Introduction The prevalent round of the Bowel Cancer Screening Programme (BCSP) in England commenced in August 2006. Analysis of the first three years of the BCSP reveals a mean adenoma detection rate (ADR) of 46.5% (range 21.9-59.8%), and a mean polyp detection rate (PDR) of 59.7% (range 39.8–76.3%).1
Anecdotally, BCSP colonoscopists have suggested that the PDR, ADR and cancer detection rates in screened individuals of South Asian descent may be lower than those of Caucasian (white) descent. This has never been proven as the BCSP does not record ethnic origin of screened individuals.
Methods Between May 1st and December 31st 2013, every screened individual in Leicester and Kettering had their self-selected ethnic origin recorded in a database. The endoscopic findings and histology results noted in the Exeter online database was correlated to the database containing ethnic origin data and analysed.
Results 851 screened individuals (colonoscopy), 466 individuals had polyps (394 adenomas), PDR = 54.76%, ADR = 46.30%, cancer detection rate = 5.41%.
734 “White” individuals (86.25%)
45 individuals had cancer (cancer detection rate = 6.13%)
421 individuals had polyps, PDR = 57.36% (95% CI: 53.75–60.89%)
353 individuals had polyps, ADR = 48.09% (95% CI: 44.50–51.71%)
101 “Asian or Asian British” (11.87%)
1 individual had cancer (cancer detection rate = 0.99%)
36 individuals had polyps, PDR = 35.64% (95% CI: 26.99–45.35%)
32 individuals had polyps, ADR = 31.68% (95% CI: 23.42–41.29%)
16 “Mixed”, “Black or Black British” or “Other Ethnic Groups” (1.88%)
0 cancers, 8 individuals with polyps/adenomas (PDR/ADR = 50%)
Too few to meaningfully analyse
Conclusion This analysis reveals a statistically significant lower ADR and PDR for South Asian screened individuals when compared to Caucasian (White) individuals. There is also a strong trend showing a lower cancer detection rate. This is important for clinicians to be aware of so that they can fully inform individuals undergoing colonoscopic screening.
For regions with large South Asian populations, this observation can be used to appropriately plan services. ADR and cancer detection rates in these regions may be lower and may be a factor in the regional variations of ADR and cancer detection across the BCSP.
Lee TJW, Rutter MD, Blanks RG, et al. Colonoscopy quality measures: experience from the NHS Bowel Cancer Screening Programme. Gut 2012;61:1050-1057 doi:10.1136/gutjnl-2011-300651
Disclosure of Interest None Declared.
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