• Ge Chen, Melissa Barlow, Liz Down, Luke Timothy Allan Mounce, MerrielSamuel William DavidSWD0000-0003-2919-9087Department of Health and Community Sciences, University of Exeter, Exeter, UK.Centre for Primary Care & Health Services Research, University of Manchester, Manchester, United Kingdom., Jessica Watson, Tanimola Martins, and Sarah Elizabeth Rose Bailey.
• Department of Health and Community Sciences, University of Exeter, Exeter, UK.
• Fam Pract. 2024 Oct 8; 41 (5): 638648638-648.

BackgroundIn primary care, health professionals use blood tests to investigate nonspecific presentations to inform referral decisions. Reference ranges for the commonly used blood tests in western countries were developed in predominately White populations, and so may perform differently when applied to non-White populations. Knowledge of ethnic variation in blood test results in healthy/general populations could help address ethnic inequalities in cancer referral for diagnosis and outcomes.ObjectiveThis systematic review explored evidence of ethnic differences in the distribution of selected blood test results among healthy/general populations to inform future research aimed at addressing inequalities in cancer diagnosis.MethodsWe searched PubMed and EMBASE to identify studies reporting measures of haemoglobin, MCV, calcium, albumin, platelet count, and CRP in nondiseased adults from at least 2 different ethnic groups. Two reviewers independently screened studies, completed data extraction and quality assessment using an adapted Newcastle-Ottawa scale. Participants were stratified into White, Black, Asian, Mixed, and Other groups. Data were synthesised narratively and meta-analyses were conducted where possible.ResultsA total of 47 papers were included. Black men and women have lower average values of haemoglobin, MCV, and albumin, and higher average values of CRP relative to their White counterparts. Additionally, Black men have lower average haemoglobin than Asian men, whereas Asian women have lower average CRP values when compared with White women.ConclusionsThere is evidence of ethnic differences in average values of haemoglobin, MCV, CRP, and albumin in healthy/general populations. Further research is needed to explore the reasons for these differences. Systematic review registration: CRD42021274580.© The Author(s) 2024. Published by Oxford University Press.

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