and Hospital Episode Statistics records from 2012 to 2016. Participants This study analysed newly diagnosed breast, colon, non-small cell lung cancer (NSCLC), ovary, prostate and uterine cancers in white British, Caribbean, African, Chinese and Asian patients aged 15-99 in England. Results Caribbean, African and Asian women with breast or ovarian cancer, Caribbean and African women with uterine or colon cancer, Caribbean women with NSCLC and Caribbean men with colon cancer had increased odds of late-stage disease at diagnosis compared with the white British cohort. In contrast, Caribbean and African men with prostate cancer had decreased odds of late-stage cancer. Where stage was known, there were variations in late-stage cancer by ethnic group. Conclusions Low symptom awareness and barriers to presentation can cause delays, resulting in later stage diagnosis. 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.

Type: Article
Title: Relationship between ethnicity and stage at diagnosis in England: a national analysis of six cancer sites
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1136/bmjopen-2022-062079
Publisher version: https://doi.org/10.1136/bmjopen-2022-062079
Language: English
Additional information: © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
Keywords: adult oncology, oncology, statistics & research methods, Female, Humans, Male, England, Ethnicity, Retrospective Studies, Neoplasms, Neoplasm Staging, Adolescent, Young Adult, Adult, Middle Aged, Aged, Aged, 80 and over
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health > Behavioural Science and Health
URI: https://discovery.ucl.ac.uk/id/eprint/10165050
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