A systematic review of ethnic disparities in the uptake of colorectal cancer screening. (March 2023)

• Record Type: Journal Article
• Authors: Sekhon Inderjit Singh, HK; Lal, N; Majeed, A; Pawa, N
• Is Part Of: Perspectives in public health. Volume 143:Number 2(2023)
• Page Start: 105
• Page End: 120
• Publication Date: 2023-03
• Subjects: cancer -- ethnic health -- ethnic minorities -- health improvement -- inequalities -- screening; Public health -- Periodicals; Public health -- Great Britain -- Periodicals; Health promotion -- Periodicals; Public Health -- Periodicals; Santé publique -- Périodiques; Santé publique -- Grande-Bretagne -- Périodiques; Promotion de la santé -- Périodiques; 614
• DOI: 10.1177/17579139221093153
• Languages: English
• ISSNs: 1757-9139

Abstract

Aims: Colorectal cancer (CRC) screening reduces mortality, but variation exists in uptake. Ethnicity is suggested to play a role; however, there is no high-level evidence to support this. We aim to clarify the impact of Ethnicity on CRC screening uptake and our barriers to its understanding. Methods: A systematic review to identify studies reporting on the participation of ethnic minorities in CRC screening worldwide was performed. MEDLINE, Embase, Scopus and Google Scholar databases up until 31 May 2019 were searched. Compliance with screening according to ethnic groups and screening modality was evaluated compared to the 'White' control group. Results: Twenty-two studies were included in the review reporting on 2, 084, 213 patients. Substantial variation in categorisation of ethnicities (40 sub-categories), screening modality studied and confounding factors accounted for was observed. 8/15 studies for 'Blacks', 10/13 for 'Hispanics', 2/2 for 'Asians' and 1/1 for 'South East Asians' suggest a less likely or significantly decreased compliance with screening for all screening modalities ( p < .05) compared to 'Whites'. Interestingly 'Japanese', 'Vietnamese' and 'Filipino' groups consistently show no difference in the uptake of CRC screening compared to the 'White' majority. Conclusion: This is the only systematic review on this topic. It highlights the inconsistency in screening uptake behaviour in different ethnic minority groups and identifies barriers like variation in ethnicity categorisation, screening modality and study design utilised to understanding the intricacies of this relationship. Further collaboration and action needs to be undertaken internationally to clarify and improve inequity in the uptake of screening.