Minimising ethnic inequality is key to achieving world-class cancer outcomes in the UK. However, due to the paucity of evidence on this subject, strategies designed to address ethnic inequalities are often buried within wider plans of improving cancer outcomes, whereas targeted interventions may have a greater impact in ethnic minority population. This study aims to investigate ethnic differences in patients cancer journeys - from the first consultation in primary care to definitive diagnosis, and eventual outcomes. We will use electronic medical records of patients diagnosed with one of 11 selected cancer types (lung, breast, colorectal, prostate, stomach, oral, liver, ovarian, oesophageal, cervical, and myeloma) to examine ethnic differences in:
a) the number of general practice (GP) consultation before referral to secondary care for suspected cancer diagnosis
b) symptoms presented in primary care before diagnosis
c) the interval between first primary care consultation and diagnosis
d) the routes to diagnosis
e) the staging at diagnosis and survival rates
This study will bridge the gap in the evidence regarding ethnic inequalities in cancer. Moreover, if successful, it is anticipated that the results will contribute to policy and clinical practice, where appropriate and would help improve cancer awareness campaign, particularly among UK ethnic minority groups.
This study aims to investigate ethnic inequalities in patients cancer journeys - from the first consultation in primary care to a definitive diagnosis, and eventual outcomes. We will use CPRD Aurum records (linked to Hospital Episode Statistics (HES), Office for National Statistics (ONS) and Index of Multiple Deprivation (IMD) to examine ethnic differences in:
a) GP consultation rates before referral to secondary care for suspected cancer diagnosis
b) the profile symptoms presented in primary care before diagnosis
c) diagnostic interval - the interval between first primary care consultation and definitive diagnosis
Participants will include patients diagnosed with 11 primary cancers since 2017, including those frequently diagnosed in ethnic minority groups (lung, breast, colorectal, prostate, stomach, oral, liver, ovarian, oesophageal, cervical, and myeloma). Chi-squared tests will be used to investigate ethnic differences in symptoms profile. Poisson regression models will be fitted to examine ethnic differences in consultation rates and diagnostic intervals.
Ethnic differences in symptom profile
Ethnic differences in time to diagnosis
Ethnic differences in stage of cancer at diagnosis
Ethnic differences in route to diagnosis (principally emergency presentations)
Ethnic differences in 1 and 5-year survival rates
Tanimola Martins - Chief Investigator - University of Exeter
Tanimola Martins - Corresponding Applicant - University of Exeter
Gary Abel - Collaborator - University of Exeter
Georgios Lyratzopoulos - Collaborator - University College London ( UCL )
Obioha Ukoumunne - Collaborator - University of Exeter
William Hamilton - Collaborator - University of Exeter
HES Admitted Patient Care;HES Outpatient;ONS Death Registration Data;Patient Level Index of Multiple Deprivation;Practice Level Index of Multiple Deprivation