Why do we need EMCAW?

Cancer incidence

Even though ethnicity is not systematically recorded by cancer registries in the UK there is some evidence that certain types of cancers are experienced at different rates among ethnic minority communities. For example, compared to the general population, there are:
  • Lower rates of breast cancer in the South Asian community
  • Higher prostate cancer rates among Black Caribbean and African men
  • Higher rates of mouth cancer among South Asians
  • Higher rates, and more aggressive forms, of breast cancer among younger Black Caribbean and African women.

Lifestyle factors

There are a range of lifestyle factors which can impact upon an individual’s risk of developing cancer. A number of these, for example alcohol consumption, tend to be undertaken at lower rates within ethnic minority communities compared to the general population. At the same time some activities are predominantly found within ethnic minority communities. For example the chewing of tobacco, Paan and related products among the Bangladeshi community; there is also a high rate of heavy smoking among Bangladeshi men. In order to address these differences in cancer related behaviours within diverse communities it will be necessary to provide tailored information and support.

Symptom recognition and awareness

Breast Cancer Care found that 43 per cent of BME women indicated that they had never practised breast awareness, compared to 11 per cent of the general population. Among BME women who had not practised breast awareness, 53 per cent had not done so because they were uncertain what to look for. Cancer symptom and sign recognition may be due to a lack of appropriate information and support. Providing appropriate services in this area is likely to reduce inequalities in cancer sign and symptom recognition.

 
Cancer services

For those who do not speak English language may be a considerable barrier to the uptake of health services. One study found that 41 per cent of those with additional language needs had no one to help with interpreting when visiting their doctor or other health services. For older members of BME communities, literacy may also be a barrier to accessing health information. At the same time it is important to remember that BME communities are dynamic and that younger individuals may not require the same types of information and support that their older relatives need. For example one study found that although uptake of cancer screening, among the older South Asian community, was lower than that within the general population younger South Asians uptake more closely matched that of the general population.

BME groups are less likely to be referred to, or use, hospice cancer services. The reason for this is that such services were perceived to be less likely to meet the needs of individuals from an ethnic minority background. There is a need for services to be provided in culturally appropriate ways if inequalities in uptake of such services are to be addressed.

 
Need for recording of ethnicity data

One London based study found that 23% of CNS did not routinely collect BME ethnic coding when assessing breast cancer patients and so were unable to identify how many BME patients they were (had) treated. If this information was systematically recorded it would enable a better understanding of the needs of ethnic minority individuals within cancer services and the development of appropriate services to meet these needs.

Sources

  • Farooq, S. and Coleman, M. (2005) Breast cancer survival in South Asian women in England and Wales Journal of Epidemiology and Community Health; 59: 402-406
    Although rates are currently lower than those found in the general population there is evidence of breast cancer increasing faster in South Asians than in other ethnic groups: http://info.cancerresearchuk.org/news/
  • Prostate Cancer Charter for Action (2005) The Prostate Cancer Equality Action Plan
  • Chinegwundoh et al. (2006) Risk and presenting features of prostate cancer amongst African-Caribbean, South Asian and European men in North-East London BJU: Vol 98; Issue 6, p. 1216-1220. This study found African Caribbean men were three times more likely to be diagnosed with prostate cancer.
  • Aspinall, P. and Jacobson, B. (2004) Ethnic disparities in health and health care: A focused review of the evidence and selected examples of good practice London: London Health Observatory
  • Bowen et al. (2008) Early onset of breast cancer in a group of British black women British Journal of Cancer 2008; 98: 277-281
  • DH (2007) Health Survey for England 2004 London: Department of Health
  • Smith et al. (2003) Recent changes in lung cancer incidence for south Asians Student BMJ: Vol 11: http://student.bmj.com/search/pdf/03/03/ppr.pdf
  • Scanlon et al. (2005) Same difference: Breast awareness is for everyone Breast Cancer Care Policy Briefing London: Breast Cancer Care
  • Office for National Statistics (2004) Focus on Social Inequalities 2004 London: ONS
  • Hill, S. (2006) Ethnicity and Cancer Prevention Information (Internal CR-UK report) London: Cancer Research UK
  • Webb et al. (2007) Uptake for cervical screening by ethnicity and place-of-birth: a population-based cross-sectional study Journal of Public Health; Vol. 26: No. 3, 2004: p.293-296
  • Johnson, M. (2001) Palliative Care, Cancer and Minority Ethnic Communities: A Literature Review Leicester: De Montfort University Mary Seacole Research Institute
  • Macmillan CNS (2007)