Major ethnic group differences in breast cancer screening uptake in Scotland are not extinguished by adjustment for indices of geographical residence, area deprivation, long-term illness and education

N. Bansal, R. S. Bhopal, M. F. C. Steiner, D. H. Brewster, Scottish Health and Ethnicity Linkage Study

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Abstract

Background: Breast cancer screening data generally show lower uptake in minority ethnic groups. We investigated whether such variations occur in Scotland. Methods: Using non-disclosive computerised linkage we combined Scottish breast screening and Census 2001 data. Non-attendance at first breast-screening invitation (2002-2008) was compared between 11 ethnic groups using age-adjusted risk ratios (RR) with 95% confidence intervals (CI), multiplied by 100, using Poisson regression. Results: Compared with the White Scottish (RR=100), non-attendance was similar for Other White British (99.5, 95% CI 96.1-103.2) and Chinese (112.8, 95% CI 96.3-132.2) and higher for Pakistani (181.7, 95% CI 164.9-200.2), African (162.2, 95% CI 130.8-201.1), Other South Asian (151.7, 95% CI 118.9-193.7) and Indian (141.7, 95% CI 121.1-165.7) groups. Adjustment for rural vs urban residence, long-term illness, area deprivation and education, associated with risk of non-attendance, increased the RR for non-attendance except for Pakistani women where it was modestly attenuated (RR=164.9, 149.4-182.1). Conclusion: Our data show important inequality in breast cancer screening uptake, not attenuated by potential confounding factors. Ethnic inequalities in breast screening attendance are of concern especially given evidence that the traditionally lower breast cancer rates in South Asian groups are converging towards the risks in the White UK population. Notwithstanding the forthcoming review of breast cancer screening, these data call for urgent action.
Original languageEnglish
Pages (from-to)1361-1366
Number of pages6
JournalBritish Journal of Cancer
Volume106
Issue number8
Early online date13 Mar 2012
DOIs
Publication statusPublished - 10 Apr 2012

Fingerprint

Scotland
Early Detection of Cancer
Ethnic Groups
Confidence Intervals
Breast Neoplasms
Education
Odds Ratio
Breast
Minority Groups
Censuses
Population

Keywords

  • breast cancer
  • cancer screening
  • ethnicity
  • inequalities
  • South Asian population
  • American women
  • minority populations
  • childhood-cancer
  • African-American
  • prostate-cancer
  • uptake patterns
  • East England
  • program
  • health

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Major ethnic group differences in breast cancer screening uptake in Scotland are not extinguished by adjustment for indices of geographical residence, area deprivation, long-term illness and education. / Bansal, N.; Bhopal, R. S.; Steiner, M. F. C.; Brewster, D. H.; Scottish Health and Ethnicity Linkage Study.

In: British Journal of Cancer, Vol. 106, No. 8, 10.04.2012, p. 1361-1366.

Research output: Contribution to journalArticle

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title = "Major ethnic group differences in breast cancer screening uptake in Scotland are not extinguished by adjustment for indices of geographical residence, area deprivation, long-term illness and education",
abstract = "Background: Breast cancer screening data generally show lower uptake in minority ethnic groups. We investigated whether such variations occur in Scotland. Methods: Using non-disclosive computerised linkage we combined Scottish breast screening and Census 2001 data. Non-attendance at first breast-screening invitation (2002-2008) was compared between 11 ethnic groups using age-adjusted risk ratios (RR) with 95{\%} confidence intervals (CI), multiplied by 100, using Poisson regression. Results: Compared with the White Scottish (RR=100), non-attendance was similar for Other White British (99.5, 95{\%} CI 96.1-103.2) and Chinese (112.8, 95{\%} CI 96.3-132.2) and higher for Pakistani (181.7, 95{\%} CI 164.9-200.2), African (162.2, 95{\%} CI 130.8-201.1), Other South Asian (151.7, 95{\%} CI 118.9-193.7) and Indian (141.7, 95{\%} CI 121.1-165.7) groups. Adjustment for rural vs urban residence, long-term illness, area deprivation and education, associated with risk of non-attendance, increased the RR for non-attendance except for Pakistani women where it was modestly attenuated (RR=164.9, 149.4-182.1). Conclusion: Our data show important inequality in breast cancer screening uptake, not attenuated by potential confounding factors. Ethnic inequalities in breast screening attendance are of concern especially given evidence that the traditionally lower breast cancer rates in South Asian groups are converging towards the risks in the White UK population. Notwithstanding the forthcoming review of breast cancer screening, these data call for urgent action.",
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author = "N. Bansal and Bhopal, {R. S.} and Steiner, {M. F. C.} and Brewster, {D. H.} and {Scottish Health and Ethnicity Linkage Study}",
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T1 - Major ethnic group differences in breast cancer screening uptake in Scotland are not extinguished by adjustment for indices of geographical residence, area deprivation, long-term illness and education

