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Panayi Z, Srirangam SJ. Prostate cancer among South Asian men in the United Kingdom: A systematic review. JOURNAL OF CLINICAL UROLOGY 2023. [DOI: 10.1177/20514158221145775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Introduction: Rates of prostate cancer (PC) vary considerably between ethnic groups worldwide, and migratory studies have demonstrated the importance of both inherent and environmental influences. Healthcare systems also differ significantly worldwide, and comparisons of PC data between the United Kingdom and America have previously shown contradictory conclusions among ethnic groups. The South Asian population (SA) is the most predominant UK ethnic minority group. Aims: To systematically explore and critically analyse the available UK-based evidence regarding PC among SA men. Specifically, to review research that assesses the following factors: PC incidence, disease characteristics, treatment and survival outcomes. Results: The existing evidence suggests that UK SA men have a lower PC incidence and younger age at diagnosis, in comparison with White men in the United Kingdom. Contrasting evidence is presented in studies that separately analyse men originating from India, Pakistan and Bangladesh. There is insufficient and contradictory evidence regarding whether SA men show altered PC disease characteristics or have differential survival rates. The evidence is limited regarding PC treatment; however, this indicates that SA men are less frequently treated surgically compared to White men Conclusion: Further high-quality research is required focusing on accurate ethnicity allocation, analysis of separate SA origin countries, socio-economic adjustment, subgroup analysis of treatment in low-risk PC and identifying the support needs of SA minorities with PC. This will help to ensure that ethnic minorities with PC are appropriately diagnosed, counselled and treated Level of evidence: 3
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Abraham S, Foreman N, Sidat Z, Sandhu P, Marrone D, Headley C, Akroyd C, Nicholson S, Brown K, Thomas A, Howells LM, Walter HS. Inequalities in cancer screening, prevention and service engagement between UK ethnic minority groups. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2022; 31:S14-S24. [PMID: 35648663 DOI: 10.12968/bjon.2022.31.10.s14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
More people in the UK are living with cancer than ever before. With an increasingly ethnically diverse population, greater emphasis must be placed on understanding factors influencing cancer outcomes. This review seeks to explore UK-specific variations in engagement with cancer services in minority ethnic groups and describe successful interventions. The authors wish to highlight that, despite improvement to engagement and education strategies, inequalities still persist and work to improve cancer outcomes across our communities still needs to be prioritised. There are many reasons why cancer healthcare inequities exist for minority communities, reported on a spectrum ranging from cultural beliefs and awareness, through to racism. Strategies that successfully enhanced engagement included language support; culturally-sensitive reminders; community-based health workers and targeted outreach. Focusing on the diverse city of Leicester the authors describe how healthcare providers, researchers and community champions have worked collectively, delivering targeted community-based strategies to improve awareness and access to cancer services.
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Affiliation(s)
- Shalin Abraham
- F2 Academic Foundation Doctor, Leicester Cancer Research Centre, University of Leicester, Leicester
| | - Nalini Foreman
- Quality Assistant, Leicester Cancer Research Centre, University of Leicester, Leicester
| | - Zahirah Sidat
- Senior Research Practitioner, Hope Clinical Trials Facility, University Hospitals of Leicester NHS Trust, Leicester
| | - Pavandeep Sandhu
- Research Technician, Leicester Cancer Research Centre, University of Leicester, Leicester
| | - Domenic Marrone
- Research Technician, Leicester Cancer Research Centre, University of Leicester, Leicester
| | - Catherine Headley
- Senior Cancer Services Manager, Leicester City Clinical Commissioning Group, Leicester
| | - Carol Akroyd
- Collaboration for Leadership in Applied Health Research and Care Equality and Diversity Theme Manager, Centre for Ethnic Health Research, University of Leicester, Leicester
| | - Sarah Nicholson
- Hope Clinical Trials Facility Manager/Cancer, Haematology, Urology, Gastroenterology, General Surgery Research Lead, Hope Clinical Trials Facility, University Hospitals of Leicester NHS Trust, Leicester
| | - Karen Brown
- Professor in Translational Cancer Research, Leicester Cancer Research Centre, University of Leicester, Leicester
| | - Anne Thomas
- Professor of Cancer Therapeutics, Leicester Cancer Research Centre, University of Leicester, Leicester
| | - Lynne M Howells
- Experimental Cancer Medicine Centre Translational Research Manager, Leicester Cancer Research Centre, University of Leicester, Leicester
| | - Harriet S Walter
- Associate Professor of Medical Oncology, Leicester Cancer Research Centre, University of Leicester, Leicester
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Affar S, Morrison DS, Campbell C. Cervical cancer incidence by ethnic group in Scotland from 2008 to 2017: A population-based study. Eur J Cancer Care (Engl) 2021; 30:e13441. [PMID: 33715256 DOI: 10.1111/ecc.13441] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 01/22/2021] [Accepted: 02/25/2021] [Indexed: 01/20/2023]
Abstract
BACKGROUND There is limited information on cervical cancer incidence among different ethnic groups. This study used a name classification system to describe recent patterns of cervical cancer by ethnic group in Scotland. METHODS Data on incident cases of cancer of the cervix and carcinoma in situ diagnosed in Scotland from 2008 to 2017 were extracted from the Scottish Cancer Registry. Onomap was applied to ascribe ethnicity to each patient. Ethnic groups were categorised as White, Black, South-Asian, Chinese and Other. Age-standardised rates (ASRs) were calculated for each year, as well as cumulatively for the 10-year time period. RESULTS The Cumulative Age-standardised rate (CASR) of invasive cancer was 2.45 times higher in the White ethnic group (CASR 125.45 (95% CI 121.2-129.8) per 1,00,000) compared to the non-white ethnic groups combined (CASR 51.16 (95% CI 31.05-77.36) per 1,00,000). The highest age-specific rates within the White patients were in the 30-34 age group (18.34 per 1,00,000), whereas the highest age specific rates for the non-white patients were in the 60-64 age group (9.59 per 1,00,000). CONCLUSION Ethnic minority populations in Scotland had lower incidence of cervical cancer compared to the White population between 2008 and 2017.
