Black women from Caribbean and African backgrounds are up to two times more likely to receive a late-stage diagnosis for some cancers than White British women in England, according to new analysis by Cancer Research UK and NHS Digital.*
The review of cancer data from NHS Digital, published today in BMJ Open, revealed that ethnicity is a significant factor in stage of diagnosis for women in England with breast, ovarian, uterine, non-small cell lung cancer (NSCLC) and colon cancer, and for men with prostate cancer.** The analysis showed that:
• Caribbean and African women are more than twice as likely to be diagnosed with late-stage uterine cancer than White British women.
• Caribbean women are more likely to receive a late-stage diagnosis for NSCLC (62% more likely), ovarian (48%), colon (37%), and breast (27%), cancers than White British women.
• African women have higher odds of being diagnosed with late-stage ovarian (85% more likely), breast (71%), and colon (42%) cancers.
• Asian women, referring to those from Indian, Bangladeshi and Pakistani backgrounds, are more likely to receive late-stage ovarian (21% more likely) and breast (12%) cancer diagnoses.
• There were no significant differences found between Chinese and White British women.
Cancer Research UK said there were many possible reasons behind the late diagnoses, including poorer symptom awareness, delays in seeking help and having to present to the GP multiple times before being referred for tests.
Fear of dying from cancer and beliefs that cancer is untreatable may also contribute to late-stage diagnosis in women from ethnic minority backgrounds, as well as lower screening uptake.****
The charity recommended the government should increase cancer awareness as well as screening uptake among ethnic minority groups and make it easier for them to see the GP and get the tests needed to diagnose cancer earlier.
Cancer Research UK’s chief executive, Michelle Mitchell, said:
“Everyone deserves the best cancer care, from diagnosis to treatment. The fact that women from Black and South Asian backgrounds are more likely to be diagnosed with late-stage cancer, when treatment is less likely to be successful, is deeply troubling.
“More concerning still, is that we know the number of cancer cases diagnosed in ethnic minority groups is likely to grow over time. Meaning without any action, this gap will only continue to widen.
“Whilst the Health and Social Care Secretary’s recent decision to drop its promised 10-year cancer plan is disappointing, it is now critical that the new ‘catch-all’ major conditions strategy sets out how the Government will reduce the inequalities that persist in cancer care.”
When cancer is diagnosed matters. Catching cancer early, before it has the chance to grow and spread, greatly increases the chances of it being successfully treated. For example, more than 9 in 10 people diagnosed with colon cancer at its earliest stage survive their disease for 5 years or more, compared with 1 in 10 when diagnosed at the latest stage.***
However, a biennial survey carried out by YouGov for Cancer Research UK in September 2022, found that women from an ethnic minority background were more likely to report they didn’t know any warning signs and symptoms of cancer compared to White women (23% vs 12%).*****
It also found that women from an ethnic minority background were more likely to delay or avoid speaking to a medical professional than White women due to feelings of embarrassment and lack of confidence talking about their symptoms (10% vs 5% and 10% vs 4%, respectively). They were also more likely to be worried about how their pay/earnings would be affected if they needed further tests or treatment (5% vs 1%) and to anticipate difficulties with remote consultations (10% vs 6%).
Though cancer rates are generally lower for most cancer sites in minority ethnic groups in England, this gap is expected to close over time. Evidence suggests that factors, such as obesity and smoking, in people from Black, Asian or Mixed ethnic backgrounds could become similar to those in White people in future – leading to higher rates of cancer in some groups.
