Are there ethnic and religious variations in uptake of bowel cancer screening? A retrospective cohort study among 1.7 million people in Scotland

Campbell, C. et al. (2020) Are there ethnic and religious variations in uptake of bowel cancer screening? A retrospective cohort study among 1.7 million people in Scotland. BMJ Open, 10(10), e037011. (doi: 10.1136/bmjopen-2020-037011) (PMID:33033017) (PMCID:PMC7542953)

Abstract

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.

• Item Type: Articles
• Additional Information: 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.
• Keywords: Gastrointestinal tumours, health policy, preventive medicine, public health.
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Robb, Professor Katie
• Authors: Campbell, C., Douglas, A., Williams, L., Cezard, G., Brewster, D. H., Buchanan, D., Robb, K., Stanners, G., Weller, D., Steele, R. J.C., Steiner, M., and Bhopal, R.
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Mental Health and Wellbeing
• Journal Name: BMJ Open
• Publisher: BMJ Publishing Group
• ISSN: 2044-6055
• ISSN (Online): 2044-6055
• Published Online: 07 October 2020
• Copyright Holders: Copyright © 2020 The Authors
• First Published: First published in BMJ Open 10(10): e037011
• Publisher Policy: Reproduced under a Creative Commons License