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Affiliation(s)
- Saba Affar
- University of Glasgow, Glasgow, Scotland.,ARHAI, NHS National Services Scotland, Meridian Court, Glasgow, Scotland
| | - David S Morrison
- University of Glasgow, Glasgow, Scotland.,Public Health Scotland, Meridian Court, Glasgow, Scotland
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Araghi M, Soerjomataram I, Bardot A, Ferlay J, Cabasag CJ, Morrison DS, De P, Tervonen H, Walsh PM, Bucher O, Engholm G, Jackson C, McClure C, Woods RR, Saint-Jacques N, Morgan E, Ransom D, Thursfield V, Møller B, Leonfellner S, Guren MG, Bray F, Arnold M. Changes in colorectal cancer incidence in seven high-income countries: a population-based study. Lancet Gastroenterol Hepatol 2019; 4:511-518. [PMID: 31105047 DOI: 10.1016/s2468-1253(19)30147-5] [Citation(s) in RCA: 225] [Impact Index Per Article: 45.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Revised: 03/14/2019] [Accepted: 03/15/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND The overall incidence of colorectal cancer is decreasing in many high-income countries, yet analyses in the USA and other high-income countries such as Australia, Canada, and Norway have suggested increasing incidences among adults younger than 50 years. We aimed to examine longitudinal and generational changes in the incidence of colon and rectal cancer in seven high-income countries. METHODS We obtained data for the incidence of colon and rectal cancer from 21 population-based cancer registries in Australia, Canada, Denmark, Norway, New Zealand, Ireland, and the UK for the earliest available year until 2014. We used age-period-cohort modelling to assess trends in incidence by age group, period, and birth cohort. We stratified cases by tumour subsite according to the 10th edition of the International Classification of Diseases. Age-standardised incidences were calculated on the basis of the world standard population. FINDINGS An overall decline or stabilisation in the incidence of colon and rectal cancer was noted in all studied countries. In the most recent 10-year period for which data were available, however, significant increases were noted in the incidence of colon cancer in people younger than 50 years in Denmark (by 3·1%), New Zealand (2·9%), Australia (2·9%), and the UK (1·8%). Significant increases in the incidence of rectal cancer were also noted in this age group in Canada (by 3·4%), Australia (2·6%), and the UK (1·4%). Contemporaneously, in people aged 50-74 years, the incidence of colon cancer decreased significantly in Australia (by 1·6%), Canada (1·9%), and New Zealand (3·4%) and of rectal cancer in Australia (2·4%), Canada (1·2%), and the UK (1·2%). Increases in the incidence of colorectal cancer in people younger than 50 years were mainly driven by increases in distal (left) tumours of the colon. In all countries, we noted non-linear cohort effects, which were more pronounced for rectal than for colon cancer. INTERPRETATION We noted a substantial increase in the incidence of colorectal cancer in people younger than 50 years in some of the countries in this study. Future studies are needed to establish the root causes of this rising incidence to enable the development of potential preventive and early-detection strategies. FUNDING Canadian Partnership Against Cancer, Cancer Council Victoria, Cancer Institute New South Wales, Cancer Research UK, Danish Cancer Society, National Cancer Registry Ireland, the Cancer Society of New Zealand, NHS England, Norwegian Cancer Society, Public Health Agency Northern Ireland, Scottish Government, Western Australia Department of Health, and Wales Cancer Network.
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Affiliation(s)
- Marzieh Araghi
- Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France.
| | - Isabelle Soerjomataram
- Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France
| | - Aude Bardot
- Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France
| | - Jacques Ferlay
- Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France
| | - Citadel J Cabasag
- Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France
| | - David S Morrison
- Scottish Cancer Registry, Information Services Division, National Health Service National Services Scotland, South Gyle, Edinburgh, Scotland
| | - Prithwish De
- Analytics and Informatics, Cancer Care Ontario, Toronto, ON, Canada
| | - Hanna Tervonen
- Cancer Institute New South Wales, Alexandria, NSW, Australia
| | | | - Oliver Bucher
- Department of Epidemiology and Cancer Registry, Cancercare Manitoba, Winnipeg, MB, Canada
| | | | | | - Carol McClure
- Prince Edward Island Cancer Registry, Charlottetown, PE, Canada
| | | | | | - Eileen Morgan
- Northern Ireland Cancer Registry, Queen's University Belfast, Belfast, Northern Ireland
| | - David Ransom
- Western Australia Cancer and Palliative Care Network Policy Unit Health Networks Branch, Department of Health, Perth, WA, Australia
| | - Vicky Thursfield
- Victorian Cancer Registry, Cancer Council Victoria, Melbourne, VIC, Australia
| | - Bjørn Møller
- Institute of Population-Based Cancer Research, Cancer Registry of Norway, Oslo, Norway
| | - Suzanne Leonfellner
- NB Cancer Network, Department of Health, Province of New Brunswick, Fredericton, NB, Canada
| | - Marianne G Guren
- Department of Oncology and K G Jebsen Colorectal Cancer Research Center, Oslo University Hospital, Oslo, Norway
| | - Freddie Bray
- Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France
| | - Melina Arnold
- Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France
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Phytochemical Modulation of MiRNAs in Colorectal Cancer. MEDICINES 2019; 6:medicines6020048. [PMID: 30959836 PMCID: PMC6631275 DOI: 10.3390/medicines6020048] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 03/28/2019] [Accepted: 04/03/2019] [Indexed: 12/29/2022]
Abstract
Colorectal cancer (CRC) is one of the leading causes of death in the United States. Chemotherapy and radiotherapy are some of the most commonly used treatments, but are often associated with severe side effects, and are not entirely curative. It is therefore important to consider other preventative treatment options. Phytochemicals are naturally occurring bioactive compounds which have been shown to play a role in cancer prevention and treatment, especially in regards to a person’s lifestyle and diet. Recent evidence has shown that phytochemicals may exert their chemopreventative effects by targeting micro RNAs (miRNAs), which regulate the downstream expression of tumor suppressors and oncogenes. MiRNAs are small, endogenous, noncoding RNAs that regulate several biological processes through post-translational regulation. The dysregulation of miRNA expression has been shown to be associated with colorectal cancer. In this review, we will summarize and discuss several phytochemicals, which have been shown to exert chemopreventative effects in colorectal cancer by the modulation of miRNA expression.
