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Table 3 Characteristics and findings of reviewed studies

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)