From: Ethnic inequalities in time to diagnosis of cancer: a systematic review
Author | Country | Title/aim | Site | Sample size (n) gender age | Method | Ethnic groups | Relevant outcome measures | Results | |
---|---|---|---|---|---|---|---|---|---|
Exposure | Comparison | ||||||||
Rajan et al. (2011) [14] | UK (West Yorkshire) | To improve knowledge about late presentation and management of breast cancer among South Asian women. | Breast | n = 1,630 (36 South Asian women) all female median age = 53.5 years | Retrospective: Breast cancer waiting list database and case notes | South Asian women; Indians and Pakistanis | None; throughout the paper, including the title, the authors imply South Asian women had more delay | Duration of breast symptoms prior to presentation within primary care | 45% of Asian women delayed symptoms beyond 8 weeks before visiting their GP |
Meechan et al. (2002) [15] | New Zealand | Delay in seeking medical care for self-detected breast symptoms in New Zealand women. | Breast | n = 85 all female mean age =38 years | Retrospective: questionnaire & patient record | Minority New Zealanders - Maori, Pacific & Asian/Indian | European New Zealanders | Patient delay | No difference in patient delay by ethnicity. |
Velikova et al. (2004) [16] | UK (South Yorkshire) | To describe the effect of ethnicity on tumour stage, treatment, patient and providers delays in diagnosis of breast cancer | Breast | n = 16,879 all female mean age = 49.7 years in Asians and 62 years in non-Asians | Retrospective: Cancer registry data | South Asian | Non-Asian | Patients and providers delays to diagnosis | After adjusting for, age, SES and health care settings; patient delay was longer in Asian than in non –Asian women (median of 61 days vs. median of 31 days, P = 0.005) |
Nosarti et al. (2000) [17] | UK | To identify factors associated with delay in presentation and assessment of symptomatic breast cancer | Breast | n = 692 all female median age = 49 years | Retrospective: Interview, GP & hospital records | African Afro-Caribbean and Asian | British and other white | Patient and system delay | Ethnicity were non-contributory to patient delay in breast cancer |
Neal and Allgar (2005) [18] | UK | To explore the relationship between socio-demographic factors & delays in the diagnosis of six cancers | Breast, lung, colorectal, prostate NHL, and ovarian | n = 65,192 male & female all age groups | Retrospective: Analysis of the National Survey Data | Blacks - Africans, Caribbean & others blacks. South Asians -Indian, Pakistani, Bangladeshi, others. | Whites | Total, pre-hospital, referral and secondary care delay | After adjusting for marital status, gender, age and SES, Asian and black had longer pre-hospital delays for breast cancer in women (P = 0.001) and longer referral delay for colorectal cancer (P = 0.02). No evidence of difference for lung, prostate, NHL and ovarian. |
Sadler et al. (2009) [19] | UK (Birmingham) | The effect of ethnicity on the presentation and management of oesophageal and gastric cancers: A UK perspective | oesophageal & gastric | n = 244 male & female median age = 71 years | Retrospective: Case-note audit | Asians and Blacks | Caucasians | Referral routes and total diagnostic interval | Asians and Blacks compared to Caucasians were less likely to be diagnosed within 3 months of symptom discovery (P = 0.03) and less likely to take the optimal route to diagnosis (p = 0.01). |
Metcalfe et al. (2008) [20] | UK | To examine the pathways followed by black and white men to prostate cancer diagnosis | Prostate | n = 1,866 men median age = 67.9 years in blacks 73.3 years in whites | Retrospective: Questionnaire, hospital records and cancer registry data | Black men | White men | Delay between onset of symptoms and first GP presentation. | After adjusting for age and hospital centre, no significant difference between white and black men in patient delay (odds ratio: 0.82; 95% CI: 0.57 to 1.19) |