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deSouza A, Noronha J, Patil P, Mehta S, Engineer R, Ostwal V, Ramaswamy A, Ankathi S, Ramadwar M, Saklani A. Management of colon cancer at a tertiary referral center in India - Patterns of presentation, treatment, and survival outcomes. Indian J Cancer 2019; 56:297-301. [PMID: 31607696 DOI: 10.4103/ijc.ijc_379_18] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Mahale J, Singh R, Howells LM, Britton RG, Khan SM, Brown K. Detection of Plasma Curcuminoids from Dietary Intake of Turmeric-Containing Food in Human Volunteers. Mol Nutr Food Res 2018; 62:e1800267. [PMID: 29943914 DOI: 10.1002/mnfr.201800267] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Revised: 06/18/2018] [Indexed: 12/26/2022]
Abstract
SCOPE Curcumin (from turmeric), has been extensively investigated for potential beneficial properties in numerous diseases. Most work has focused on supra-dietary concentrations/doses that would necessitate curcumin supplementation. However, much evidence instigating curcumin research is underpinned by epidemiological data based on low dietary intake via turmeric consumption. METHODS AND RESULTS Here, a novel, highly sensitive liquid chromatography-electrospray ionization-mass spectrometry (LC-ESI-MS/MS) method for detection of curcuminoids is described. Assay sensitivity is demonstrated in a pilot pharmacokinetic volunteer study following ingestion of foodstuffs containing a standardized mass of turmeric, representative of daily consumption by certain South Asian populations. Free parent curcumin was detectable in plasma from one individual, reaching maximal plasma concentrations (Cmax ) of 3.2 nm. Curcumin conjugates were detected in all volunteers; Cmax for curcumin glucuronide is 47.6 ± 28.5 nm 30 min post-food, while Cmax for demethoxycurcumin glucuronide and curcumin sulfate is ≈2 nm. Curcumin and its major metabolites persist in plasma for at least 8 h. CONCLUSION Despite poor absorption and rapid conjugation, dietary intake of standard culinary turmeric within complex food matrices furnished human plasma with detectable levels of curcuminoids. Whether sustained low systemic concentrations of these non-nutritive, biologically active, dietary components may have pharmacological activity for human health benefit, warrants further research.
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Affiliation(s)
- Jagdish Mahale
- Leicester Cancer Research Centre, Robert Kilpatrick Clinical Science Building, University of Leicester, Leicester Royal Infirmary, Leicester, LE2 7LX, UK
| | - Rajinder Singh
- Leicester Cancer Research Centre, Robert Kilpatrick Clinical Science Building, University of Leicester, Leicester Royal Infirmary, Leicester, LE2 7LX, UK
| | - Lynne M Howells
- Leicester Cancer Research Centre, Robert Kilpatrick Clinical Science Building, University of Leicester, Leicester Royal Infirmary, Leicester, LE2 7LX, UK
| | - Robert G Britton
- Leicester Cancer Research Centre, Robert Kilpatrick Clinical Science Building, University of Leicester, Leicester Royal Infirmary, Leicester, LE2 7LX, UK
| | - Sameena M Khan
- Leicester Cancer Research Centre, Robert Kilpatrick Clinical Science Building, University of Leicester, Leicester Royal Infirmary, Leicester, LE2 7LX, UK
| | - Karen Brown
- Leicester Cancer Research Centre, Robert Kilpatrick Clinical Science Building, University of Leicester, Leicester Royal Infirmary, Leicester, LE2 7LX, UK
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8
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Hjerkind KV, Qureshi SA, Møller B, Weiderpass E, Deapen D, Kumar B, Ursin G. Ethnic differences in the incidence of cancer in Norway. Int J Cancer 2017; 140:1770-1780. [PMID: 28063159 DOI: 10.1002/ijc.30598] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Revised: 12/06/2016] [Accepted: 12/20/2016] [Indexed: 01/08/2023]
Abstract
Traditionally there have been differences in cancer incidence across geographic regions. When immigrants have moved from low-income to high-income countries, their incidence have changed as they have adapted to the lifestyle in the new host country. Given worldwide changes in lifestyle factors over time, we decided to examine cancer incidence in immigrant groups in Norway, a country with a recent immigration history, complete cancer registration and universal public health care. We linked immigration history for the complete population to information on cancer diagnosis from the Cancer Registry of Norway for the period 1990-2012. Age-standardized (world) overall and site-specific cancer incidence were estimated for different immigrant groups and compared to incidence among individuals born in Norway. Among 850,008 immigrants, 9,158 men and 10,334 women developed cancer, and among 5,508,429 Norwegian-born, 263,316 men and 235,020 women developed cancer. While incidence of breast and colorectal cancer were highest among individuals born in Norway and other high-income countries, other cancer types were higher in immigrants from low-income countries. Lung cancer incidence was highest in Eastern European men, and men and women from Eastern Europe had high incidence of stomach cancer. Incidence of liver cancer was substantially higher in immigrants from low-income countries than in individuals born in Norway and other high-income countries. Our results mirror known cancer challenges across the world. Although cancer incidence overall is lower in immigrants from low-income countries, certain cancers, such as lung, liver and stomach cancer, represent major challenges in specific immigrant groups.
