Socioeconomic and ethnic inequalities in screen-detected breast cancer in London

Background We investigated socioeconomic and ethnic inequalities in screen-detected breast cancer in London—a city with relatively low breast cancer screening uptake and a diverse population.

Methods Data on 11 957 breast cancers in London women aged 50–64 between 1998 and 2005 were extracted from the Thames Cancer Registry. We investigated the relationship between socioeconomic deprivation and the incidence and 5-year relative survival of screen-detected and non screen-detected cancers. Using logistic regression analysis we explored whether differences in screen-detected cancers between White, Asian and Black women were influenced by age and socioeconomic deprivation.

Results The incidence of screen-detected breast cancer was lower in deprived women and their 5-year relative survival was worse than affluent women. However, survival differences were smaller for screen-detected disease. Among women with breast cancer the odds ratios (OR) for screen-detected disease differed between ethnic groups and these differences were not influenced by adjustment for age and deprivation. Compared with White women, Indian women had higher odds (OR 1.50, 95% confidence interval (1.23–1.84)], and Black Caribbean [0.68 (0.54–0.87)] and Black African women [0.53 (0.38–0.76)] significantly lower odds.

Conclusion A sustained focus on increasing screening uptake among deprived women and in Black communities could decrease inequalities in early diagnosis.