AU - Bansal, N.

AU - Bhopal, R. S.

AU - Steiner, M. F. C.

AU - Brewster, D. H.

AU - Scottish Health and Ethnicity Linkage Study

N1 - Copyright 2012 Elsevier B.V., All rights reserved.

PY - 2012/4/10

Y1 - 2012/4/10

N2 - Background: Breast cancer screening data generally show lower uptake in minority ethnic groups. We investigated whether such variations occur in Scotland. Methods: Using non-disclosive computerised linkage we combined Scottish breast screening and Census 2001 data. Non-attendance at first breast-screening invitation (2002-2008) was compared between 11 ethnic groups using age-adjusted risk ratios (RR) with 95% confidence intervals (CI), multiplied by 100, using Poisson regression. Results: Compared with the White Scottish (RR=100), non-attendance was similar for Other White British (99.5, 95% CI 96.1-103.2) and Chinese (112.8, 95% CI 96.3-132.2) and higher for Pakistani (181.7, 95% CI 164.9-200.2), African (162.2, 95% CI 130.8-201.1), Other South Asian (151.7, 95% CI 118.9-193.7) and Indian (141.7, 95% CI 121.1-165.7) groups. Adjustment for rural vs urban residence, long-term illness, area deprivation and education, associated with risk of non-attendance, increased the RR for non-attendance except for Pakistani women where it was modestly attenuated (RR=164.9, 149.4-182.1). Conclusion: Our data show important inequality in breast cancer screening uptake, not attenuated by potential confounding factors. Ethnic inequalities in breast screening attendance are of concern especially given evidence that the traditionally lower breast cancer rates in South Asian groups are converging towards the risks in the White UK population. Notwithstanding the forthcoming review of breast cancer screening, these data call for urgent action.

AB - Background: Breast cancer screening data generally show lower uptake in minority ethnic groups. We investigated whether such variations occur in Scotland. Methods: Using non-disclosive computerised linkage we combined Scottish breast screening and Census 2001 data. Non-attendance at first breast-screening invitation (2002-2008) was compared between 11 ethnic groups using age-adjusted risk ratios (RR) with 95% confidence intervals (CI), multiplied by 100, using Poisson regression. Results: Compared with the White Scottish (RR=100), non-attendance was similar for Other White British (99.5, 95% CI 96.1-103.2) and Chinese (112.8, 95% CI 96.3-132.2) and higher for Pakistani (181.7, 95% CI 164.9-200.2), African (162.2, 95% CI 130.8-201.1), Other South Asian (151.7, 95% CI 118.9-193.7) and Indian (141.7, 95% CI 121.1-165.7) groups. Adjustment for rural vs urban residence, long-term illness, area deprivation and education, associated with risk of non-attendance, increased the RR for non-attendance except for Pakistani women where it was modestly attenuated (RR=164.9, 149.4-182.1). Conclusion: Our data show important inequality in breast cancer screening uptake, not attenuated by potential confounding factors. Ethnic inequalities in breast screening attendance are of concern especially given evidence that the traditionally lower breast cancer rates in South Asian groups are converging towards the risks in the White UK population. Notwithstanding the forthcoming review of breast cancer screening, these data call for urgent action.

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KW - ethnicity

KW - inequalities

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KW - American women

KW - minority populations

KW - childhood-cancer

KW - African-American

KW - prostate-cancer

KW - uptake patterns

KW - East England

KW - program

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