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Affiliation(s)
- Kirsti V Hjerkind
- Cancer Registry of Norway, Institute of Population-based Cancer Research, Oslo, Norway
| | - Samera A Qureshi
- Norwegian Centre for Migrant and Minority Health Research, Oslo, Norway
| | - Bjørn Møller
- Cancer Registry of Norway, Institute of Population-based Cancer Research, Oslo, Norway
| | - Elisabete Weiderpass
- Cancer Registry of Norway, Institute of Population-based Cancer Research, Oslo, Norway.,Department of Community Medicine, University of Tromsø, The Arctic University of Norway, Tromsø, Norway.,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.,Genetic Epidemiology Group, Folkhalsän Research Center, Helsinki, Finland
| | - Dennis Deapen
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Bernadette Kumar
- Norwegian Centre for Migrant and Minority Health Research, Oslo, Norway
| | - Giske Ursin
- Cancer Registry of Norway, Institute of Population-based Cancer Research, Oslo, Norway.,Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA.,Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
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Ethnic variation in colorectal cancer risk following a positive faecal occult blood test in an English bowel cancer screening programme centre. Eur J Gastroenterol Hepatol 2015; 27:1281-5. [PMID: 26267240 DOI: 10.1097/meg.0000000000000443] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
BACKGROUND AND AIMS The literature on colorectal cancer (CRC) screening and ethnic diversity is dominated by studies from the USA. There are no such published data from the UK bowel cancer screening programme (BCSP) population. The Wolverhampton Bowel Cancer Screening Centre serves a population of 900,000 in the Black Country and South Staffordshire. South Asians (SA) comprise 9% of the population. We aimed to determine the effects of ethnicity and sex on the risk for cancer or adenoma detected by colonoscopy following a positive faecal occult blood test over a 5-year period (2007-2011). METHODS Data were collected from the prospectively maintained BCSP cohort. South Asian patients were identified and compared with those of non-South Asian ethnicity, and colonoscopy outcomes were determined. RESULTS A total of 3552 participants underwent BCSP colonoscopy (non-South Asian=3363; SA=189). There were 271 cancers (7.6%) detected within the non-South Asian group and seven cancers (0.2%) in the South Asian population (P<0.05). The probability of colon cancer is higher [odds ratio (OR)=3.84, P<0.05] in non-South Asians compared with South Asians. Patients in the 65-70-year age group have the highest risk (OR=1.60; P<0.05) for CRC. During the study 1313 adenomas were detected. A total of 771 high-risk and intermediate-risk adenomas were detected in the non-South Asian group, and 14 were detected in the South Asian group. The risk of adenoma in non-South Asians is six times higher than in South Asians (OR=5.99, P<0.001) following positive faecal occult blood testing. CONCLUSION There are fewer colorectal cancers in South Asians compared with the non-South Asian population in this regional study. This is the first such study in the BCSP population.
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10
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Maringe C, Li R, Mangtani P, Coleman MP, Rachet B. Cancer survival differences between South Asians and non-South Asians of England in 1986-2004, accounting for age at diagnosis and deprivation. Br J Cancer 2015; 113:173-81. [PMID: 26079299 PMCID: PMC4647525 DOI: 10.1038/bjc.2015.182] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2014] [Revised: 04/14/2015] [Accepted: 04/22/2015] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND South Asian migrants show lower cancer incidence than their host population in England for most major cancers. We seek to study the ethnic differences in survival from cancer. METHODS We described and modelled the effect of ethnicity, time, age and deprivation on survival for the five most incident cancers in each sex in South Asians in England between 1986 and 2004 using national cancer registry data. South Asian ethnicity was flagged using the validated name-recognition algorithm SANGRA (South Asian Names and Group Recognition Algorithm). RESULTS We observed survival advantage in South Asians in earlier periods. This ethnic gap either remained constant or narrowed over time. By 2004, age-standardised net survival was comparable for all cancers except three in men, where South Asians had higher survival 5 years after diagnosis: colorectal (58.9% vs 53.6%), liver (15.0% vs 9.4%) and lung (15.9% vs 9.3%). Compared with non-South Asians, South Asians experienced a slower increase in breast and prostate cancer survival, both cancers associated with either a screening programme or an early diagnosis test. We did not find differential patterns in survival by deprivation between both ethnicities. CONCLUSIONS Considering recent survival trends, appropriate action is required to avoid deficits in cancer survival among South Asians in the near future.
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Affiliation(s)
- C Maringe
- Faculty of Epidemiology and population Health, London school of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK
| | - R Li
- Faculty of Epidemiology and population Health, London school of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK
| | - P Mangtani
- Faculty of Epidemiology and population Health, London school of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK
| | - M P Coleman
- Faculty of Epidemiology and population Health, London school of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK
| | - B Rachet
- Faculty of Epidemiology and population Health, London school of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK
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Samy EF, Ross J, Bolton E, Morris EJ, Oliver SE. Variation in incidence and survival by ethnicity for patients with myeloma in England (2002-2008). Leuk Lymphoma 2015; 56:2660-7. [PMID: 25651425 DOI: 10.3109/10428194.2014.1003060] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Incidence and relative survival of myeloma by ethnic group was estimated using data from cancer registries in England (2002-2008). Multiple imputation was used to address missing ethnicity data. In total 24 361 cases of myeloma were identified. Age-standardized incidence rate (ASIR) (per 100 000) was higher in the Black ethnic category at 15.00 (95% confidence interval [CI] 13.50-16.40), than amongst South Asians (ASIR = 5.45, 95% CI 4.76-6.14) or the White group (ASIR = 6.11, 95% CI 6.00-6.22). There was a lower risk of death in the Black group for both 1- and 3-year survival (hazard ratio [HR]1 year = 0.66, 95% CI 0.55-0.79; HR3 year = 0.69, 95% CI 0.58-0.83) and South Asians at 1, 3 and 5 years (HR1 year = 0.65, 95% CI 0.51-0.82; HR3 year = 0.72, 95% CI I 0.57-0.90; HR5 year = 0.68, 95% CI 0.50-0.92) when compared to the White population. Further study of differences in myeloma and precursor biology between population groups is important.
