Ethnicity, deprivation and screening: survival from breast cancer among screening-eligible women in the West Midlands diagnosed from 1989 to 2011

• Published in: British journal of cancer Vol. 113; no. 3; pp. 548 - 555
• Main Authors: Morris, M, Woods, L M, Rogers, N, O'Sullivan, E, Kearins, O, Rachet, B
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 28.07.2015; Nature Publishing Group
• Subjects: 692/699/67/1347; 692/699/67/2322; 692/699/67/2324; 692/700/1750/1976; Aged; Biomedical and Life Sciences; Biomedicine; Breast Neoplasms - diagnosis; Breast Neoplasms - mortality; Cancer Research; Drug Resistance; Early Detection of Cancer - statistics & numerical data; Epidemiology; Ethnicity - statistics & numerical data; Female; Health Services Accessibility - statistics & numerical data; Humans; Mammography - statistics & numerical data; Middle Aged; Molecular Medicine; Oncology; Patient Participation - statistics & numerical data; Psychosocial Deprivation; Socioeconomic Factors; Survival Analysis; United Kingdom - epidemiology; United Kingdom; Great Britain; survival analysis; mammography; breast neoplasms; ethnic groups; mass screening; socio-economic factors
• ISSN: 0007-0920; 1532-1827
• DOI: 10.1038/bjc.2015.204

Background: Social inequalities in breast cancer survival are smaller when the cancer is screen-detected. We examined survival from screen-detected and non screen-detected breast cancer by ethnicity and deprivation. Methods: Cancer registry data for 20 283 women aged 50–70 years, diagnosed between 1989–2011 and invited for screening, were linked with screening and ethnicity data. We examined Asian, Black and White groups, less deprived and middle/more deprived women. Net survival was estimated using ethnic- and deprivation-specific life tables. Estimates were corrected for lead-time bias and over-diagnosis. Results: Net survival varied by screening history. No significant differences in survival were found by ethnicity. Five-year net survival was 90.0% (95% CI, 89.3–90.8%) in less deprived groups and 86.7% (85.9–87.4%) among middle/more deprived women. Screening benefitted all ethnic and both deprivation groups. Whether screen-detected or not, more deprived women had significantly poorer outcomes: 5-year net survival was 78.0% (76.7–79.2%) for deprived women who were not screen-detected compared with 94.0% (93.1–95.1%) for less deprived women who were screen-detected. Conclusions: The three ethnic groups differed little in their breast cancer survival. Although screening confers a survival benefit to all, there are still wide disparities in survival by deprivation. More needs to be done to determine what underlies these differences and tackle them.