Assessing Ethnic Inequalities in Diagnostic Interval of Common Cancers: A Population-Based UK Cohort Study

Martins, Tanimola; Abel, Gary; Ukoumunne, Obioha C; Price, Sarah; Lyratzopoulos, Georgios; Chinegwundoh, Frank; Hamilton, William

doi:10.3390/cancers14133085

Cited by 8 publications

(11 citation statements)

References 48 publications

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“…Moreover, the time Black patients spend waiting to receive cancer diagnosis is significantly longer than that of White patients both in the United States ( 42 ) and the United Kingdom. ( 43 ). Our study contributes to this line of this research by showing that Black scientists in the United States suffer from longer delays before their manuscript is accepted for publication.…”

Section: Discussionmentioning

confidence: 99%

Non-White scientists appear on fewer editorial boards, spend more time under review, and receive fewer citations

Liu

Rahwan²,

AlShebli³

2023

Proc. Natl. Acad. Sci. U.S.A.

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Disparities continue to pose major challenges in various aspects of science. One such aspect is editorial board composition, which has been shown to exhibit racial and geographical disparities. However, the literature on this subject lacks longitudinal studies quantifying the degree to which the racial composition of editors reflects that of scientists. Other aspects that may exhibit racial disparities include the time spent between the submission and acceptance of a manuscript and the number of citations a paper receives relative to textually similar papers, but these have not been studied to date. To fill this gap, we compile a dataset of 1,000,000 papers published between 2001 and 2020 by six publishers, while identifying the handling editor of each paper. Using this dataset, we show that most countries in Asia, Africa, and South America (where the majority of the population is ethnically non-White) have fewer editors than would be expected based on their share of authorship. Focusing on US-based scientists reveals Black as the most underrepresented race. In terms of acceptance delay, we find, again, that papers from Asia, Africa, and South America spend more time compared to other papers published in the same journal and the same year. Regression analysis of US-based papers reveals that Black authors suffer from the greatest delay. Finally, by analyzing citation rates of US-based papers, we find that Black and Hispanic scientists receive significantly fewer citations compared to White ones doing similar research. Taken together, these findings highlight significant challenges facing non-White scientists.

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Section: Discussionmentioning

confidence: 99%

Non-White scientists appear on fewer editorial boards, spend more time under review, and receive fewer citations

Liu

Rahwan²,

AlShebli³

2023

Proc. Natl. Acad. Sci. U.S.A.

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“… 41–50 This finding is reinforced within recent findings that black and Asian patients wait up to a month longer than white patients for some cancer diagnoses. 71 Rural residence and being part of a VSG also appear linked to limited treatment access 51–56 including access to timely and appropriate care. 58 59 72 Multiple studies demonstrated the negative impact of deprivation on access to surgery, 48 60 61 73 a finding consistent with previous work which found that low socioeconomic position reduced the likelihood of receipt of any type of LC treatment, surgery or chemotherapy.…”

Section: Discussionmentioning

confidence: 99%

What health inequalities exist in access to, outcomes from and experience of treatment for lung cancer? A scoping review

Lennox,

Lambe,

Hindocha

et al. 2023

BMJ Open

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ObjectivesLung cancer (LC) continues to be the leading cause of cancer-related deaths and while there have been significant improvements in overall survival, this gain is not equally distributed. To address health inequalities (HIs), it is vital to identify whether and where they exist. This paper reviews existing literature on what HIs impact LC care and where these manifest on the care pathway.DesignA systematic scoping review based on Arksey and O’Malley’s five-stage framework.Data sourcesMultiple databases (EMBASE, HMIC, Medline, PsycINFO, PubMed) were used to retrieve articles.Eligibility criteriaSearch limits were set to retrieve articles published between January 2012 and April 2022. Papers examining LC along with domains of HI were included. Two authors screened papers and independently assessed full texts.Data extraction and synthesisHIs were categorised according to: (a) HI domains: Protected Characteristics (PC); Socioeconomic and Deprivation Factors (SDF); Geographical Region (GR); Vulnerable or Socially Excluded Groups (VSG); and (b) where on the LC pathway (access to, outcomes from, experience of care) inequalities manifest. Data were extracted by two authors and collated in a spreadsheet for structured analysis and interpretation.Results41 papers were included. The most studied domain was PC (32/41), followed by SDF (19/41), GR (18/41) and VSG (13/41). Most studies investigated differences in access (31/41) or outcomes (27/41), with few (4/41) exploring experience inequalities. Evidence showed race, rural residence and being part of a VSG impacted the access to LC diagnosis, treatment and supportive care. Additionally, rural residence, older age or male sex negatively impacted survival and mortality. The relationship between outcomes and other factors (eg, race, deprivation) showed mixed results.ConclusionsFindings offer an opportunity to reflect on the understanding of HIs in LC care and provide a platform to consider targeted efforts to improve equity of access, outcomes and experience for patients.

