Breast and bowel cancer screening uptake patterns over 15 years for UK south Asian ethnic minority populations, corrected for differences in socio-demographic characteristics

Szczepura, Ala; Price, Charlotte L; Gumber, Anil

doi:10.1186/1471-2458-8-346

Cited by 117 publications

(120 citation statements)

References 44 publications

(31 reference statements)

Supporting

Mentioning

112

Contrasting

Order By: Relevance

“…27 Despite recent progress, breast cancer screening uptake remains much lower in South Asians than in non-South Asians. 28 Similarly, the pilot bowel cancer screening programme showed that uptake in South Asians was much lower than in non-South Asians. 28 We applied flexible models on all incident cancer cases in South Asians resident in England over a period of 19 years, enabling a more robust estimation of temporal and socioeconomic patterns in incidence than is possible with a solely descriptive approach.…”

Section: Discussionmentioning

confidence: 99%

“…28 Similarly, the pilot bowel cancer screening programme showed that uptake in South Asians was much lower than in non-South Asians. 28 We applied flexible models on all incident cancer cases in South Asians resident in England over a period of 19 years, enabling a more robust estimation of temporal and socioeconomic patterns in incidence than is possible with a solely descriptive approach. The assignment of South Asian ethnicity, however, differed between the cancer registrations and the general population, but SANGRA has been shown to have high sensitivity (89-96%) and specificity (94-98%) against self-assigned South Asian ethnicity.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Cancer incidence in South Asian migrants to England, 1986–2004: Unraveling ethnic from socioeconomic differentials

Maringe

Mangtani

Rachet

et al. 2012

Intl Journal of Cancer

View full text Add to dashboard Cite

Studies on cancer in migrants are informative about the relative influence of environmental and genetic factors on cancer risk. This study investigates trends in incidence from colorectal, lung, breast and prostate cancer in England among South Asians and examines the influence of deprivation, a key environmental exposure. South Asian ethnicity was assigned to patients recorded in the population-based National Cancer Registry of England during 1986-2004, using the computerized algorithm SANGRA: South Asian Names and Groups Recognition Algorithm. Population denominators were derived from population censuses. Multivariable flexible (splines) Poisson models were used to estimate trends and socioeconomic differentials in incidence in South Asians compared to non-South Asians. Overall, age-adjusted cancer incidence in South Asians was half that in non-South Asians but rose over time. Cancer-specific incidence trends and patterns by age and deprivation differed widely between the two ethnic groups. In contrast to non-South Asians, lung cancer incidence in South Asians did not fall. Colorectal and breast cancer incidence rose in both groups, more steeply in South Asians though remaining less common than in non-South Asians. The deprivation gaps in cancer-specific incidence were much less marked among South Asians, explaining some of the ethnic differences in overall incidence. Although still lower than in non-South Asians, cancer incidence is rising in South Asians, supporting the concept of transition in cancer incidence among South Asians living in England. Although these trends vary by cancer, they have important implications for both prevention and anticipating health-care demand.Longstanding studies on cancer in migrants highlight the predominant influences of lifestyle rather than genetic factors on cancer risk.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Cancer incidence in South Asian migrants to England, 1986–2004: Unraveling ethnic from socioeconomic differentials

Maringe

Mangtani

Rachet

et al. 2012

Intl Journal of Cancer

View full text Add to dashboard Cite

show abstract

“…Yet, utilization of breast cancer screening services is poor in South Asian women living in Asia (Maqsood et al, 2009;Bhatt et al, 2011;Grosse Frie et al, 2013), the US (Islam et al, 2006;Glenn et al, 2009;Lee et al, 2010) as well as other western countries (Sutton et al, 2001;Szczepura et al, 2008;Price et al, 2010;Rajan et al, 2011;Peltzer and Phaswana-Mafuya, 2014). Across the various studies among South Asians, the mammography rates range from 30-56%.…”

Section: Introductionmentioning

confidence: 99%

Attitudes of South Asian Women to Breast Health and Breast Cancer Screening: Findings from a Community Based Sample in the United States

Poonawalla

Goyal

Mehrotra

et al. 2014

Asian Pacific Journal of Cancer Prevention

View full text Add to dashboard Cite

Background: Breast cancer incidence is increasing among South Asian migrants to the United States (US). However, their utilization of cancer screening services is poor. This study characterizes attitudes of South Asians towards breast health and screening in a community sample. Materials and Methods: A cross-sectional survey based on the Health Belief Model (HBM) was conducted among South Asians (n=124) in New Jersey and Chicago. The following beliefs and attitudes towards breast cancer screening were assessed-health motivation, breast self-examination confidence, breast cancer susceptibility and fear, and mammogram benefits and barriers. Descriptive statistics and Spearman rank correlation coefficients were computed for HBM subscales. Findings: Mean age of participants was 36 years with an average 10 years stay in the US. Most women strived to care for their health (3.82±1.18) and perceived high benefits of screening mammography (3.94±0.95). However, they perceived lower susceptibility to breast cancer in the future (2.30±0.94). Conclusions: Increasing awareness of breast cancer risk for South Asian women may have a beneficial effect on cancer incidence because of their positive attitudes towards health and breast cancer screening. This is especially relevant because South Asians now constitute one of the largest minority populations in the US and their incidence of breast cancer is steadily increasing.

