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

Christine Campbell, Anne Douglas, Linda Jane Williams, Genevieve Cezard, David Brewster, Duncan Buchanan, Kathryn A. Robb, Greig Stanners, David Weller, Robert Steele, Markus Steiner, Raj Bhopal

Research output: Contribution to journalArticlepeer-review

Abstract

Objective
Cancer screening should be equitably accessed by all populations. Uptake of colorectal can-cer 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 Pro-gramme (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% confidence intervals (CI).

Results
In the first, incidence screening round, compared to White Scottish men, Other White British (RR 109.6, 95% CI 108.8, 110.3) and Chinese (107.2, CI 102.8, 111.8) men had higher up-take. In contrast, men of all South Asian groups had lower uptake (Indian RR 80.5, CI 76.1, 85.1; Pakistani RR 65.9, CI 62.7, 69.3; Bangladeshi RR 76.6, CI 63.9, 91.9; Other South Asian RR 88.6, CI 81.8, 96.1). Comparable patterns were seen among women in all ethnic groups, e.g. Pakistani (RR 55.5, CI 52.5, 58.8). Variation in uptake was also observed by reli-gion, with lower rates among Hindu (RR [95%CI]: 78.4 [71.8; 85.6]), Muslim (69.5 [66.7; 72.3]), and Sikh (73.4 [67.1; 80.3]) men compared to 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 reli-gion in Scotland, for both sexes that require further research and targeted interventions.
Original languageEnglish
Pages (from-to)e037011
JournalBMJ Open
Volume10
Early online date7 Oct 2020
DOIs
Publication statusE-pub ahead of print - 7 Oct 2020

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