TY - JOUR
T1 - Are there ethnic and religious variations in uptake of bowel cancer screening?
T2 - A retrospective cohort study among 1.7 million people in Scotland
AU - Campbell, Christine
AU - Douglas, Anne
AU - Williams, Linda
AU - Cezard, Geneviève
AU - Brewster, David H.
AU - Buchanan, Duncan
AU - Robb, Kathryn
AU - Stanners, Greig
AU - Weller, David
AU - Steele, Robert J. C.
AU - Steiner, Markus
AU - Bhopal, Raj
N1 - Funding Information:
Funding This work was supported by the Chief Scientist’s Office (grant number CZH/4/878), Cancer Research UK (grant number C3743/A16594), and supplementary funding from NHS Health Scotland. ISD and National Records of Scotland both made ‘in-house’ contributions to the work.
Publisher Copyright:
©
Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2020/10/7
Y1 - 2020/10/7
N2 - Objective: Cancer screening should be equitably accessed by all populations. Uptake of colorectal cancer screening was examined using the Scottish Health and Ethnicity Linkage Study that links the Scottish Census 2001 to health data by individual-level self-reported ethnicity and religion.Setting: Data on 1.7 million individuals in two rounds of the Scottish Bowel Cancer Screening Programme (2007-2013) were linked to the 2001 Census using the Scottish Community Health Index number.Main outcome measure: Uptake of colorectal cancer screening, reported as age-adjusted risk ratios (RRs) by ethnic group and religion were calculated for men and women with 95% CI.Results: In the first, incidence screening round, compared with white Scottish men, Other White British (RR 109.6, 95% CI 108.8 to 110.3) and Chinese (107.2, 95% CI 102.8 to 111.8) men had higher uptake. In contrast, men of all South Asian groups had lower uptake (Indian RR 80.5, 95% CI 76.1 to 85.1; Pakistani RR 65.9, 95% CI 62.7 to 69.3; Bangladeshi RR 76.6, 95% CI 63.9 to 91.9; Other South Asian RR 88.6, 95% CI 81.8 to 96.1). Comparable patterns were seen among women in all ethnic groups, for example, Pakistani (RR 55.5, 95% CI 52.5 to 58.8). Variation in uptake was also observed by religion, with lower rates among Hindu (RR (95%CI): 78.4 (71.8 to 85.6)), Muslim (69.5 (66.7 to 72.3)) and Sikh (73.4 (67.1 to 80.3)) men compared with the reference population (Church of Scotland), with similar variation among women: lower rates were also seen among those who reported being Jewish, Roman Catholic or with no religion.Conclusions: There are important variations in uptake of bowel cancer screening by ethnic group and religion in Scotland, for both sexes, that require further research and targeted interventions.
AB - Objective: Cancer screening should be equitably accessed by all populations. Uptake of colorectal cancer screening was examined using the Scottish Health and Ethnicity Linkage Study that links the Scottish Census 2001 to health data by individual-level self-reported ethnicity and religion.Setting: Data on 1.7 million individuals in two rounds of the Scottish Bowel Cancer Screening Programme (2007-2013) were linked to the 2001 Census using the Scottish Community Health Index number.Main outcome measure: Uptake of colorectal cancer screening, reported as age-adjusted risk ratios (RRs) by ethnic group and religion were calculated for men and women with 95% CI.Results: In the first, incidence screening round, compared with white Scottish men, Other White British (RR 109.6, 95% CI 108.8 to 110.3) and Chinese (107.2, 95% CI 102.8 to 111.8) men had higher uptake. In contrast, men of all South Asian groups had lower uptake (Indian RR 80.5, 95% CI 76.1 to 85.1; Pakistani RR 65.9, 95% CI 62.7 to 69.3; Bangladeshi RR 76.6, 95% CI 63.9 to 91.9; Other South Asian RR 88.6, 95% CI 81.8 to 96.1). Comparable patterns were seen among women in all ethnic groups, for example, Pakistani (RR 55.5, 95% CI 52.5 to 58.8). Variation in uptake was also observed by religion, with lower rates among Hindu (RR (95%CI): 78.4 (71.8 to 85.6)), Muslim (69.5 (66.7 to 72.3)) and Sikh (73.4 (67.1 to 80.3)) men compared with the reference population (Church of Scotland), with similar variation among women: lower rates were also seen among those who reported being Jewish, Roman Catholic or with no religion.Conclusions: There are important variations in uptake of bowel cancer screening by ethnic group and religion in Scotland, for both sexes, that require further research and targeted interventions.
KW - gastrointestinal tumours
KW - health policy
KW - preventive medicine
KW - public health
UR - http://www.scopus.com/inward/record.url?scp=85092553482&partnerID=8YFLogxK
U2 - 10.1136/bmjopen-2020-037011
DO - 10.1136/bmjopen-2020-037011
M3 - Article
C2 - 33033017
SN - 2044-6055
VL - 10
JO - BMJ Open
JF - BMJ Open
IS - 10
M1 - 037011
ER -
