Black patients in England had 37% higher odds of being diagnosed with breast cancer after arriving as an emergency, and 29% lower odds of having it found through routine screening, than white patients. The figures come from a University of Surrey study published Monday that followed 86,564 adults diagnosed in England between 2009 and 2018.
The route matters because cancers found in an emergency tend to be found later, when survival is lower. Black women in the UK already face a higher risk of dying from breast cancer, according to an earlier Surrey review that found them diagnosed at later stages and with more aggressive forms of the disease.
The researchers linked anonymized GP records to the national cancer registry, then measured delays at each step: screening, seeing a GP, diagnosis, treatment. Black patients waited about five days longer on average to begin treatment. The study, published in Breast Cancer Research and funded by the charity Breast Cancer Now, is believed to be the first in the UK to measure these delays across the whole pathway.
It did not isolate one cause. “The inequalities we found are not down to one single thing,” said lead author Tetyana Perchyk. “They add up across the system, and they add up most for the women who already face the most barriers.” Robert Kerrison, a co-lead on the work, said the country “currently has a system that is letting down the patients who already face the most barriers.”
The study measured outcomes, not reasons. For reasons, there is a separate Surrey study from July, in the British Journal of Cancer, based on focus groups and interviews with 47 Black African and Caribbean women aged 50 to 71. It reported that 45% of Black women take part in screening, against 63% of white women. The women described having little information before a first invitation, especially those born outside the UK, and some asked why they should be screened with no symptoms. Others pointed to formal invitation letters, images that did not look like them, and no trusted conversation with a GP about screening. The authors called for materials designed with Black women and closer ties between GP practices, screening services and community groups.
A smaller qualitative study of 15 Black women in England, published in Frontiers in Public Health, named fear of a diagnosis and cultural links between cancer and death, and asked for short, shareable content and booking links in the places women already spend time online. Its authors say the sample is too small to generalize.
What is the NHS doing? Overall breast screening uptake among women 50 to 71 was 70.6% in 2024-25, below the 80% target, according to NHS England data analyzed by Breast Cancer Now. Uptake ranged from 55.8% in one London area to 81.0% in Nottinghamshire. The National Cancer Plan for England, published in January, directs local services to run campaigns in deprived, ethnic minority and underserved communities, and the government announced a Neighbourhood Early Diagnosis Fund for Cancer Alliances. NHS England’s Breast Screening Uptake Review commits to letting women manage appointments through the NHS App by 2028. The uptake figures we reviewed are not broken down by ethnicity, and we found no NHS response to the Surrey findings.
The researchers also found delays for people with a learning disability and severe mental illness, and the worst gaps for people facing several disadvantages at once. Breast Cancer Now says it will fund further research on who is missed.
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