The intersectionality of sex and ethnicity on primary care management of symptoms of suspected colorectal cancer (360G-Wellcome-344268_Z_26_Z)

Colorectal cancer (CRC), the second leading cause of all UK cancer-related deaths has worse outcomes when diagnostic delays are over two weeks. Ethnic minorities face delays of up to three weeks longer than white counterparts. Suboptimal referrals may contribute to females having longer referral times and worse survival than males. Urgent primary care referrals for diagnosis depend on symptoms or faecal immunochemical test(FIT) results. Identifying variations in management could inform interventions. Aim: To explore the inequalities associated with the sex-ethnicity intersectionality on primary care management and outcomes in people with suspected CRC. Methods: Work package(WP)1 (systematic review) will identify factors affecting timeliness of FIT and referrals in primary care patients with suspected CRC symptoms across sex and ethnicities. WP2 will analyse CPRD-Aurum, HES and ONS data to investigate sex and ethnic differences in tests, treatments and alternate diagnoses for suspected CRC symptoms. WP3 will investigate if sex and ethnicity are associated with (a)time to FIT (b)time to referral and (c)death. WP4, will collate WP1-3 findings through focus group discussions with stakeholders. Findings will inform a consensus panel to guide recommendations. Impact: This will provide critical evidence on CRC detection across sex and ethnicities, informing intervention development and influencing policy.