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“…However, a small proportion of women had breast pain, which was recorded as an isolated feature in over half of Black women with that feature. These women may form the bulk of those experiencing greater pre-referral consultations and longer times to diagnosis [ 10 , 11 ], since isolated breast pain is less predictive of cancer [ 31 , 34 , 35 ], with no current UK recommendation for urgent investigation. Breast pain has been linked to a greater risk of advanced-stage breast cancer [ 33 ].…”

Section: Discussionmentioning

confidence: 99%

“…A recent multi-method study of UK men presenting with possible prostate cancer symptoms in primary care showed that men, particularly Black men, may not fully disclose their concerns or symptoms during initial consultations, partly due to the relatively short duration of primary-care consultations [ 9 ]. Non-disclosure of symptoms may explain the greater frequency of primary-care consultations [ 10 ] and the longer time to diagnosis among the UK Asian and Black groups compared with the White group [ 11 ], although this aspect has not been fully examined. In the present study, we used cancer-registry-linked data to investigate possible ethnic differences in the number and type of cancer features recorded in primary care before a cancer diagnosis.…”

Section: Introductionmentioning

confidence: 99%

Are There Ethnic Differences in Recorded Features among Patients Subsequently Diagnosed with Cancer? An English Longitudinal Data-Linked Study

Martins

Ukoumunne

Lyratzopoulos

et al. 2023

Cancers

Self Cite

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We investigated ethnic differences in the presenting features recorded in primary care before cancer diagnosis. Methods: English population-based cancer-registry-linked primary care data were analysed. We identified the coded features of six cancers (breast, lung, prostate, colorectal, oesophagogastric, and myeloma) in the year pre-diagnosis. Logistic regression models investigated ethnic differences in first-incident cancer features, adjusted for age, sex, smoking status, deprivation, and comorbidity. Results: Of 130,944 patients, 92% were White. In total, 188,487 incident features were recorded in the year pre-diagnosis, with 48% (89,531) as sole features. Compared with White patients, Asian and Black patients with breast, colorectal, and prostate cancer were more likely than White patients to have multiple features; the opposite was seen for the Black and Other ethnic groups with lung or prostate cancer. The proportion with relevant recorded features was broadly similar by ethnicity, with notable cancer-specific exceptions. Asian and Black patients were more likely to have low-risk features (e.g., cough, upper abdominal pain) recorded. Non-White patients were less likely to have alarm features. Conclusion: The degree to which these differences reflect disease, patient or healthcare factors is unclear. Further research examining the predictive value of cancer features in ethnic minority groups and their association with cancer outcomes is needed.

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Assessing Ethnic Inequalities in Diagnostic Interval of Common Cancers: A Population-Based UK Cohort Study

Cited by 8 publications

References 48 publications

Non-White scientists appear on fewer editorial boards, spend more time under review, and receive fewer citations

Non-White scientists appear on fewer editorial boards, spend more time under review, and receive fewer citations

What health inequalities exist in access to, outcomes from and experience of treatment for lung cancer? A scoping review

Are There Ethnic Differences in Recorded Features among Patients Subsequently Diagnosed with Cancer? An English Longitudinal Data-Linked Study

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