Cancer Intelligence Team, Cancer Research UK, 2 Redman Place, London, E20 1JQ, UK.
National Disease Registration Service, NHS Digital, 7 and 8 Wellington Place, Leeds, LS1 4AP, UK.
Br J Cancer. 2022 Jun;126(12):1765-1773. doi: 10.1038/s41416-022-01718-5. Epub 2022 Mar 2.
Cancer incidence variation between population groups can inform public health and cancer services. Previous studies have shown cancer incidence rates vary by ethnic group in England. Since their publication, the completeness of ethnicity recording in cancer data has improved, and relevant inequalities (e.g. risk factor prevalence and healthcare access) may have changed.
Age-standardised incidence rates were calculated for Asian, Black, Mixed/Multiple and White ethnic groups in England in 2013-2017, using almost 3 million diagnoses across 31 cancer sites. Rate ratios were calculated with the White ethnic group as reference. Sensitivity analyses used imputed ethnicity for cases with missing data and perturbed population estimates.
Incidence rates for most cancer sites and ethnic group and sex combinations were lower in non-White minority ethnic groups compared with the corresponding White group, with particularly low rate ratios (below 0.5) for melanoma skin cancer and some smoking-related cancers (lung, bladder and oesophageal cancers). Exceptions included prostate cancer (2.1 times higher in males of Black ethnicity), myeloma (2.7-3.0 times higher in people of Black ethnicity), several gastrointestinal cancers (1.1-1.9 times higher in people of Black ethnicity, 1.4-2.2 times higher in people of Asian ethnicity), Hodgkin lymphoma (1.1 times higher in males of Asian ethnicity, 1.3 times higher in males of Black ethnicity) and thyroid cancers (1.4 times higher in people of Asian ethnicity, 1.2 times higher in people of Black ethnicity). Sensitivity analyses did not materially alter these results (rate ratios changed by a maximum of 12 percentage points, the direction and significance of results were unchanged in all but two cancer site/sex/ethnic group combinations).
People of non-White minority ethnicity in England generally have lower cancer risk than the White population, though there are a number of notable exceptions. These results should galvanise efforts to better understand the reasons for this variation, and the possible impact on cancer services, patient experiences and outcomes.
人群间癌症发病率的差异可以为公共卫生和癌症服务提供信息。此前的研究表明，英格兰的不同族裔群体的癌症发病率存在差异。自这些研究发表以来，癌症数据中种族记录的完整性得到了提高，相关的不平等现象（如风险因素的流行程度和医疗保健的可及性）可能已经发生了变化。
使用英格兰 31 个癌症部位近 300 万例诊断病例的数据，计算了 2013-2017 年期间亚洲、黑人、混血/多种族和白人族裔群体的年龄标准化发病率。以白人群体为参照，计算率比。敏感性分析使用了缺失数据病例的推断种族和受扰人群估计值。
与相应的白人群体相比，非白少数族裔群体的大多数癌症部位和族裔群体及性别组合的发病率较低，黑色素瘤皮肤癌和一些与吸烟有关的癌症（肺癌、膀胱癌和食管癌）的率比值特别低（低于 0.5）。例外情况包括前列腺癌（黑人男性的发病率高出 2.1 倍）、骨髓瘤（黑人的发病率高出 2.7-3.0 倍）、几种胃肠道癌症（黑人的发病率高出 1.1-1.9 倍，亚洲人的发病率高出 1.4-2.2 倍）、霍奇金淋巴瘤（亚洲男性的发病率高出 1.1 倍，黑人男性的发病率高出 1.3 倍）和甲状腺癌（亚洲人的发病率高出 1.4 倍，黑人的发病率高出 1.2 倍）。敏感性分析并没有实质性地改变这些结果（率比最多变化了 12 个百分点，除了两个癌症部位/性别/族裔群体组合外，所有结果的方向和意义都没有改变）。
英格兰的非白少数族裔群体的癌症风险一般低于白人，尽管存在一些显著的例外情况。这些结果应该激励人们努力更好地理解这种差异的原因，以及对癌症服务、患者体验和结果的可能影响。