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Affiliation(s)
- E Faye Samy
- a Public Health England Knowledge and Information Team (Northern and Yorkshire), Innovation Centre, University of York , York , UK
| | - James Ross
- b Haematological Malignancy Clinical Reference Group, National Cancer Intelligence Network , London , UK
| | - Edward Bolton
- c Cancer Informatics Team, Leeds Teaching Hospitals , Leeds , UK
| | - Eva J Morris
- d Cancer Epidemiology Group, Leeds Institute of Cancer and Pathology, University of Leeds, St James's University Hospital , Leeds , UK
| | - Steven E Oliver
- e Department of Health Sciences and the Hull York Medical School , University of York , York , UK
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12
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Shirley MH, Barnes I, Sayeed S, Finlayson A, Ali R. Incidence of breast and gynaecological cancers by ethnic group in England, 2001-2007: a descriptive study. BMC Cancer 2014; 14:979. [PMID: 25522857 PMCID: PMC4301395 DOI: 10.1186/1471-2407-14-979] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2014] [Accepted: 12/11/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Although international comparisons reveal large geographical differences in the incidence of breast and gynaecological cancers, incidence data for ethnic groups in England remains scarce. METHODS We compared the incidence of breast, ovarian, cervical and endometrial cancer in British Indians, Pakistanis, Bangladeshis, Black Africans, Black Caribbeans, Chinese and Whites between 2001 and 2007. We identified 357,476 cancer registrations from which incidence rates were calculated using mid-year population estimates from 2001 to 2007. Ethnicity was obtained through linkage to the Hospital Episodes Statistics database. Incidence rate ratios were calculated, comparing the 6 non-White ethnic groups to Whites, and were adjusted for age and income. RESULTS We found evidence of differences in the incidence of all 4 cancers by ethnic group (p<0.001). Relative to Whites, South Asians had much lower rates of breast, ovarian and cervical cancer (IRRs of 0.68, 0.66 and 0.33 respectively), Blacks had lower rates of breast, ovarian and cervical cancer but higher rates of endometrial cancer (IRRs of 0.85, 0.62, 0.72 and 1.16 respectively), and Chinese had lower rates of breast and cervical cancer (IRRs of 0.72 and 0.68 respectively). There were also substantial intra-ethnic differences, particularly among South Asians, with Bangladeshis experiencing the lowest rates of all 4 cancers. CONCLUSIONS Our study provides evidence that the risk of breast and gynaecological cancers varies by ethnic group and that those groups typically grouped together are not homogenous with regards to their cancer risk. Furthermore, several of our findings cannot be readily explained by known risk factors and therefore warrant further investigation.
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Affiliation(s)
- Megan H Shirley
- />Cancer Epidemiology Unit, University of Oxford, Richard Doll Building, Oxford, OX3 7LF UK
| | - Isobel Barnes
- />Cancer Epidemiology Unit, University of Oxford, Richard Doll Building, Oxford, OX3 7LF UK
| | - Shameq Sayeed
- />Cancer Epidemiology Unit, University of Oxford, Richard Doll Building, Oxford, OX3 7LF UK
| | - Alexander Finlayson
- />Cancer Epidemiology Unit, University of Oxford, Richard Doll Building, Oxford, OX3 7LF UK
| | - Raghib Ali
- />Cancer Epidemiology Unit, University of Oxford, Richard Doll Building, Oxford, OX3 7LF UK
- />17666 Al Ain, United Arab Emirates
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Takeshita H, Fujihara J, Yasuda T, Kimura-Kataoka K. Worldwide Distribution of Four SNPs in X-Ray and Repair and Cross-Complementing Group 1 (XRCC1). Clin Transl Sci 2014; 8:347-50. [PMID: 25387884 DOI: 10.1111/cts.12237] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
PURPOSE X-ray repair cross-complementing group 1 (XRCC1) repairs single-strand breaks in DNA. Several reports have shown the association of single nucleotide polymorphisms (SNPs) (Arg194Trp, Pro206Pro, Arg280His, Arg399Gln) in XRCC1 to diseases. Limited population data are available regarding SNPs in XRCC1, especially in African populations. In this study, genotype distributions of four SNPs in worldwide populations were examined and compared with those reported previously. MATERIALS AND METHODS Four SNPs (Arg194Trp, Pro206Pro, Arg280His, Arg399Gln) in XRCC1 from genomic DNA samples of 10 populations were evaluated by using polymerase chain reaction followed by restriction fragment length polymorphism analysis. RESULTS The frequency of the minor allele corresponding to the Trp allele of XRCC1Arg194Trp was higher in Asian populations than in African and Caucasian populations. As for XRCC1Pro206Pro, Africans showed higher minor allele frequencies than did Asian populations, except for Tamils and Sinhalese. XRCC1 Arg280His frequencies were similar among Africans and Caucasians but differed among Asian populations. Similarly, lower mutant XRCC1 Arg399Gln frequencies were observed in Africans. CONCLUSIONS This study is the first to show the existence of a certain genetic heterogeneity in the worldwide distribution of four SNPs in XRCC1.
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Affiliation(s)
- Haruo Takeshita
- Department of Legal Medicine, Shimane, University Faculty of Medicine, Shimane, Japan.,Autopsy Imaging Center, University of Fukui, Eiheiji-cho, Japan
| | - Junko Fujihara
- Department of Legal Medicine, Shimane, University Faculty of Medicine, Shimane, Japan
| | - Toshihiro Yasuda
- Division of Medical Genetics and Biochemistry, Faculty of Medical Sciences, University of Fukui, Eiheiji-cho, Japan
| | - Kaori Kimura-Kataoka
- Department of Legal Medicine, Shimane, University Faculty of Medicine, Shimane, Japan
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Stotter A, Jenkins J, Edmondson-Jones M, Blackledge H, Kearins O. Temporal changes in breast cancer incidence in South Asian women. Cancer Epidemiol 2014; 38:663-9. [PMID: 25214237 DOI: 10.1016/j.canep.2014.08.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2014] [Revised: 07/16/2014] [Accepted: 08/26/2014] [Indexed: 11/25/2022]
Abstract
BACKGROUND Breast cancer in the UK resident population of South Asian ethnicity has been lower than that in indigenous women. Leicester has a large South Asian population and a breast cancer unit with comprehensive data on diagnosed cancers. This study analysed the annual incidence of new breast cancer diagnoses in females from 1998 to 2009 to determine any changes in recent years. METHODS Ethnicity was known in over 98% of cases. Population denominators were based on published figures for 2001 and 2011, projected back to 1998. Age-adjusted directly standardised incidence rates were determined by ethnicity and broken down by invasive status and screening classification. Incidence rates were analysed using logistic regression in order to identify statistically significant effects of age, ethnicity, deprivation and year of diagnosis. Interactions with invasive status and screening classification were also investigated. RESULTS At the start of the study period South Asian incidence was estimated to be 45% of that of the white population (p<0.001); by the end of the period the difference was still significant (p=0.022) but smaller, at 17%. CONCLUSION South Asians should no longer be considered at low risk of breast cancer.
