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Racial and Ethnic Disparities in Treatment Outcomes of Patients with Colorectal Cancer (CRC) in the UK: A Systematic Review

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Abstract

Aim

Implementing a standardised National Health System (NHS) in the United Kingdom (UK) has promoted equitable healthcare access. This review aims to explore disparities in treatment outcomes for individuals with colorectal cancer (CRC) based on their race or ethnicity.

Methods

This prospectively registered review on the INPLASY database and a systematic search was conducted following PRISMA guidelines using EBSCO, Medline and EMBASE databases from inception to June 2024. Observational, experimental or qualitative studies reporting disparity in treatment outcomes for adult patients with CRC in the UK were included. Our primary outcomes included were survival rates and morbidity. Our secondary outcome was rate of surgery with curative intent. Studies reported or performed outside of the UK were excluded.

Results

Three retrospective cohort studies were identified (1992, 1995 and 2009). One study reported lower mortality from CRC in patients of Indian ethnicities born in India compared to their UK-born counterparts by 40%. One study reported East African males had a 30% lower risk of mortality compared to their UK-born counterparts. One study found no significant difference in 5-year survival outcomes between Caucasian and South Asian patients [p > 0.05]. There was a larger number of Caucasian patients undergoing definitive surgical resection (72.8%) compared to the South Asian population (63%). One study reported a higher proportion of South Asian patients undergoing palliative surgery compared with Caucasian patients (14.2% vs 7.2%, respectively, p = 0.017].

Conclusion

Disparities in treatment outcomes within the UK remain under-explored. Robust national studies are needed to investigate disparities between different ethnic and racial groups in the UK.

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Data Availability

No datasets were generated or analysed during the current study.

Code Availability

Not applicable.

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Authors and Affiliations

  1. Department of General and Colorectal Surgery, The Dudley Group NHS Trust, Russells Hall Hospital, Dudley, UK

    Omar Ezzat Saber Mostafa, Shafquat Zaman & Akinfemi Akingboye

  2. Institute of Cancer and Genomic Science, College of Medical and Dental Science, University of Birmingham, Edgbaston, Birmingham, UK

    Shafquat Zaman & Mark Robert Openshaw

  3. Aston Medical School, Aston University, Birmingham, UK

    Akinfemi Akingboye

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  2. Shafquat Zaman
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by OM, SZ and MO. The first draft of the manuscript was written by OM and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Omar Ezzat Saber Mostafa.

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Mostafa, O.E.S., Zaman, S., Openshaw, M. et al. Racial and Ethnic Disparities in Treatment Outcomes of Patients with Colorectal Cancer (CRC) in the UK: A Systematic Review. SN Compr. Clin. Med. 7, 302 (2025). https://doi.org/10.1007/s42399-025-02074-0

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