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伦敦西部人群中结直肠癌筛查的种族差异分析。

Ethnic disparities in the uptake of colorectal cancer screening: An analysis of the West London population.

机构信息

Department of Colorectal Surgery, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK.

Department of Surgery, Sheffield Teaching Hospital NHS Foundation Trust, Sheffield, UK.

出版信息

Colorectal Dis. 2021 Jul;23(7):1804-1813. doi: 10.1111/codi.15682. Epub 2021 May 14.

Abstract

AIM

Colorectal cancer (CRC) screening reduces mortality but variation exists in uptake, with poorer uptake in ethnic minority groups. The aim of this work was to evaluate the relationship between ethnicity and uptake of CRC screening in West London.

METHOD

Results of CRC screening from the Central London, West London, Hammersmith and Fulham, Hounslow and Ealing Clinical commissioning group collaborative between 2012 and 2017 were retrospectively analysed. These five clinical commissioning groups (CCGs) are located in West London. Compliance with screening according to ethnic group was evaluated compared with White British as the control.

RESULTS

A total of 155 038 individuals were screened. White British individuals had the highest compliance (52.6%). A maximum difference in compliance of 8.2% was seen between CCGs. The odds of being less likely to participate were significant (p < 0.05) in all ethnic minorities except for Asian Chinese on univariate and multivariate analysis (adjusted OR 1.091, p = 0.88).

CONCLUSION

This is the largest retrospective study focusing on the role of ethnicity in the uptake of CRC screening in England. Poor uptake of screening in all ethnic minorities in West London, with the exception of Asian Chinese individuals in particular, is a novel finding. A mandate to routinely collect ethnicity data, the use of a single more diverse census and further intervention are needed to understand this disparity and reduce health inequity.

摘要

目的

结直肠癌(CRC)筛查可降低死亡率,但筛查参与率存在差异,少数族裔的参与率较低。本研究旨在评估伦敦西部种族与 CRC 筛查参与率之间的关系。

方法

回顾性分析了 2012 年至 2017 年期间伦敦中部、伦敦西部、哈默史密斯和富勒姆、豪恩斯洛和伊灵临床委托组合作的 CRC 筛查结果。这五个临床委托组(CCG)位于伦敦西部。根据种族评估与白种英国人(对照组)相比筛查的合规性。

结果

共筛查了 155038 人。白种英国人的合规性最高(52.6%)。不同 CCG 之间的合规性差异最大为 8.2%。除亚裔中国人外,所有少数族裔的参与率较低的可能性均具有统计学意义(p<0.05),无论在单变量还是多变量分析中(调整后的 OR 1.091,p=0.88)。

结论

这是英国最大规模的回顾性研究,重点关注种族在 CRC 筛查参与率中的作用。伦敦西部所有少数族裔的筛查参与率较低,除了亚裔中国人,这是一个新的发现。需要强制常规收集种族数据、使用单一更多样化的人口普查并进一步干预,以了解这种差异并减少健康不平等。

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