{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T05:14:56Z","timestamp":1787030096555,"version":"build-2736575974"},"reference-count":55,"publisher":"Royal College of General Practitioners","issue":"754","license":[{"start":{"date-parts":[[2019,2,12]],"date-time":"2019-02-12T00:00:00Z","timestamp":1549929600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Br J Gen Pract"],"accepted":{"date-parts":[[2024,12,9]]},"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>UK Asian and Black patients experience longer cancer diagnostic intervals \u2014 the period between initial symptomatic presentation in primary care and cancer diagnosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To determine whether the differences in diagnostic intervals are because of prolonged primary care, referral, or secondary care interval.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design and setting<\/jats:title>\n                    <jats:p>A cohort study was undertaken of 70 971 patients with seven cancers (breast, lung, prostate, colorectal, oesophagogastric, myeloma, ovarian) diagnosed after symptom presentation in English primary care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>Data on symptom presentation and diagnosis were extracted from cancer registry-linked primary care and secondary care data. Primary interval was defined as the period between first primary care presentation and secondary care referral, referral interval as the period between referral and first secondary care appointment, and secondary care interval as the period between the first secondary care appointment and diagnosis. Accelerated failure time models were used to investigate ethnic differences across all four intervals.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Across all sites, the median diagnostic interval was 46 days, ranging from 13 days for breast cancer to 116 days for lung cancer. It was 14% longer for Black patients (adjusted time ratio [ATR] 1.14, 95% confidence interval [CI] = 1.05 to 1.25) and 13% longer for Asian patients (ATR 1.13, 95% CI = 1.03 to 1.23) compared with White patients. Site-specific analyses showed that, for myeloma, lung, prostate, and colorectal cancer, the secondary care interval was longer in Asian and Black patients, who also had a longer primary care interval in breast and colorectal cancer. There was little evidence of ethnic differences in referral interval.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study found evidence of ethnic differences in diagnostic intervals, with prolonged secondary care intervals for four common cancers and prolonged primary care intervals for two. Although these differences are relatively modest, they are unjustified and may indicate shortcomings in healthcare delivery that disproportionately affect ethnic minorities.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3399\/bjgp.2024.0518","type":"journal-article","created":{"date-parts":[[2024,12,27]],"date-time":"2024-12-27T11:54:31Z","timestamp":1735300471000},"page":"e333-e340","source":"Crossref","is-referenced-by-count":3,"title":["Understanding ethnic inequalities in cancer diagnostic intervals: a cohort study of patients presenting suspected cancer symptoms to GPs in England"],"prefix":"10.3399","volume":"75","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5226-4073","authenticated-orcid":false,"given":"Tanimola","family":"Martins","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2738-2710","authenticated-orcid":false,"given":"Liz","family":"Down","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alfred","family":"Samuels","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5922-9366","authenticated-orcid":false,"given":"Deepthi","family":"Lavu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1611-1373","authenticated-orcid":false,"given":"William","family":"Hamilton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2231-5161","authenticated-orcid":false,"given":"Gary","family":"Abel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3544-2744","authenticated-orcid":false,"given":"Richard D","family":"Neal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1987","published-online":{"date-parts":[[2024,12,17]]},"reference":[{"key":"2025050203501006000_75.754.e333.1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2022-062079"},{"issue":"12","key":"2025050203501006000_75.754.e333.2","doi-asserted-by":"crossref","first-page":"2978","DOI":"10.1016\/j.ejso.2021.08.025","article-title":"Ethnicity and breast cancer in the UK: where are we now?","volume":"47","author":"Gathani","year":"2021","journal-title":"Eur J Surg Oncol"},{"key":"2025050203501006000_75.754.e333.3","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bjc.6604852"},{"key":"2025050203501006000_75.754.e333.4","doi-asserted-by":"publisher","DOI":"10.1111\/ecc.12267"},{"key":"2025050203501006000_75.754.e333.5","doi-asserted-by":"publisher","DOI":"10.1136\/bmjqs-2011-000088"},{"key":"2025050203501006000_75.754.e333.6","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.g6034"},{"key":"2025050203501006000_75.754.e333.7","doi-asserted-by":"publisher","DOI":"10.1038\/bjc.2013.316"},{"key":"2025050203501006000_75.754.e333.8","doi-asserted-by":"publisher","DOI":"10.1158\/1055-9965.EPI-13-1328"},{"issue":"18","key":"2025050203501006000_75.754.e333.9","doi-asserted-by":"crossref","first-page":"6456","DOI":"10.1002\/cam4.4158","article-title":"Relationship of established risk factors with breast cancer subtypes","volume":"10","author":"McCarthy","year":"2021","journal-title":"Cancer Med"},{"key":"2025050203501006000_75.754.e333.10","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2021-055735"},{"issue":"1","key":"2025050203501006000_75.754.e333.11","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1038\/bjc.2016.158","article-title":"Ethnic differences in cancer symptom awareness and barriers to seeking medical help in England","volume":"115","author":"Niksic","year":"2016","journal-title":"Br J Cancer"},{"key":"2025050203501006000_75.754.e333.12","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2020-037011"},{"key":"2025050203501006000_75.754.e333.13","doi-asserted-by":"publisher","DOI":"10.1016\/j.puhe.2012.05.005"},{"key":"2025050203501006000_75.754.e333.14","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bjc.6605387"},{"key":"2025050203501006000_75.754.e333.15","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1186\/1471-2296-14-197","article-title":"Ethnic inequalities in time to diagnosis of cancer: a systematic review","volume":"14","author":"Martins","year":"2013","journal-title":"BMC Fam Prac"},{"key":"2025050203501006000_75.754.e333.16","unstructured":"National Institute for Health and Care Excellence (NICE) (2015) Suspected cancer: recognition and referral. 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