Black, Asian and Mixed-Background Patients in England Up to 33% Less Likely to Be Diagnosed Through Breast Screening, Surrey Study Finds

New English research looks at a pointed problem in breast cancer care: who gets caught early, and who doesn't.

The analysis, carried out by University of Surrey academics and funded by the charity Breast Cancer Now, covered 86,564 adults diagnosed with breast cancer in England between 2009 and 2019. It drew on the Clinical Practice Research Datalink and the Cancer Registration Tumour and Treatment datasets.

What the numbers show

People from Black, Asian and mixed backgrounds, along with people from deprived backgrounds, were up to 33% less likely to be diagnosed through routine screening.

The same groups were up to 31% more likely to be diagnosed through an urgent suspected-cancer referral. They were up to 37% more likely to be diagnosed after turning up in an emergency setting.

The "up to" figures are the largest gaps found, not a uniform figure for every group.

The study also looked at people with a learning disability. Their time to diagnosis was 18% longer than for people without one, and their wait for treatment was 10% longer.

What the researchers say

Study lead Rob Kerrison, an associate professor at the University of Surrey, said unequal access to screening and timely treatment may partly explain differences in survival after breast cancer. Women from a range of disadvantaged and under-served groups were less likely to have their cancer detected through screening, he said, and often waited longer to start treatment.

The analysis ties diagnosis route to survival as a possible factor, not a proven one.

Manveet Basra, associate director of public health, inclusion and awareness at Breast Cancer Now, went further. She said people from marginalised groups "face inequalities at every stage of their breast cancer experience, and tragically this impacts their survival rates."

Basra said the research helps identify who is less likely to be diagnosed through screening and who may wait longer for diagnosis or treatment. "Knowing what barriers they face enables us to work towards eliminating them," she said.

Why diagnosis route matters

Breast cancer is the most common cancer among women worldwide. It accounts for about one in four cancer cases and is one of the leading causes of death in women under 50. Identifying women at higher risk early can pave the way for additional screening or preventive treatment.

A cancer found through screening is generally caught before symptoms push a patient into the system. An emergency diagnosis means the disease surfaced on its own terms. That difference is central to the finding.

Earlier evidence points the same direction

The analysis adds to existing evidence of unequal cancer outcomes for people from marginalised backgrounds. A previous study showed that ethnic minority patients required more GP visits than other people before a cancer diagnosis. On average, one in five people in England needs three or more GP interactions before being diagnosed with cancer. For people from ethnic minority backgrounds, that rises to one in three, according to analysis of the NHS cancer patient experience 2022 survey by QualityWatch, a joint programme from the Nuffield Trust and the Health Foundation.

Research from the UK Health Security Agency has also suggested that young Black women are more likely to have aggressive breast cancer tumours, experience poorer care and have higher mortality rates, but are significantly under-represented in clinical research.

Limits of the findings

The study covers patients diagnosed between 2009 and 2019.

The findings also group ethnicity and deprivation together. Breast Cancer Now's own summary lists both, and the figures released do not say how much of each gap comes from ethnicity and how much from income or area.

Kerrison said that until now there has been only a limited understanding of why some groups of women in the UK have poorer breast cancer survival than others. His account describes the pattern and suggests inequalities in access to screening and timely treatment may be part of the explanation. It does not establish the cause.

What comes next

Breast Cancer Now says it is working with policymakers to improve equal access to screening, and says its information, campaigns and support services will reflect the diverse needs of everyone affected by the disease. Kerrison said that to improve breast cancer outcomes, everyone needs to be able to access screening and receive prompt treatment, regardless of their background or circumstances.