Researchers found that some ethnic-background and deprived groups were up to 37% more likely to be diagnosed in an emergency setting. The lead investigator calls for equal access to screening and prompt treatment.
University of Surrey researchers found that Black, Asian and mixed-ethnicity patients, alongside patients from deprived backgrounds, were up to 33% less likely to have breast cancer diagnosed through routine screening in England. Their analysis also found longer waits for diagnosis and treatment among people with a learning disability.
The researchers examined clinical and cancer-registration records for 86,564 adults diagnosed between 2009 and 2019. Breast Cancer Now funded the work, which the Guardian disclosed on 25 October.
Lead investigator Dr Rob Kerrison said differences in breast cancer survival between groups of women were already known, but the reasons were only partly understood. The analysis examines differences in how patients reached a diagnosis and how long they waited for care.
Routine screening checks for cancer before symptoms prompt an investigation. The researchers compared diagnosis through screening with diagnosis following an urgent referral for suspected cancer or an emergency presentation.
| Route to diagnosis | Relative difference |
|---|---|
| Routine screening | Up to 33% less likely |
| Urgent suspected-cancer referral |
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| Up to 31% more likely |
| Emergency presentation | Up to 37% more likely |
These figures describe diagnostic routes among people who had breast cancer, not screening participation across the wider population. They are relative differences, not percentage-point gaps, and the “up to” figures should not be read as applying equally to every group.
Analysis
The researchers also found longer waits for people with a learning disability, compared with people without one.
| Measure | Compared with patients without a learning disability |
|---|---|
| Time to diagnosis | 18% longer |
| Wait for treatment | 10% longer |
The comparisons show associations, not proof that ethnic background, deprivation or learning disability caused the differences. Absolute rates for each group, the methods used to account for other differences between patients, and whether the study has undergone peer review remain unspecified.
Kerrison said unequal access to screening and timely treatment may partly explain previously known survival gaps. That is a possible explanation, not a measured effect on survival from this analysis. He called for everyone to have access to screening and prompt treatment, regardless of background or circumstances.
Breast Cancer Now said it was working with policymakers to improve equal access to screening and ensuring that its information, campaigns and support services reflect the different needs of people affected by breast cancer.
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