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Affiliation(s)
- Anne Stotter
- Department Breast Surgery, Glenfield Hospital, University Hospitals of Leicester NHS Trust, Groby Road, Leicester LE3 9QP, UK.
| | - Jacquie Jenkins
- East Midlands Breast Screening Quality Assurance Reference Centre, Nottingham University Hospitals, City Campus, Hucknall Road, Nottingham, NG5 1PB, UK.
| | - Mark Edmondson-Jones
- Directorate of Public Health, Leicester City PCT, New Walk Centre, Welford Place, Leicester LE1 6ZG, UK.
| | - Hanna Blackledge
- Directorate of Public Health, Leicester City PCT, New Walk Centre, Welford Place, Leicester LE1 6ZG, UK.
| | - Olive Kearins
- Breast Screening Quality Assurance, West Midlands Cancer Intelligence Unit, Public health Building, University of Birmingham, Birmingham B15 2TT, UK.
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Sharma JD, Kalita M, Barbhuiya JA, Lahon R, Sharma A, Barman D, Kataki AC, Roy BD. Descriptive report on pattern of variation in cancer cases within selected ethnic groups in Kamrup Urban District of Assam, 2009-2011. Asian Pac J Cancer Prev 2014; 15:6381-6. [PMID: 25124629 DOI: 10.7314/apjcp.2014.15.15.6381] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The global burden of cancer is continuously increasing. According to recent report of the National Cancer Registry Programme (NCRP) on time trends it is estimated that future burden of cancer cases for India in 2020 will be 1,320,928. It is well known that knowledge of the incidence of cancer is a fundamental requirement of rational planning and monitoring of cancer control programs. It would help health planners to formulate public health policy if relevant ethnic groups were considered. North East-India alone contains over 160 Scheduled Tribes and 400 other sub-tribal communities and groups, whose cancer incidence rates are high compared to mainland India. As since no previous study was done focusing on ethnicity, the present investigation was performed. MATERIALS AND METHODS In this paper PBCR-Guwahati data on all cancer registrations from January 2009 to December 2011 for residents of the Kamrup Urban District, comprising an area of 261.8 sq. km with a total population of 900,518, including individual records with information on sex, age, ethnicity and cancer site are provided. Descriptive statistics including age adjusted rates (AARs) were taken as provided by NCRP. For comparison of proportional incidence ratios (PIR) the Student's t test was used, with p<0.05 considered as statistically significant. RESULTS AND CONCLUSIONS Differences in leading sites of Kamrup Urban District since from the beginning of the PBCR-Guwahati were revealed among different ethnic groups by this study. The results should help policy makers to formulate different strategies to control the level of burden as well as for treatment planning. This study also suggests that age is an important factor of cancer among different ethnic populations as well as for overall population of Kamrup District of Assam.
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Affiliation(s)
- Jagannath Dev Sharma
- Population Based Cancer Registry, Indian Council of Medical Research, Dr. B. Borooah Cancer Institute, Guwahati, Assam, India E-mail :
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Zhang J, Jiang D, Li X, Lv J, Xie L, Zheng L, Gavine PR, Hu Q, Shi Y, Tan L, Ge D, Xu S, Li L, Zhu L, Hou Y, Wang Q. Establishment and characterization of esophageal squamous cell carcinoma patient-derived xenograft mouse models for preclinical drug discovery. J Transl Med 2014; 94:917-26. [PMID: 24999713 DOI: 10.1038/labinvest.2014.77] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2014] [Revised: 03/27/2014] [Accepted: 04/08/2014] [Indexed: 12/22/2022] Open
Abstract
The purpose of this study was to establish and characterize patient-derived esophageal squamous cell carcinoma xenograft (PDECX) mice for utilization in antitumor drug discovery. A total of 96 esophageal squamous cell carcinoma (ESCC) tissues from Chinese patients were transplanted subcutaneously into immunodeficient mice. Histology, EGFR, K-ras, B-raf, and PIK3CA mutations, and HER2 gene amplifications were analyzed in both patient tumors and mouse xenograft tissues using immunohistochemistry, mutant-enriched liquid chip sequencing and fluorescence in situ hybridization assays, respectively. Furthermore, in vivo efficacy studies using five PDECX mice harboring a variety of genetic aberrations were performed using the chemotherapy agents 5-fluorouracil (5-FU) and cisplatin. Thirty-seven PDECX mouse models were successfully established in immunodeficient mice. Pathological analysis revealed similar histological architecture and degrees of differentiation between patient ESCC and xenografted tumors. No mutations were identified in EGFR, K-ras, and B-raf genes in either xenograft models or patient ESCC tissues. In contrast, PIK3CA gene mutations were detected in 12.5% (12/96) ESCC patients and 18.9% (7/37) PDECX models. Interestingly, patient ESCC tissues exhibiting HER2 overexpression or gene amplification were unable to survive in immunodeficient mice. Further analysis showed that PDECX models carrying HER2 2+ expression had no response to 5-FU/cisplatin, compared with HER2-negative models. In conclusion, a panel of PDECX mouse models, which include PIK3CA mutant and HER2-positive models, was established and characterized thus mimicking the current clinical genetic setting of esophageal carcinoma. The sensitivity of HER2-negative ESCC models to chemotherapy supports stratification approaches in the treatment of esophageal carcinoma patients and warrants further investigation of the impact of PI3KCA on treatment response.
