Journal of Medical Screening > Volume 15, Number 3 > Pp. 130-136

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Original Articles

Ethnic differences in participation in flexible sigmoidoscopy screening in the UK

Kathryn A Robb, Research Fellow  , Department of Epidemiology and Public Health, University College of London, London, UK

Emily Power, PhD Student , Department of Epidemiology and Public Health, University College of London, London, UK

Wendy Atkin, Professor of Gastrointestinal Epidemiology , Imperial College London, St Mark's Hospital, Harrow, UK

Jane Wardle, Director , Cancer Research UK Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College of London, London, UK

Correspondence to: Kathryn Robb, Cancer Research UK Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College of London, Gower Street, London WC1E 6BT, UK; k.robb{at}ucl.ac.uk

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Objectives The aim of the study was to examine ethnic differences in participation in colorectal cancer screening by flexible sigmoidoscopy (FS). It assessed both intentions to be screened and actual screening uptake, and considered whether demographic, health and psychosocial factors mediated the ethnic differences. The setting of this study follows a subset of participants from the UK FS Trial.

Methods A postal questionnaire assessed ethnicity, demographic characteristics, health, attitudes to screening and FS screening intentions. Data on screening intentions were available for 17,333 adults aged 55–64 years (Sample 1). Screening uptake was recorded in a subsample of 4303 respondents who were subsequently randomized to receive an invitation to screening (Sample 2).

Results Screening intentions in Sample 1 were equally high across all the ethnic groups (>80% [13,724/17,042] reported they were interested). In contrast, attendance (Sample 2) was considerably lower among Asians (54% [43/79]) compared with White (69% [2843/4123]) or Black (80% [33/41]) respondents. Multivariate analysis showed that potential explanatory factors, including socioeconomic deprivation, poor health and fearful and fatalistic attitudes did not account for the lower screening attendance among Asians.

Conclusion Further research is required to identify explanations for the gap between intentions and behaviour in UK Asians if any future FS screening programme is to be introduced equitably.

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				K L Austin, E Power, I Solarin, W S Atkin, J Wardle, and K A Robb Perceived barriers to flexible sigmoidoscopy screening for colorectal cancer among UK ethnic minority groups: a qualitative study J Med Screen, December 1, 2009; 16(4): 174 - 179. [Abstract] [Full Text] [PDF]