“Trends in cancer incidence among South Asians in England, 1986-2004”


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Camille Maringe1, Punam Mangtani1, Bernard Rachet1, Nicola Cooper2, Michel P Coleman1, Isabel Dos Santos Silva1
1LSHTM, London, United Kingdom,2NCIN, London, United Kingdom

Background

Studies on cancer in migrants help determine the influence of lifestyle and genetic factors on cancer risk. It is now possible to examine more robustly national cancer incidence trends in South Asian migrants, the UK’s largest minority group, who are moving into age groups when cancer risks increase. This study aimed to quantify cancer incidence in South Asians taking into account socio-economic deprivation.

Method

South Asian ethnicity was assigned to patients diagnosed 1986-2004 in the English National Cancer Registry using SANGRA (South Asian Names and Groups Recognition Algorithm). Population denominators were derived from the 1991 and 2001 censuses. Flexible multivariable Poisson models were used to examine incidence trends in South Asians and non-South Asians, with and without adjustment for socio-economic deprivation, for the 20 most common cancers.

Results

Overall cancer incidence in South Asians was half that of non-South Asians. The deprivation gaps in cancer-specific incidence were absent, or less marked among South Asians than non-South Asians.  Colorectal cancer incidence appeared to rise more steeply over time among South Asians than non South Asians but were similar after adjusting for deprivation. Male lung cancer incidence trends were also similar when deprivation was adjusted for. Incidence of breast and gynaecological cancers, the most common among South Asians, increased more in South Asians than non-South Asians. Prostate cancer trends rose in both groups even after adjustment for SES.

Conclusion

Overall cancer incidence is rising in South Asians over time, but remains lower than in non-South Asians.  Adjustment for socio-economic status affects these trends, some of which may reflect access to health-care and screening.  Convergence of incidence of several cancers to that in high cancer risk settings is occurring in migrants from a generally low cancer incidence setting. The trends also have implications for the management of aging populations by cancer care services.