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Table 3 Characteristics and findings of reviewed studies

From: Ethnic inequalities in time to diagnosis of cancer: a systematic review





Sample size (n) gender age


Ethnic groups

Relevant outcome measures






Rajan et al. (2011) [14]

UK (West Yorkshire)

To improve knowledge about late presentation and management of breast cancer among South Asian women.


n = 1,630 (36 South Asian women) all female median age = 53.5 years

Retrospective: Breast cancer waiting list database and case notes

South Asian women; Indians and Pakistanis

None; throughout the paper, including the title, the authors imply South Asian women had more delay

Duration of breast symptoms prior to presentation within primary care

45% of Asian women delayed symptoms beyond 8 weeks before visiting their GP

Meechan et al. (2002) [15]

New Zealand

Delay in seeking medical care for self-detected breast symptoms in New Zealand women.


n = 85 all female mean age =38 years

Retrospective: questionnaire & patient record

Minority New Zealanders - Maori, Pacific & Asian/Indian

European New Zealanders

Patient delay

No difference in patient delay by ethnicity.

Velikova et al. (2004) [16]

UK (South Yorkshire)

To describe the effect of ethnicity on tumour stage, treatment, patient and providers delays in diagnosis of breast cancer


n = 16,879 all female mean age = 49.7 years in Asians and 62 years in non-Asians

Retrospective: Cancer registry data

South Asian


Patients and providers delays to diagnosis

After adjusting for, age, SES and health care settings; patient delay was longer in Asian than in non –Asian women (median of 61 days vs. median of 31 days, P = 0.005)

Nosarti et al. (2000) [17]


To identify factors associated with delay in presentation and assessment of symptomatic breast cancer


n = 692 all female median age = 49 years

Retrospective: Interview, GP & hospital records

African Afro-Caribbean and Asian

British and other white

Patient and system delay

Ethnicity were non-contributory to patient delay in breast cancer

Neal and Allgar (2005) [18]


To explore the relationship between socio-demographic factors & delays in the diagnosis of six cancers

Breast, lung, colorectal, prostate NHL, and ovarian

n = 65,192 male & female all age groups

Retrospective: Analysis of the National Survey Data

Blacks - Africans, Caribbean & others blacks. South Asians -Indian, Pakistani, Bangladeshi, others.


Total, pre-hospital, referral and secondary care delay

After adjusting for marital status, gender, age and SES, Asian and black had longer pre-hospital delays for breast cancer in women (P = 0.001) and longer referral delay for colorectal cancer (P = 0.02). No evidence of difference for lung, prostate, NHL and ovarian.

Sadler et al. (2009) [19]

UK (Birmingham)

The effect of ethnicity on the presentation and management of oesophageal and gastric cancers: A UK perspective

oesophageal & gastric

n = 244 male & female median age = 71 years

Retrospective: Case-note audit

Asians and Blacks


Referral routes and total diagnostic interval

Asians and Blacks compared to Caucasians were less likely to be diagnosed within 3 months of symptom discovery (P = 0.03) and less likely to take the optimal route to diagnosis (p = 0.01).

Metcalfe et al. (2008) [20]


To examine the pathways followed by black and white men to prostate cancer diagnosis


n = 1,866 men median age = 67.9 years in blacks 73.3 years in whites

Retrospective: Questionnaire, hospital records and cancer registry data

Black men

White men

Delay between onset of symptoms and first GP presentation.

After adjusting for age and hospital centre, no significant difference between white and black men in patient delay (odds ratio: 0.82; 95% CI: 0.57 to 1.19)