Ethnic disparities in the uptake of colorectal cancer screening: An analysis of the West London population

• Published in: Colorectal disease Vol. 23; no. 7; pp. 1804 - 1813
• Main Authors: Sekhon Inderjit Singh, Harpreet Kaur, Lal, Nikhil, Majeed, Azeem, Pawa, Nikhil
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01-07-2021
• Subjects: Cancer screening; Colorectal cancer; Colorectal carcinoma; Compliance; Ethnicity; Health disparities; health inequality; Medical screening; Minority & ethnic groups; Multivariate analysis; screening; health inequality; screening; colorectal cancer; ethnicity
• ISSN: 1462-8910; 1463-1318
• DOI: 10.1111/codi.15682

Aim
Colorectal cancer (CRC) screening reduces mortality but variation exists in uptake, with poorer uptake in ethnic minority groups. The aim of this work was to evaluate the relationship between ethnicity and uptake of CRC screening in West London.
Method
Results of CRC screening from the Central London, West London, Hammersmith and Fulham, Hounslow and Ealing Clinical commissioning group collaborative between 2012 and 2017 were retrospectively analysed. These five clinical commissioning groups (CCGs) are located in West London. Compliance with screening according to ethnic group was evaluated compared with White British as the control.
Results
A total of 155 038 individuals were screened. White British individuals had the highest compliance (52.6%). A maximum difference in compliance of 8.2% was seen between CCGs. The odds of being less likely to participate were significant (p < 0.05) in all ethnic minorities except for Asian Chinese on univariate and multivariate analysis (adjusted OR 1.091, p = 0.88).
Conclusion
This is the largest retrospective study focusing on the role of ethnicity in the uptake of CRC screening in England. Poor uptake of screening in all ethnic minorities in West London, with the exception of Asian Chinese individuals in particular, is a novel finding. A mandate to routinely collect ethnicity data, the use of a single more diverse census and further intervention are needed to understand this disparity and reduce health inequity.