Abstract
BackgroundBreast screening uptake in London is below the Government's target of 70% and we investigate whether ethnicity affects this. Information on the ethnicity for the individual women invited is unavailable, so we use an area-based method similar to that routinely used to derive a geographical measure for socioeconomic deprivation.MethodsWe extracted 742,786 observations on attendance for routine appointments between 2004 and 2007 collected by the London Quality Assurance Reference Centre. Each woman was assigned to a lower super output (LSOA) based on her postcode of residence. The proportions of the ethnic groups within each LSOA are known, so that the likelihood of a woman belonging to White, Black and Asian groups can be assigned. We investigated screening attendance by age group, socioeconomic deprivation using the Index of Deprivation 2004 income quintile, invitation type and breast screening service. Using logistic regression analysis we calculated odds ratios for attendance based on ethnic composition of the population, adjusting for age, socioeconomic status, the invitation type and screening service.ResultsThe unadjusted attendance odds ratios were high for the White population (OR: 3.34 95% CI [3.26-3.42]) and low for the Black population (0.13 [0.12-0.13]) and the Asian population (0.55 [0.53-0.56]). Multivariate adjustment reduced the differences, but the Black population remained below unity (0.47 [0.44-0.50]); while the White (1.30 [1.26-1.35]) and Asian populations (1.10 [1.05-1.15]) were higher. There was little difference in the attendance between age groups. Attendance was highest for the most affluent group and fell sharply with increasing deprivation. For invitation type, the routine recall was higher than the first call. There were wide variations in the attendance for different ethnic groups between the individual screening services.ConclusionsOverall breast screening attendance is low in communities with large Black populations, suggesting the need to improve participation of Black women. Variations in attendance for the Asian population require further investigation at an individual screening service level.
Highlights
Breast screening uptake in London is below the Government’s target of 70% and we investigate whether ethnicity affects this
One of the reasons suggested for the low attendance in London is that the population is ethnically diverse, with 6% of the screened age group consisting of Black ethnic groups and 7% from the Asian ethnic groups estimated from the Census 2001
Analysis We investigated screening attendance by age in the age groups 50-52, 53-54, 55-59, 60-64 and 65-70 years; by socioeconomic deprivation based on the income quintile of the Indices of Deprivation 2004[11], by invitation type and by breast screening service
Summary
Breast screening uptake in London is below the Government’s target of 70% and we investigate whether ethnicity affects this. One of the reasons suggested for the low attendance in London is that the population is ethnically diverse, with 6% of the screened age group consisting of Black ethnic groups and 7% from the Asian ethnic groups estimated from the Census 2001. These compare to figures of 1.3% and 2.4% respectively, for England and Wales as a whole. A qualitative study in Hackney which included a sample of women representing the ethnic diversity of the area found that, a women’s comprehension of her risk of developing breast cancer was associated with her ethnicity and this influenced screening attendance[7]. A recent UK study using data from the women’s health screening module of the National Statistics Omnibus Survey found no differences in attendance for breast screening between White British and the other ethnic groups combined, White British women were significantly more likely to have had a cervical smear than were women in the other ethnic group[8]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
