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Assessing Ethnic Inequalities in Diagnostic Interval of Common Cancers: A Population-Based UK Cohort Study

SIMPLE SUMMARY: UK ethnic minorities have poorer outcomes of some cancers and are less likely to report positive health care experiences. We wanted to determine whether these differences are related to inequalities in time to diagnosis once patients sought medical help with cancer symptoms. We found...

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Autores principales: Martins, Tanimola, Abel, Gary, Ukoumunne, Obioha C., Price, Sarah, Lyratzopoulos, Georgios, Chinegwundoh, Frank, Hamilton, William
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9264889/
https://www.ncbi.nlm.nih.gov/pubmed/35804858
http://dx.doi.org/10.3390/cancers14133085
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author Martins, Tanimola
Abel, Gary
Ukoumunne, Obioha C.
Price, Sarah
Lyratzopoulos, Georgios
Chinegwundoh, Frank
Hamilton, William
author_facet Martins, Tanimola
Abel, Gary
Ukoumunne, Obioha C.
Price, Sarah
Lyratzopoulos, Georgios
Chinegwundoh, Frank
Hamilton, William
author_sort Martins, Tanimola
collection PubMed
description SIMPLE SUMMARY: UK ethnic minorities have poorer outcomes of some cancers and are less likely to report positive health care experiences. We wanted to determine whether these differences are related to inequalities in time to diagnosis once patients sought medical help with cancer symptoms. We found that in five of the seven cancers studied, the minority groups experienced a longer time to diagnosis when compared with the White group. However, the differences were small and unlikely to be the sole explanation for the ethnic variation in cancer outcomes. Nonetheless, addressing such differences will help to improve trust and care experiences among ethnic minority groups. ABSTRACT: Background: This study investigated ethnic differences in diagnostic interval (DI)—the period between initial primary care presentation and diagnosis. Methods: We analysed the primary care-linked data of patients who reported features of seven cancers (breast, lung, prostate, colorectal, oesophagogastric, myeloma, and ovarian) one year before diagnosis. Accelerated failure time (AFT) models investigated the association between DI and ethnicity, adjusting for age, sex, deprivation, and morbidity. Results: Of 126,627 eligible participants, 92.1% were White, 1.99% Black, 1.71% Asian, 1.83% Mixed, and 2.36% were of Other ethnic backgrounds. Considering all cancer sites combined, the median (interquartile range) DI was 55 (20–175) days, longest in lung [127, (42–265) days], and shortest in breast cancer [13 (13, 8–18) days]. DI for the Black and Asian groups was 10% (AFT ratio, 95%CI 1.10, 1.05–1.14) and 16% (1.16, 1.10–1.22), respectively, longer than for the White group. Site-specific analyses revealed evidence of longer DI in Asian and Black patients with prostate, colorectal, and oesophagogastric cancer, plus Black patients with breast cancer and myeloma, and the Mixed group with lung cancer compared with White patients. DI was shorter for the Other group with lung, prostate, myeloma, and oesophagogastric cancer than the White group. Conclusion: We found limited and inconsistent evidence of ethnic differences in DI among patients who reported cancer features in primary care before diagnosis. Our findings suggest that inequalities in diagnostic intervals, where present, are unlikely to be the sole explanation for ethnic variations in cancer outcomes.
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spelling pubmed-92648892022-07-09 Assessing Ethnic Inequalities in Diagnostic Interval of Common Cancers: A Population-Based UK Cohort Study Martins, Tanimola Abel, Gary Ukoumunne, Obioha C. Price, Sarah Lyratzopoulos, Georgios Chinegwundoh, Frank Hamilton, William Cancers (Basel) Article SIMPLE SUMMARY: UK ethnic minorities have poorer outcomes of some cancers and are less likely to report positive health care experiences. We wanted to determine whether these differences are related to inequalities in time to diagnosis once patients sought medical help with cancer symptoms. We found that in five of the seven cancers studied, the minority groups experienced a longer time to diagnosis when compared with the White group. However, the differences were small and unlikely to be the sole explanation for the ethnic variation in cancer outcomes. Nonetheless, addressing such differences will help to improve trust and care experiences among ethnic minority groups. ABSTRACT: Background: This study investigated ethnic differences in diagnostic interval (DI)—the period between initial primary care presentation and diagnosis. Methods: We analysed the primary care-linked data of patients who reported features of seven cancers (breast, lung, prostate, colorectal, oesophagogastric, myeloma, and ovarian) one year before diagnosis. Accelerated failure time (AFT) models investigated the association between DI and ethnicity, adjusting for age, sex, deprivation, and morbidity. Results: Of 126,627 eligible participants, 92.1% were White, 1.99% Black, 1.71% Asian, 1.83% Mixed, and 2.36% were of Other ethnic backgrounds. Considering all cancer sites combined, the median (interquartile range) DI was 55 (20–175) days, longest in lung [127, (42–265) days], and shortest in breast cancer [13 (13, 8–18) days]. DI for the Black and Asian groups was 10% (AFT ratio, 95%CI 1.10, 1.05–1.14) and 16% (1.16, 1.10–1.22), respectively, longer than for the White group. Site-specific analyses revealed evidence of longer DI in Asian and Black patients with prostate, colorectal, and oesophagogastric cancer, plus Black patients with breast cancer and myeloma, and the Mixed group with lung cancer compared with White patients. DI was shorter for the Other group with lung, prostate, myeloma, and oesophagogastric cancer than the White group. Conclusion: We found limited and inconsistent evidence of ethnic differences in DI among patients who reported cancer features in primary care before diagnosis. Our findings suggest that inequalities in diagnostic intervals, where present, are unlikely to be the sole explanation for ethnic variations in cancer outcomes. MDPI 2022-06-23 /pmc/articles/PMC9264889/ /pubmed/35804858 http://dx.doi.org/10.3390/cancers14133085 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Martins, Tanimola
Abel, Gary
Ukoumunne, Obioha C.
Price, Sarah
Lyratzopoulos, Georgios
Chinegwundoh, Frank
Hamilton, William
Assessing Ethnic Inequalities in Diagnostic Interval of Common Cancers: A Population-Based UK Cohort Study
title Assessing Ethnic Inequalities in Diagnostic Interval of Common Cancers: A Population-Based UK Cohort Study
title_full Assessing Ethnic Inequalities in Diagnostic Interval of Common Cancers: A Population-Based UK Cohort Study
title_fullStr Assessing Ethnic Inequalities in Diagnostic Interval of Common Cancers: A Population-Based UK Cohort Study
title_full_unstemmed Assessing Ethnic Inequalities in Diagnostic Interval of Common Cancers: A Population-Based UK Cohort Study
title_short Assessing Ethnic Inequalities in Diagnostic Interval of Common Cancers: A Population-Based UK Cohort Study
title_sort assessing ethnic inequalities in diagnostic interval of common cancers: a population-based uk cohort study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9264889/
https://www.ncbi.nlm.nih.gov/pubmed/35804858
http://dx.doi.org/10.3390/cancers14133085
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