Ethnic and socioeconomic disparities in participation in breast cancer risk assessment: Findings from the BCAN-RAY study (NCT05305963)

Background: Breast cancer risk assessment for women aged 30-39 years would facilitate the offer of early screening and prevention approaches in those at increased risk. The Breast CANcer Risk Assessment in Young women (BCAN-RAY) study (NCT05305963) is evaluating the feasibility of breast cancer risk assessment in women aged 30-39 years without a strong family history, aiming to recruit a diverse ethnic and socioeconomic sample. The present analysis compares uptake rates to the study by ethnicity and socioeconomic status.

Methods: A total of 14,366 women aged 30-39 years, without a strong family history of breast cancer, were invited via general practices across Greater Manchester and Cheshire. Aggregated data on ethnicity and socioeconomic status of residence (via Index of Multiple Deprivation quintiles) at general practice level were used for invited women and self-reported ethnicity for those enrolled into the study. Chi-squared tests assessed differences in study uptake according to ethnicity and socioeconomic status.

Results: Overall uptake to BCAN-RAY was 5.2% (750 /14,366 women). Highest uptake was seen in White women (654/5005; 13.1%) compared to Black (10/511; 2%) and Asian women (50/2089; 2.4%) (χ2 (4) = 219.86, p <.001). Women residing in the most deprived areas were also underrepresented among enrolled participants (χ2 (4) = 75.31, p <.001).

Conclusion: Alternative delivery models need to be considered to improve accessibility and engagement in future research and in any implementation to routine practice.