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South Asian population less likely to attend cancer screening than the non-Asian communityIn the first study of its kind, research made available today has revealed that members of the South Asian community are only half as likely to take up an invitation for bowel cancer screening and 15 per cent less likely to attend breast cancer screening than members of the non-Asian community. Authored by Professor Ala Szczepura at the University of Warwick and funded by the NHS Cancer Screening Programmes, the research is based on a survey of 400,000 people over the period 1989 to 2005.
In response to the findings the Director of the NHS Cancer Screening programmes, Julietta Patnick has today committed the screening programme to working with all Primary Care Trusts to do more to encourage greater uptake among BME communities.
Publication of the research coincides with the 20th anniversary of NHS breast and cervical screening programmes. Since they were launched in 1988 the breast and cervical screening programmes have screened over 70 million women and detected over 100,000 cancers. The NHS Bowel Cancer Screening Programme was launched in 2006, initially for those aged 60 – 69, and is the first ever screening programme to target both men and women. It is currently being rolled out across the country and will achieve nationwide coverage by the end of 2009.
Key findings include:
* Among the non-Asian population 2 out of 3 individuals invited, participated in bowel screening. Among the South Asian population as a whole this dropped to 1 out of 3, and for members of the Muslim community only 1 out of 4 individuals participated.
* For the breast screening programme a similar pattern is seen. In the non-Asian population three quarters of those invited attended for screening. Among members of the South Asian population this dropped to under two thirds, and for members of the Muslim population was just over half.
* In contrast, the Hindu-Gujarati population had the highest uptake of both bowel and breast cancer screening in the South Asian population.
* Despite the risk of breast cancer increasing with age the number of women in both the South Asian and non Asian communities accepting their invitation decreased as they got older. For bowel screening the reverse is seen and the number of men and women in both communities participating increases as they get older.
* Of those who participated in the bowel screening programme, members of the South Asian community were slower than non-Asians to come forward for further investigation following an initial screen which revealed abnormalities.
* Following basic breast screening all women with an abnormal mammogram attended for breast assessment regardless of ethnicity.
* The research eliminated socio-economic status, age and gender as reasons for the differences in uptake between different groups.
Commenting on the findings Julietta Patnick, Director of the NHS Cancer Screening Programmes said;
“The information produced by Professor Szczepura and her team is invaluable. Whilst the findings are specific to the breast and bowel screening programmes, we are continuing the research to extend the findings to the cervical screening programme. We know that encouraging uptake among BME communities is one of our biggest challenges. The Government’s recently published Cancer Reform Strategy highlighted the need to tackle inequalities and this is something we are committed to addressing. We need to support PCTs to redouble their efforts to understand the needs of their local communities to remove barriers and improve accessibility to cancer screening.”
Professor Ala Szczepura said:
“This type of information is essential to tailor appropriate and effective interventions and education programmes for the South Asian community. From our findings we can only conclude that cultural differences lie at the heart of the reason why fewer South Asians are coming forward for cancer screening.”
“Improved ethnicity recording by primary care trusts would help us understand why uptake of cancer screening varies so dramatically among black and ethnic minorities. In addition our findings underline the need for health promotion materials specific to certain ethnic groups. This will be crucial to the continued success of the national cancer screening programmes.”
The study examined uptake in the NHS breast and bowel screening programmes among over 400,000 residents in Coventry and Warwickshire. The full research paper is available on request. To identify ethnicity, researchers used name recognition software which is 97% accurate in identifying which ethnic group those attending breast or bowel cancer screening belonged to. Multivariate methods were used to correct for differences in age, gender and socio-economic status amongst the population groups.