Haworth E A, Soni Raleigh V, Balarajan R
Centre for Public Health Monitoring and Ethnic Studies, London School of Hygiene and Tropical Medicine.
Ethn Health. 1999 Feb-May;4(1-2):93-9. doi: 10.1080/13557859998227.
To examine mortality from cirrhosis of the liver and primary liver cancer among first generation migrants to England and Wales.
Comparison of standardised mortality ratios (SMRs) for cirrhosis of the liver and primary liver cancer in men and women aged 20-69, by country of birth for the five year period 1988-1992.
England and Wales.
There was a statistically significant two-fold excess of mortality from cirrhosis of the liver among male migrants from East Africa (SMR 286), India (SMR 261) and Bangladesh (SMR 254) as well as men born in Scotland (SMR 253) and Ireland (SMR252). Among women, only those born in Scotland (SMR 254) and Ireland (SMR 237) showed significant excess mortality. For liver cancer, significant excess mortality occurred among men born in the Caribbean (SMR 312), Bangladesh (910) and the African Commonwealth other than East Africa (1014), with Scottish and Irish born men showing more moderate excesses (136 and 170, respectively). SMRs were elevated also in all groups of foreign-born women but, probably owing to the small numbers of deaths, none of the findings reached statistical significance.
Of public health concern is the excess mortality from cirrhosis in first generation immigrants to England and Wales from Scotland and Ireland (men and women) and in male migrants from India, Bangladesh and East Africa. Of equal concern is increased mortality from liver cancer in all foreign-born groups of both sexes, particularly among Bangladeshis, and African-Caribbeans. As well as promoting sensible drinking among immigrant men, specific preventive measures for those of Bangladeshi, African-Caribbean origin may include selective screening for hepatitis B and C and other tumour markers. Screening for liver cancer using imaging techniques needs further investigation. The benefit/cost ratio should be assessed by the Screening Committees of the UK Departments of Health. At local level, variation in incidence and prevalence of hepatic disease and feasible prevention programmes should be assessed within developing health improvement programmes.
研究第一代移民到英格兰和威尔士的人群中肝硬化和原发性肝癌的死亡率。
比较1988 - 1992年五年期间，20 - 69岁男性和女性中，按出生国划分的肝硬化和原发性肝癌的标准化死亡率（SMRs）。
英格兰和威尔士。
来自东非的男性移民（SMR 286）、印度的男性移民（SMR 261）、孟加拉国的男性移民（SMR 254）以及出生在苏格兰的男性（SMR 253）和爱尔兰的男性（SMR 252）中，肝硬化死亡率在统计学上显著高出两倍。在女性中，只有出生在苏格兰的女性（SMR 254）和爱尔兰的女性（SMR 237）显示出显著的高死亡率。对于肝癌，出生在加勒比地区的男性（SMR 312）、孟加拉国的男性（910）以及东非以外的非洲英联邦国家的男性（1014）中出现了显著的高死亡率，出生在苏格兰和爱尔兰的男性死亡率也有一定程度的升高（分别为136和170）。所有外国出生的女性组的SMRs也有所升高，但可能由于死亡人数较少，没有一项结果达到统计学显著性。
对于移民到英格兰和威尔士的第一代移民，来自苏格兰和爱尔兰（男性和女性）以及来自印度、孟加拉国和东非的男性移民中肝硬化导致的高死亡率值得公共卫生关注。同样值得关注的是，所有外国出生的男女群体中肝癌死亡率的增加，特别是孟加拉国人和加勒比非洲人。除了促使移民男性合理饮酒外，针对孟加拉国和加勒比非洲裔人群的具体预防措施可能包括对乙肝和丙肝以及其他肿瘤标志物进行选择性筛查。使用成像技术筛查肝癌需要进一步研究。英国卫生部的筛查委员会应评估其效益/成本比。在地方层面，应在制定健康改善计划时评估肝脏疾病发病率和患病率的差异以及可行的预防方案。
