Ethnic minorities in England less likely to get breast cancer diagnosis from routine screening

People from minority ethnic backgrounds in England are up to a third less likely to be diagnosed with breast cancer via routine screening, and are more likely to be diagnosed in an emergency setting, analysis has found.

The research, carried out by academics at the University of Surrey and funded by the charity Breast Cancer Now, involved analysis of 86,564 adults diagnosed with the disease between 2009 and 2019, from the Clinical Practice Research Datalink and the Cancer Registration Tumour and Treatment datasets.

The analysis found that people from Black, Asian and mixed backgrounds, alongside people from deprived backgrounds, were up to 33% less likely to be diagnosed with breast cancer via screening, while these groups were also up to 31% more likely to be diagnosed via urgent suspected cancer referral, and up to 37% more likely to be diagnosed via emergency presentation.

Manveet Basra, the associate director of public health, inclusion and awareness at Breast Cancer Now, said the analysis revealed that people from marginalised groups “face inequalities at every stage of their breast cancer experience, and tragically this impacts their survival rates”.

Basra added: “This research helps us understand who is less likely to be diagnosed with breast cancer via screening, [who] might wait longer to get diagnosed or experience delays in treatment, and knowing what barriers they face enables us to work towards eliminating them.

“Determined to improve breast cancer care and survival rates outcomes, we’re funding world-class research that actively identifies and addresses inequities, working with policymakers to improve equal access to screening, and ensuring our information, campaigns and life-changing support services reflect the diverse needs of everyone affected by this devastating disease.”

Breast cancer is the most common cancer worldwide among women. It accounts for about one in four cases of cancer and is one of the leading causes of death in women under 50. Identifying women at higher risk early can pave the way for additional screening or preventive treatment.

The research also revealed that people living with a learning disability faced poorer cancer outcomes: their time to diagnosis was 18% longer than people without a learning disability, and they faced a 10% longer wait time for treatment.

This research adds to existing evidence of the unequal outcomes people from marginalised backgrounds face in regards to cancer.

A previous study showed that ethnic minorities required more visits to GPs than other people before being diagnosed with cancer. On average, one in five people across England require three or more GP interactions before being diagnosed with cancer. But for people from ethnic minority backgrounds, the figure rises to one in three, according to analysis of the NHS cancer patient experience 2022 survey by QualityWatch, a joint programme from the Nuffield Trust and the Health Foundation.

Research from the UK Health Security Agency has also suggested that young black women are more likely to have aggressive breast cancer tumours, experience poorer care and have higher mortality rates, but are significantly under-represented in clinical research.

Dr Rob Kerrison, an associate professor of cancer care and co-lead of the cancer care expert group at the University of Surrey and the lead investigator of this study, said: “We know that some groups of women in the UK have poorer breast cancer survival than others, but until now we have had only a limited understanding of why. Our findings suggest that inequalities in access to screening and timely treatment may be part of the explanation.

“Women from a range of disadvantaged and under-served groups were less likely to have their cancer detected through screening and often waited longer to start treatment. If we are serious about improving breast cancer outcomes, we need to ensure that everyone can access screening and receive prompt treatment, regardless of their background or circumstances.”