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Affiliation(s)
- Jingchuan Zhang
- Innovation Center China, AstraZeneca Global R&D, Zhangjiang Hi-Tech Park, Shanghai, People's Republic of China
| | - Dongxian Jiang
- Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China
| | - Xiaojing Li
- Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China
| | - Jing Lv
- Innovation Center China, AstraZeneca Global R&D, Zhangjiang Hi-Tech Park, Shanghai, People's Republic of China
| | - Liang Xie
- Innovation Center China, AstraZeneca Global R&D, Zhangjiang Hi-Tech Park, Shanghai, People's Republic of China
| | - Li Zheng
- Innovation Center China, AstraZeneca Global R&D, Zhangjiang Hi-Tech Park, Shanghai, People's Republic of China
| | - Paul R Gavine
- Innovation Center China, AstraZeneca Global R&D, Zhangjiang Hi-Tech Park, Shanghai, People's Republic of China
| | - Qin Hu
- Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China
| | - Yuan Shi
- Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China
| | - Lijie Tan
- Department of Thorax Surgery, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China
| | - Di Ge
- Department of Thorax Surgery, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China
| | - Songtao Xu
- Department of Thorax Surgery, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China
| | - Leon Li
- Innovation Center China, AstraZeneca Global R&D, Zhangjiang Hi-Tech Park, Shanghai, People's Republic of China
| | - Lifang Zhu
- Innovation Center China, AstraZeneca Global R&D, Zhangjiang Hi-Tech Park, Shanghai, People's Republic of China
| | - Yingyong Hou
- Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China
| | - Qun Wang
- Department of Thorax Surgery, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China
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Raman R, Kongara R, Kotapalli V, Gowrishankar S, Sastry RA, Nagari B, Bashyam MD. Pathological stage significantly predicts survival in colorectal cancer patients: a study from two tertiary care centers in India. COLORECTAL CANCER 2014. [DOI: 10.2217/crc.14.12] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
SUMMARY Aims: An increase in incidence of early-onset colorectal cancer (EOCRC) in developing countries, including India, is reported recently; however, systematic analyses of clinico-pathological features and disease prognosis has seldom been undertaken. Materials & methods: We studied clinical data pertaining to 1259 colorectal adenocarcinoma patients from two tertiary cancer centers in south India. Results: Approximately 45% of patients were aged below 50 years and poor grade and late-stage tumors were significantly associated with early disease onset. Although tumor grade and stage significantly influenced disease-free survival independently, significant association between survival and age of onset or tumor location was not detected unlike previous observations. Conclusion: Given the sizeable proportion of EOCRC, implementation of the revised Bethesda guidelines may not be tenable in India. More importantly, the previous observation of EOCRC being significantly associated with poor survival could, in part, be due to a higher proportion of advanced-stage tumors.
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Affiliation(s)
- Ratheesh Raman
- Laboratory of Molecular Oncology, Centre for DNA Fingerprinting & Diagnostics, Hyderabad, India
| | - Ravikanth Kongara
- Department of Surgical Gastroenterology, Nizam's Institute of Medical Sciences, Hyderabad, India
- Bariatry & Obesity Clinic, Endocare Hospital, Vijayawada, India
| | - Viswakalyan Kotapalli
- Laboratory of Molecular Oncology, Centre for DNA Fingerprinting & Diagnostics, Hyderabad, India
| | | | - Regulagadda A Sastry
- Department of Surgical Gastroenterology, Nizam's Institute of Medical Sciences, Hyderabad, India
- Department of Surgical Gastroenterology & HPB Surgery, Krishna Institute of Medical Sciences, Hyderabad, India
| | - Bheerappa Nagari
- Department of Surgical Gastroenterology, Nizam's Institute of Medical Sciences, Hyderabad, India
| | - Murali D Bashyam
- Laboratory of Molecular Oncology, Centre for DNA Fingerprinting & Diagnostics, Hyderabad, India
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19
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Gathani T, Ali R, Balkwill A, Green J, Reeves G, Beral V, Moser KA. Ethnic differences in breast cancer incidence in England are due to differences in known risk factors for the disease: prospective study. Br J Cancer 2014; 110:224-9. [PMID: 24169349 PMCID: PMC3887283 DOI: 10.1038/bjc.2013.632] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2013] [Revised: 09/11/2013] [Accepted: 09/14/2013] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND In the United Kingdom, breast cancer incidence is lower in South Asian and Black women than in White women, but the extent to which this is due to known risk factors is unknown. In a large prospective study, we describe breast cancer incidence by ethnicity, before and after adjustment for known risk factors for the disease. METHODS Women were recruited into the Million Women Study in 1996-2001, when information on reproductive and lifestyle factors known to influence the risk of breast cancer was obtained. Ethnicity was determined from study questionnaires and hospital admission data. Cox regression models were used to calculate adjusted relative risks (RR) for incident breast cancer in South Asians and Blacks compared with Whites. RESULTS Analyses included 5877 South Asian, 4919 Black, and 1,038,144 White women in England. The prevalence of 8 out of the 9 risk factors for breast cancer examined, differed substantially by ethnicity (P<0.001 for each), such that South Asian and Black women were at a lower risk of the disease than White women. During 12.2 years of follow-up incident breast cancer occurred in 217 South Asians, 180 Blacks, and 45,191 Whites. As expected, breast cancer incidence was lower in South Asians (RR=0.82, 95% CI 0.72-0.94) and Blacks (RR=0.85, 0.73-0.98) than in Whites when the analyses were adjusted only for age and region of residence. However, after additional adjustment for the known risk factors for the disease, breast cancer incidence was similar to that of Whites, both in South Asians (0.95, 0.83-1.09) and in Blacks (0.91, 0.78-1.05). CONCLUSION South Asian and Black women in England have lower incidence rates of breast cancer than White women, but this is largely, if not wholly, because of differences in known risk factors for the disease.
