A systematic review of ethnic disparities in the uptake of colorectal cancer screening

• Published in: Perspectives in Public Health 2023-03, Vol.143 (2), p.105-120
• Main Authors: Sekhon Inderjit Singh, HK, Lal, N, Majeed, A, Pawa, N
• Format: Article
• Language: English
• Subjects: Black people; Cancer; Cancer screening; Classification; Colorectal cancer; Colorectal carcinoma; Colorectal Neoplasms - diagnosis; Compliance; Confounding factors; Early Detection of Cancer; East Asian People; Ethnic differences; Ethnic groups; Ethnicity; Hispanic or Latino; Humans; Inconsistency; Inequality; Medical screening; Minority & ethnic groups; Minority Groups; Philippino; Search engines; Systematic review; Uptake; Variation; White People
• ISSN: 1757-9139; 1757-9147
• DOI: 10.1177/17579139221093153

Aims: Colorectal cancer (CRC) screening reduces mortality, but variation exists in uptake. Ethnicity is suggested to play a role; however, there is no high-level evidence to support this. We aim to clarify the impact of Ethnicity on CRC screening uptake and our barriers to its understanding. Methods: A systematic review to identify studies reporting on the participation of ethnic minorities in CRC screening worldwide was performed. MEDLINE, Embase, Scopus and Google Scholar databases up until 31 May 2019 were searched. Compliance with screening according to ethnic groups and screening modality was evaluated compared to the ‘White’ control group. Results: Twenty-two studies were included in the review reporting on 2,084,213 patients. Substantial variation in categorisation of ethnicities (40 sub-categories), screening modality studied and confounding factors accounted for was observed. 8/15 studies for ‘Blacks’, 10/13 for ‘Hispanics’, 2/2 for ‘Asians’ and 1/1 for ‘South East Asians’ suggest a less likely or significantly decreased compliance with screening for all screening modalities (p