B32
Breast cancer incidence, treatment and survival in ethnic groups in south east England
Ruth Jack, Elizabeth Davies, Henrik Mller
King's College London, UK
Background
Ethnicity has not been well recorded in UK cancer registries to date. However, Hospital Episode Statistics (HES) data are available for all inpatient admissions to English NHS hospitals and include self-assigned ethnicity, which can be linked to cancer registrations. This study aimed to use all the available ethnicity data to describe the different patterns of breast cancer incidence, stage, treatment and survival in different ethnic groups in South East England.
Method
Data on 35,631 women diagnosed with breast cancer in South East England between 1998 and 2003 with self-assigned ethnicity information available were analysed. Results are reported for White, Indian, Pakistani, Bangladeshi, Black Caribbean, Black African and Chinese women. Age-standardised breast cancer incidence rate ratios, recorded treatment, overall and breast cancer-specific survival were examined.
Results
All ethnic groups studied had lower age-standardised breast cancer incidence rates than White women, with Bangladeshi women having the lowest rate ratio (0.23, 95% CI 0.200.26). Black African women were the least likely to have a record of cancer surgery (63%) or hormone therapy (32%), and most likely to receive chemotherapy (38%). After fully adjusting for age, socioeconomic deprivation, stage of disease and treatment received, there was no significant variation in breast cancer-specific survival. However, Black African women had significantly worse overall survival (hazard ratio 1.24, p=0.025).
Conclusion
This study found variations in breast cancer incidence and treatment received between different ethnic groups. Variation in survival between ethnic groups was explained by differences in stage of disease at diagnosis and treatment received. These findings suggest that a strategy of earlier detection should be pursued in Black and South Asian women.
