Our study provides evidence that active smoking may play a role in breast cancer etiology and suggests that further research into the connection is warranted, especially with respect to genetic susceptibilities.

CTS members have high rates of several major cancers, particularly breast cancer, and low rates of lung and cervix cancer. Although late age at first birth can explain a portion of the observed excess risk of breast cancer in this cohort, the unique risk factor profile of CTS members may account for much of their higher risk of breast and selected other cancers. The CTS offers a rich resource for future studies of cancer risk and of women's health, in general.

ObjectivesThis study sought to explore the differential patient satisfaction reported by patients with cancer who are from ethnic minority backgrounds, examining patient-reported experience of interacting with medical and nursing staff.SettingAs a secondary analysis, we collated data collected over two consecutive annual rounds of the National Cancer Patient Experience Survey (NCPES) from September 2012 to November 2013.ParticipantsThere were 138 878 responses from 155 hospital trusts across the National Health Service in England, representing a response rate of 63.9% based on the total identified cohort of patients receiving cancer care over those 2 years.OutcomesWe used the results of the annual survey, which sought to assess overall patient satisfaction along with patient experience of interacting with clinical nurse specialists, hospital doctors and ward nurses.ResultsEthnic minority patients reported lower satisfaction and less positive experiences of care overall. While some of this difference appeared related to demographic and socioeconomic variation, ethnic minority patients remained less positive than those in the White British group, after statistical adjustment. Ethnic minority patients also reported lower confidence in, and less understanding of, healthcare professionals, including clinical nurse specialists, doctors and ward nurses.ConclusionsGiven the diversity of the British population, as well as the clustering of ethnic minority patients in certain urban areas, a better understanding of the expectations and additional needs of ethnic minority patients is required to improve their experience of and satisfaction with cancer care.