title: Ethnicity, deprivation and screening: survival from breast cancer among screening-eligible women in the West Midlands diagnosed from 1989 to 2011.
abstract: BACKGROUND
  Social inequalities in breast cancer survival are smaller when the cancer is screen-detected. We examined survival from screen-detected and non screen-detected breast cancer by ethnicity and deprivation.
  
  
  METHODS
  Cancer registry data for 20 283 women aged 50-70 years, diagnosed between 1989-2011 and invited for screening, were linked with screening and ethnicity data. We examined Asian, Black and White groups, less deprived and middle/more deprived women. Net survival was estimated using ethnic- and deprivation-specific life tables. Estimates were corrected for lead-time bias and over-diagnosis.
  
  
  RESULTS
  Net survival varied by screening history. No significant differences in survival were found by ethnicity. Five-year net survival was 90.0% (95% CI, 89.3-90.8%) in less deprived groups and 86.7% (85.9-87.4%) among middle/more deprived women. Screening benefitted all ethnic and both deprivation groups. Whether screen-detected or not, more deprived women had significantly poorer outcomes: 5-year net survival was 78.0% (76.7-79.2%) for deprived women who were not screen-detected compared with 94.0% (93.1-95.1%) for less deprived women who were screen-detected.
  
  
  CONCLUSIONS
  The three ethnic groups differed little in their breast cancer survival. Although screening confers a survival benefit to all, there are still wide disparities in survival by deprivation. More needs to be done to determine what underlies these differences and tackle them.
authors.affiliation: Cancer Research UK Cancer Survival Group, Department of Non-Communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, Keppel St, London WC1E 7HT, UK.
authors.forename: M
authors.initials: M
authors.lastname: Morris
authors.affiliation: Cancer Research UK Cancer Survival Group, Department of Non-Communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, Keppel St, London WC1E 7HT, UK.
authors.forename: L M
authors.initials: LM
authors.lastname: Woods
authors.affiliation: West Midlands Breast Screening Quality Assurance Reference Centre, Public Health England, 5 St Philip's Place, Birmingham B3 2PW, UK.
authors.forename: N
authors.initials: N
authors.lastname: Rogers
authors.affiliation: West Midlands Breast Screening Quality Assurance Reference Centre, Public Health England, 5 St Philip's Place, Birmingham B3 2PW, UK.
authors.forename: E
authors.initials: E
authors.lastname: O'Sullivan
authors.affiliation: West Midlands Breast Screening Quality Assurance Reference Centre, Public Health England, 5 St Philip's Place, Birmingham B3 2PW, UK.
authors.forename: O
authors.initials: O
authors.lastname: Kearins
authors.affiliation: Cancer Research UK Cancer Survival Group, Department of Non-Communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, Keppel St, London WC1E 7HT, UK.
authors.forename: B
authors.initials: B
authors.lastname: Rachet
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis / Q000401:mortality*; D055088:Early Detection of Cancer / Q000706:statistics & numerical data*; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006801:Humans; D008327:Mammography / Q000706:statistics & numerical data*; D008875:Middle Aged; D010358:Patient Participation / Q000706:statistics & numerical data; D011610:Psychosocial Deprivation; D012959:Socioeconomic Factors; D016019:Survival Analysis; D006113:United Kingdom / Q000453:epidemiology