show abstract

“…12,40,54 A single study on FS screening (an invasive form of bowel cancer screening not routinely used in the NHS BCSP at the time this research was conducted) identified specific cultural barriers associated with the threats to masculinity in African Caribbean men. 55 However, it is not known whether such barriers are also present in relation to gFOBt or if there are any culturally specific issues related to gFOBt screening among African Caribbean women.…”

Section: Introductionmentioning

confidence: 99%

“…12,[40][41][42] Low uptake of colorectal cancer (CRC) screening in the UK has continued to be identified in areas with higher ethnic diversity, 5,12 and within all South Asian religiolinguistic groups even when age, deprivation and gender are adjusted for. 40,43 We therefore also explored culturally specific barriers to uptake in South Asian communities to identify additional appropriate methods which could be specifically targeted at minority ethnic groups who speak English. To do this, we carried out interviews with 16 participants acting as 'key informants' on behalf of their communities.…”

Section: Introductionmentioning

confidence: 99%

Testing innovative strategies to reduce the social gradient in the uptake of bowel cancer screening: a programme of four qualitatively enhanced randomised controlled trials

Raine

Atkin

Wagner

et al. 2017

Programme Grants Appl Res

View full text Add to dashboard Cite

Objective: To reduce socioeconomic inequalities in uptake of the NHS BCSP ’ s guaiac faecal occult blood test (gFOBt) without compromising uptake in any socioeconomic group. Design: Workstream 1 explored psychosocial determinants of non-uptake of gFOBt in focus groups and interviews. Workstream 2 developed and tested four theoretically based interventions: (1) ‘ gist ’ information, (2) a ‘ narrative ’ leaflet, (3) ‘ general practice endorsement ’ (GPE) and (4) an ‘ enhanced reminder ’ (ER). Workstream 3 comprised four national cluster randomised controlled trials (RCTs) of the cost-effectiveness of each intervention. Methods: Interventions were co-designed with user panels, user tested using interviews and focus groups, and piloted with postal questionnaires. RCTs compared ‘ usual care ’ (existing NHS BCSP invitations) with usual care plus each intervention. The four trials tested: (1) ‘ gist ’ leaflet ( n = 163,525), (2) ‘ narrative ’ leaflet ( n = 150,417), (3) GPE on the invitation letter ( n = 265,434) and (4) ER ( n = 168,480). Randomisation was based on day of mailing of the screening invitation. The Index of Multiple Deprivation (IMD) score associated with each individual ’ s home address was used as the marker of socioeconomic circumstances (SECs). Change in the socioeconomic gradient in uptake (interaction between treatment group and IMD quintile) was the primary outcome. Screening uptake was defined as the return of a gFOBt kit within 18 weeks of the invitation that led to a ‘ definitive ’ test result of either ‘ normal ’ (i.e. no further investigation required) or ‘ abnormal ’ (i.e. requiring referral for further testing). Difference in overall uptake was the secondary outcome. Results: The gist and narrative trials showed no effect on the SECs gradient or overall uptake (57.6% and 56.7%, respectively, compared with 57.3% and 58.5%, respectively, for usual care; all p -values > 0.05). GPE showed no effect on the gradient ( p = 0.5) but increased overall uptake [58.2% vs. 57.5% in usual care, odds ratio (OR) = 1.07, 95% confidence interval (CI) 1.04 to 1.10; p < 0.0001]. ER showed a significant interaction with SECs ( p = 0.005), with a stronger effect in the most deprived IMD quintile (14.1% vs. 13.3% in usual care, OR = 1.11, 95% CI 1.04 to 1.20; p = 0.003) than the least deprived (34.7% vs. 34.9% in usual care OR = 1.00, 95% CI 0.94 to 1.06; p = 0.98), and higher overall uptake (25.8% vs. 25.1% in usual care, OR = 1.07, 95% CI 1.03 to 1.11; p = 0.001). All interventions were inexpensive to provide. Limitations: In line with NHS policy, the gist and narrative leaflets supplemented rather than replaced existing NHS BCSP information. This may have undermined their effect. Conclusions: Enhanced reminder reduced the gradient and modestly increased overall uptake, whereas GPE increased overall uptake but did not reduce the gradient. Therefore, given their effectiveness and very low cost, the findings suggest that implementation of both by the NHS BCSP would be beneficial. The gist and narrative results hig...

show abstract

Breast and bowel cancer screening uptake patterns over 15 years for UK south Asian ethnic minority populations, corrected for differences in socio-demographic characteristics

Abstract: Background: A number of studies have reported low uptake of cancer screening programmes by South Asian populations in the UK. However, studies to date have not adjusted findings for differences in demographics and socio-economic status of these populations.

Cited by 117 publications

References 44 publications

Cancer incidence in South Asian migrants to England, 1986–2004: Unraveling ethnic from socioeconomic differentials

Cancer incidence in South Asian migrants to England, 1986–2004: Unraveling ethnic from socioeconomic differentials

Attitudes of South Asian Women to Breast Health and Breast Cancer Screening: Findings from a Community Based Sample in the United States

Testing innovative strategies to reduce the social gradient in the uptake of bowel cancer screening: a programme of four qualitatively enhanced randomised controlled trials

Contact Info

Product

Resources

About