Inequalities in colorectal cancer diagnosis by ethnic group: a population-level study in the English National Health Service
Objective Studies in the USA examining the relationship between ethnicity and colorectal cancer (CRC) identified significant variation. This study sought to examine the relationship between ethnic group, route to diagnosis, early-onset CRC and stage at diagnosis in the English National Health Servic...
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| Language: | English |
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BMJ Publishing Group
2025-01-01
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| Series: | BMJ Open Gastroenterology |
| Online Access: | https://bmjopengastro.bmj.com/content/12/1/e001629.full |
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| author | Amy Downing Mo Thoufeeq James Turvill Eva J A Morris Phil Quirke John C Taylor Rebecca J Birch Nick E Burr |
| author_facet | Amy Downing Mo Thoufeeq James Turvill Eva J A Morris Phil Quirke John C Taylor Rebecca J Birch Nick E Burr |
| author_sort | Amy Downing |
| collection | DOAJ |
| description | Objective Studies in the USA examining the relationship between ethnicity and colorectal cancer (CRC) identified significant variation. This study sought to examine the relationship between ethnic group, route to diagnosis, early-onset CRC and stage at diagnosis in the English National Health Service.Methods Data from COloRECTal cancer data Repository for all individuals diagnosed with CRC (International Classification of Diseases version 10, C18–C20) between 2012 and 2017. A descriptive analysis of the characteristics of the study population was performed. Multivariable logistic regression models were used to assess the association between ethnicity, route to diagnosis, stage at diagnosis and early-onset CRC.Results Early-onset CRC was least common in those in the white ethnic group (5.5% diagnosed <50, vs 17.9% in the Asian, 15.5% in the black and 21.8% in the mixed and multiple ethnic groups, p<0.01). Diagnosis following a 2-week wait referral was significantly less common among individuals from the Asian, black, other and unknown ethnic groups than the white ethnic group (Asian OR 0.84, 95% CI 0.79 to 0.91, black OR 0.86, 95% CI 0.79 to 0.93, other OR 0.81, 95% CI 0.73 to 0.90 and unknown OR 0.70, 95% CI 0.66 to 0.73). The Asian ethnic group had significantly lower odds of emergency diagnosis than the white ethnic group (OR 0.90, 95% CI 0.83 to 0.97). Following adjustment, individuals from the Asian ethnic group were significantly less likely, than their white counterparts, to be diagnosed at stage IV (OR 0.82, 95% CI 0.76 to 0.88).Conclusion This study identified different demographic profiles of those diagnosed with CRC between broad ethnic groups, highlighting the need to consider access to diagnostic CRC services in the context of ethnicity. |
| format | Article |
| id | doaj-art-36db476b2c1f4114a0c00f644489c7e6 |
| institution | Kabale University |
| issn | 2054-4774 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open Gastroenterology |
| spelling | doaj-art-36db476b2c1f4114a0c00f644489c7e62025-01-09T08:55:09ZengBMJ Publishing GroupBMJ Open Gastroenterology2054-47742025-01-0112110.1136/bmjgast-2024-001629Inequalities in colorectal cancer diagnosis by ethnic group: a population-level study in the English National Health ServiceAmy Downing0Mo Thoufeeq1James Turvill2Eva J A Morris3Phil Quirke4John C Taylor5Rebecca J Birch6Nick E Burr7Pathology and Data Analytics, Leeds Institute of Medical Research, University of Leeds, Leeds, UK4 Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UKGastroenterology, York and Scarborough Teaching Hospitals NHS Foundation Trust, York, UKNuffield Department of Population Health, Oxford University, Oxford, UKPathology and Data Analytics, Leeds Institute of Medical Research, University of Leeds, Leeds, UKPathology and Data Analytics, Leeds Institute of Medical Research, University of Leeds, Leeds, UKPathology and Data Analytics, Leeds Institute of Medical Research, University of Leeds, Leeds, UKMid Yorkshire Teaching NHS Trust, Wakefield, UKObjective Studies in the USA examining the relationship between ethnicity and colorectal cancer (CRC) identified significant variation. This study sought to examine the relationship between ethnic group, route to diagnosis, early-onset CRC and stage at diagnosis in the English National Health Service.Methods Data from COloRECTal cancer data Repository for all individuals diagnosed with CRC (International Classification of Diseases version 10, C18–C20) between 2012 and 2017. A descriptive analysis of the characteristics of the study population was performed. Multivariable logistic regression models were used to assess the association between ethnicity, route to diagnosis, stage at diagnosis and early-onset CRC.Results Early-onset CRC was least common in those in the white ethnic group (5.5% diagnosed <50, vs 17.9% in the Asian, 15.5% in the black and 21.8% in the mixed and multiple ethnic groups, p<0.01). Diagnosis following a 2-week wait referral was significantly less common among individuals from the Asian, black, other and unknown ethnic groups than the white ethnic group (Asian OR 0.84, 95% CI 0.79 to 0.91, black OR 0.86, 95% CI 0.79 to 0.93, other OR 0.81, 95% CI 0.73 to 0.90 and unknown OR 0.70, 95% CI 0.66 to 0.73). The Asian ethnic group had significantly lower odds of emergency diagnosis than the white ethnic group (OR 0.90, 95% CI 0.83 to 0.97). Following adjustment, individuals from the Asian ethnic group were significantly less likely, than their white counterparts, to be diagnosed at stage IV (OR 0.82, 95% CI 0.76 to 0.88).Conclusion This study identified different demographic profiles of those diagnosed with CRC between broad ethnic groups, highlighting the need to consider access to diagnostic CRC services in the context of ethnicity.https://bmjopengastro.bmj.com/content/12/1/e001629.full |
| spellingShingle | Amy Downing Mo Thoufeeq James Turvill Eva J A Morris Phil Quirke John C Taylor Rebecca J Birch Nick E Burr Inequalities in colorectal cancer diagnosis by ethnic group: a population-level study in the English National Health Service BMJ Open Gastroenterology |
| title | Inequalities in colorectal cancer diagnosis by ethnic group: a population-level study in the English National Health Service |
| title_full | Inequalities in colorectal cancer diagnosis by ethnic group: a population-level study in the English National Health Service |
| title_fullStr | Inequalities in colorectal cancer diagnosis by ethnic group: a population-level study in the English National Health Service |
| title_full_unstemmed | Inequalities in colorectal cancer diagnosis by ethnic group: a population-level study in the English National Health Service |
| title_short | Inequalities in colorectal cancer diagnosis by ethnic group: a population-level study in the English National Health Service |
| title_sort | inequalities in colorectal cancer diagnosis by ethnic group a population level study in the english national health service |
| url | https://bmjopengastro.bmj.com/content/12/1/e001629.full |
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