Swerdlow A J, Marmot M G, Grulich A E, Head J
Epidemiological Monitoring Unit, London School of Hygiene & Tropical Medicine, UK.
Br J Cancer. 1995 Nov;72(5):1312-9. doi: 10.1038/bjc.1995.507.
Risk of cancer mortality from 1973 to 1985 in persons born in the Indian subcontinent who migrated to England and Wales was analysed by ethnicity, and compared with cancer mortality in the England and Wales native population, using data from England and Wales death certificates. There were substantial highly significant raised risks in Indian ethnic migrants for cancers of the mouth and pharynx, gall bladder, and liver in each sex, larynx and thyroid in males, and oesophagus in females. There were also substantial raised risks in these migrants of each sex for non-Hodgkin's lymphoma and myeloma. For the mouth and pharynx, and liver in each sex, and gall bladder in females, there were also raised risks of lesser magnitude in British ethnic migrants. For colon and rectal cancer and cutaneous melanoma in each sex, ovarian cancer in women and bladder cancer in men, there were appreciable significantly reduced risks in the Indian ethnic migrants not shared by those of British ethnicity. Appreciable raised risks in British ethnic migrants not shared by those of Indian ethnicity occurred for nasopharyngeal cancer in males, soft tissue malignancy in both sexes and non-melanoma skin cancer in males. In migrants of both ethnicities there were appreciable significantly raised risks in each sex for leukaemia and decreased risks in each sex for gastric cancer, for lung cancer except in females of British ethnicity and in males for testicular cancer. The results suggest the need for public health measures to combat the high risks of oral and pharyngeal cancers and liver cancer in the Indian ethnic immigrant population of England and Wales, by prevention of betel quid chewing and hepatitis transmission respectively. The data also imply that early exposures or early acquired behaviours in India, or exposures during migration, may increase the risk of leukaemia and reduce the risks of gastric and testicular cancers in the migrants irrespective of their ethnicity. Aetiological studies would be worthwhile to investigate the reasons for the sizeable decreased risk of colon and rectal cancer and increased risk of gall bladder cancer in each sex and the increased risk of thyroid and laryngeal cancer in males and oesophageal cancer in females of Indian ethnicity but not of British ethnicity who have migrated from the Indian subcontinent.
利用英格兰和威尔士死亡证明数据，按种族分析了1973年至1985年期间从印度次大陆移民到英格兰和威尔士的人群的癌症死亡风险，并与英格兰和威尔士本地人群的癌症死亡率进行了比较。印度裔移民中，男女患口腔和咽喉癌、胆囊癌和肝癌的风险大幅显著升高，男性患喉癌和甲状腺癌的风险升高，女性患食管癌的风险升高。这些移民中男女患非霍奇金淋巴瘤和骨髓瘤的风险也大幅升高。对于口腔和咽喉、男女的肝癌以及女性的胆囊癌，英国裔移民的风险也有较小幅度的升高。对于男女的结肠癌和直肠癌以及皮肤黑色素瘤、女性的卵巢癌和男性的膀胱癌，印度裔移民的风险明显降低，而英国裔移民没有这种情况。英国裔移民中男性患鼻咽癌、男女患软组织恶性肿瘤以及男性患非黑色素瘤皮肤癌的风险明显升高，而印度裔移民没有这种情况。在两个种族的移民中，男女患白血病的风险明显升高，男女患胃癌的风险降低，除英国裔女性外的各性别患肺癌的风险以及男性患睾丸癌的风险降低。结果表明，需要采取公共卫生措施，分别通过预防嚼槟榔和肝炎传播，来应对英格兰和威尔士印度裔移民人口中口腔和咽喉癌及肝癌的高风险。数据还表明，在印度的早期接触或早期养成的行为，或移民期间的接触，可能会增加移民患白血病的风险，降低患胃癌和睾丸癌的风险，而不论其种族如何。开展病因学研究，以调查从印度次大陆移民而来的印度裔而非英国裔男女结肠癌和直肠癌风险大幅降低、胆囊癌风险增加以及男性甲状腺癌和喉癌风险增加、女性食管癌风险增加的原因，将是很有价值的。
