PTH-102 Bowel Cancer Screening; variations in adenoma detection rates, cancer rates, and comfort scores by ethnicity
Year: 2021
Type: conference-abstract
Abstract: Introduction Colonoscopy is the investigation of choice after a positive stool test for occult blood (faecal occult blood test or faecal immunochemical test) as part of the Bowel Cancer Screening Programme (BCSP). Uptake of bowel cancer screening can be influenced by many factors; one such factor is ethnicity. 1 In the BCSP, subject’s ethnicity is not routinely recorded by the specialist screening practitioners at the clinic appointment prior to having a colonoscopy. Therefore, data on differences in key performance indicators between different ethnic groups is poor. Aims & Methods The purpose of this study was to assess differences in adenoma and cancer detection rates and comfort scores within the BCSP. 1508 subjects with a positive faecal occult blood test self-reported their ethnicity prior to colonoscopy. Demographic and endoscopic data was retrieved from the Exeter online database (which is used to record BCSP data). Multivariate logistic regression was used to examine independent variables (age, sex, ethnicity, colonoscopy findings) as predictors of discomfort, adenoma and cancer detection. The number of non-white/non-South Asian subjects was too small for meaningful comparison, we have analysed differences between white and South Asian populations. Results The adenoma detection rate (ADR) was greater in White than South Asian patients (43.5% vs. 31.9%; OR: 1.64, P=0.015); and in Males than Females (45.7% vs. 38.0%; OR: 1.37, P=0.003). Similarly, cancer detection was higher in White than South Asian patients (6.9% vs. 1.7%; OR: 4.33, P=0.042). Female patients were more likely to experience significant discomfort during colonoscopy (OR: 3.08, P<0.001), no differences in comfort scores were found between ethnicities. Conclusion A lower adenoma detection rate and cancer detection rate was found in South Asian patients requiring colonoscopy as part of bowel cancer screening programme compared to White patients. Comfort scores were not dissimilar between ethnicities, although female participants reported greater discomfort than males. Understanding the differences between the two largest ethnic groups allows funding to be directed towards communication of these findings to South Asian communities, which may help improve poor attendance to screening programmes that is influenced by fear of adverse findings and the procedure itself. Reference Palmer CK, Thomas MC, McGregor LM, von Wagner C, Raine R. Understanding low colorectal cancer screening uptake in South Asian faith communities in England–a qualitative study. BMC Public Health 2015;15(1):998-1005.
Authors: Maurice Dungey, Mina Hanna, Vicki Lewin, Nalin Natarajan, Benjamin Robinson, Richard Robinson, Ajay Verma
Language: English
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
OpenAlex ID: W3213018800