Cancer Research UK Cancer Survival Group, Department of Non-Communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom.
Int J Cancer. 2013 Apr 15;132(8):1886-94. doi: 10.1002/ijc.27826. Epub 2012 Oct 12.
Studies on cancer in migrants are informative about the relative influence of environmental and genetic factors on cancer risk. This study investigates trends in incidence from colorectal, lung, breast and prostate cancer in England among South Asians and examines the influence of deprivation, a key environmental exposure. South Asian ethnicity was assigned to patients recorded in the population-based National Cancer Registry of England during 1986-2004, using the computerized algorithm SANGRA: South Asian Names and Groups Recognition Algorithm. Population denominators were derived from population censuses. Multivariable flexible (splines) Poisson models were used to estimate trends and socioeconomic differentials in incidence in South Asians compared to non-South Asians. Overall, age-adjusted cancer incidence in South Asians was half that in non-South Asians but rose over time. Cancer-specific incidence trends and patterns by age and deprivation differed widely between the two ethnic groups. In contrast to non-South Asians, lung cancer incidence in South Asians did not fall. Colorectal and breast cancer incidence rose in both groups, more steeply in South Asians though remaining less common than in non-South Asians. The deprivation gaps in cancer-specific incidence were much less marked among South Asians, explaining some of the ethnic differences in overall incidence. Although still lower than in non-South Asians, cancer incidence is rising in South Asians, supporting the concept of transition in cancer incidence among South Asians living in England. Although these trends vary by cancer, they have important implications for both prevention and anticipating health-care demand.
移民癌症研究对于环境和遗传因素对癌症风险的相对影响提供了有价值的信息。本研究调查了英格兰南亚人群中结直肠癌、肺癌、乳腺癌和前列腺癌发病率的趋势，并探讨了贫困这一关键环境因素的影响。在 1986 年至 2004 年期间，英格兰基于人群的国家癌症登记处记录的患者，使用计算机算法 SANGRA（南亚人名和群体识别算法）分配南亚裔种族。人口除数来自人口普查。多变量灵活（样条）泊松模型用于估计与非南亚裔人群相比，南亚裔人群的发病率趋势和社会经济差异。总体而言，南亚裔人群的年龄调整癌症发病率是非南亚裔人群的一半，但随着时间的推移而上升。两种族裔之间的癌症特异性发病率趋势和年龄及贫困差异模式差异很大。与非南亚裔人群不同，南亚裔人群的肺癌发病率没有下降。结直肠癌和乳腺癌的发病率在两个群体中均上升，尽管在南亚裔人群中上升更为陡峭，但仍低于非南亚裔人群。癌症特异性发病率的贫困差距在南亚裔人群中明显较小，这解释了总体发病率方面的一些种族差异。尽管南亚裔人群的癌症发病率仍低于非南亚裔人群，但仍在上升，这支持了在英国生活的南亚裔人群癌症发病率发生转移的概念。尽管这些趋势因癌症而异，但它们对预防和预测医疗保健需求都具有重要意义。
