The Associations of Ethnicity and Breast Cancer

The largest ethnic minority groups in England are Indian, Pakistani, Black Caribbean and Black African and breast cancer patients from within these groups represent an under-researched population.

Limited data are available in these groups on breast cancer incidence and prevalence of known risk factors for the disease. We have already shown that these groups have, on average, more advanced disease at presentation and more aggressive breast cancer tumour characteristics compared to white women, an observation which requires further examination.

Furthermore, lower levels of engagement in healthcare research are generally reported in these ethnic groups but the reasons for this are not fully understood.

Work is underway to establish a national Ethnicity and Breast Cancer Working Group (EBCWG) and an ethnically diverse Patient and Public Involvement (PPI) panel, both of which will be used to support the delivery and dissemination of the proposed research.

The Prevention and Population Research Committee at Cancer Research UK have awarded a three year project grant (started May 2023) to support this research work.

key research objectives

To describe breast cancer incidence and prevalence of known risk factors for the disease in Indian, Pakistani, Black Caribbean, Black African and white women using large prospective cohort and routine cancer registry data.
To summarise the barriers and facilitators to the early diagnosis of breast cancer in ethnic minority women through a qualitative evidence synthesis.
To assess the feasibility and acceptability of establishing a national multicentre case-case study of incident invasive breast cancer cases, adequately powered to examine the associations of tumour characteristics with ethnicity after accounting for differences in known risk factors.

How the results of this research will be used

We will provide new information on variations in breast cancer incidence, prevalence of known risk factors by ethnicity, age and country of birth which will influence future breast cancer incidence rates and the barriers to the early diagnosis of breast cancer which will inform future qualitative and interventions studies in this area.

The feasibility study will provide a testbed for approaches to engagement and recruitment of an ethnically diverse population which, if appropriate, could then be used at scale in a national case-case study of breast cancer in ethnic minority groups.