Current Topic:
Access to cancer services – do culture and ethnicity make a difference?
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Abstract
No one would question that there should be equity of access to cancer services, regardless of who you are and where you come from. But the reality is frequently different. Health services, including those for cancer, are developed in each country according to the customs and practices of the indigenous population of that country. Freedom of movement within Europe has led to a much more multi-cultural society which in turn, needs to be reflected in the commissioning of health services.
The 2001 census showed that 9% of the non-white population of England describe themselves as being from a Black or Minority Ethnic (BME) community. A number of UK cancer documents have highlighted unmet needs relating to health information, support and services for BME communities. The incidence of different cancers varies between different BME communities and the general population, and is thought to be linked to a combination of factors, including lifestyle, and in some cases cancer genetics.
Although ethnicity coding was introduced into UK NHS inpatient services in 1995, the data collected in primary care and outpatient services is not complete and there is still a dearth of research in this area.
Nearly half of the UK BME population live in and around London. The Thames Cancer Registry (TCR) has made some headway in collecting, and beginning to interpret ethnic data, but much of the statistical data has come from information recorded in NHS In patient services, rather than outpatient services, where most cancer patients are seen and treated.
A particular problem is a lower uptake of cancer screening services among BME communities and late diagnosis. In part, this is due to a lack of accessible culturally sensitive information, poorer knowledge about services, and literacy and language barriers. The UK BME population is generally younger than the indigenous population and as cancer predominantly affects elders, a lack of cancer experience in BME communities has also contributed to their lack of cancer awareness.
People need to be aware of the risk factors, and signs and symptoms of cancer to look out. They also need to be encouraged to present early to their family doctor. Therefore, services should be planned which are appropriate to the needs and culture of local communities.
This module aims to provide you with knowledge and understanding of the diverse cultural needs of people affected by cancer, and assessing and meeting those needs. We will use the UK experience to explore the issues of awareness of and detection of cancer in BME communities.