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Affiliation(s)
- T Gathani
- Cancer Epidemiology Unit, University of Oxford, Richard Doll Building, Roosevelt Drive, Oxford OX3 7LF, UK
- Department of Breast Surgery, Oxford University Hospitals NHS Trust, Oxford, UK
| | - R Ali
- Cancer Epidemiology Unit, University of Oxford, Richard Doll Building, Roosevelt Drive, Oxford OX3 7LF, UK
| | - A Balkwill
- Cancer Epidemiology Unit, University of Oxford, Richard Doll Building, Roosevelt Drive, Oxford OX3 7LF, UK
| | - J Green
- Cancer Epidemiology Unit, University of Oxford, Richard Doll Building, Roosevelt Drive, Oxford OX3 7LF, UK
| | - G Reeves
- Cancer Epidemiology Unit, University of Oxford, Richard Doll Building, Roosevelt Drive, Oxford OX3 7LF, UK
| | - V Beral
- Cancer Epidemiology Unit, University of Oxford, Richard Doll Building, Roosevelt Drive, Oxford OX3 7LF, UK
| | - K A Moser
- Cancer Epidemiology Unit, University of Oxford, Richard Doll Building, Roosevelt Drive, Oxford OX3 7LF, UK
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20
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Ali R, Barnes I, Cairns BJ, Finlayson AE, Bhala N, Mallath M, Beral V. Incidence of gastrointestinal cancers by ethnic group in England, 2001-2007. Gut 2013; 62:1692-703. [PMID: 23092766 DOI: 10.1136/gutjnl-2012-303000] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/08/2022]
Abstract
OBJECTIVE To compare the incidence of six gastrointestinal cancers (colorectal, oesophageal, gastric, liver, gallbladder and pancreatic) among the six main 'non-White' ethnic groups in England (Indian, Pakistani, Bangladeshi, Black African, Black Caribbean and Chinese) to each other and to Whites. METHODS We analysed all 378 511 gastrointestinal cancer registrations from 2001-2007 in England. Ethnicity was obtained by linkage to the Hospital Episodes Statistics database and we used mid-year population estimates from 2001-2007. Incidence rate ratios adjusted for age, sex and income were calculated, comparing the six ethnic groups (and combined 'South Asian' and 'Black' groups) to Whites and to each other. RESULTS There were significant differences in the incidence of all six cancers between the ethnic groups (all p<0.001). In general, the 'non-White' groups had a lower incidence of colorectal, oesophageal and pancreatic cancer compared to Whites and a higher incidence of liver and gallbladder cancer. Gastric cancer incidence was lower in South Asians but higher in Blacks and Chinese. There was strong evidence of differences in risk between Indians, Pakistanis and Bangladeshis for cancer of the oesophagus, stomach, liver and gallbladder (all p<0.001) and between Black Africans and Black Caribbeans for liver and gallbladder cancer (both p<0.001). CONCLUSIONS The risk of gastrointestinal cancers varies greatly by individual ethnic group, including within those groups that have traditionally been grouped together (South Asians and Blacks). Many of these differences are not readily explained by known risk factors and suggest that important, potentially modifiable causes of these cancers are still to be discovered.
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Affiliation(s)
- Raghib Ali
- Cancer Epidemiology Unit, University of Oxford, Oxford, UK
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Prabhu A, Obi KO, Rubenstein JH. Systematic review with meta-analysis: race-specific effects of alcohol and tobacco on the risk of oesophageal squamous cell carcinoma. Aliment Pharmacol Ther 2013; 38:1145-55. [PMID: 24079938 DOI: 10.1111/apt.12514] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2013] [Revised: 02/09/2013] [Accepted: 09/10/2013] [Indexed: 12/17/2022]
Abstract
BACKGROUND Oesophageal squamous cell carcinoma (OSCC) is associated with alcohol use, tobacco use and African or Asian descent. However, little is known about how racial background modifies the effects of alcohol or tobacco. AIM To investigate how racial and geographical background modifies the effect of alcohol and tobacco on OSCC via a systematic review and meta-analysis of published literature. METHODS We performed a literature search in multiple online databases regardless of language. Eligible studies were population-based assessments of the effect of tobacco and/or alcohol on the risk of OSCC allowing stratification by race. The quality of studies was assessed by the Newcastle-Ottawa Scale. Meta-analyses were performed to estimate summary effects using random effect models. RESULTS Systematic review identified 9668 unique citations of which 34 were eligible. The majority were of high quality. The effect of current smoking vs. never-smoking was weaker among Asians than among Europeans [European: odds ratio (OR) = 4.21, 95% confidence interval (CI) 3.13, 5.66; Asian: OR = 2.31, 95% CI 1.78, 2.99], with the 95% CIs not crossing, indicating statistical significance. Asians also trended towards weaker effects of long-duration cigarette use and of heavy daily cigarette use. There was no difference in the effect of alcohol on OSCC risk by race. CONCLUSIONS Contrary to our hypothesis, a weaker effect of tobacco for OSCC was observed among Asians than among Europeans. Differences in other factors must explain the higher incidence of OSCC among Asians. More studies are needed to understand the cause of the disparate incidence of OSCC between races.
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Affiliation(s)
- A Prabhu
- Division of Gastroenterology, University of Michigan Medical School, Ann Arbor, MI, USA
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Molecular Origins of Colon and Rectal Cancer: Not a Wnt–Wnt Situation. CURRENT COLORECTAL CANCER REPORTS 2013. [DOI: 10.1007/s11888-013-0189-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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Shirley MH, Sayeed S, Barnes I, Finlayson A, Ali R. Incidence of haematological malignancies by ethnic group in England, 2001-7. Br J Haematol 2013; 163:465-77. [PMID: 24033296 DOI: 10.1111/bjh.12562] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2013] [Accepted: 08/03/2013] [Indexed: 12/24/2022]
Abstract
The aetiology of most haematological malignancies is largely unknown. Studies of migrant populations can provide insights into the relative importance of genetic and environmental risk factors for these diseases. This study compares incidence rates in British Indians, Pakistanis, Bangladeshis, Black Africans, Black Caribbeans, Chinese and Whites in England from 2001 to 2007. We analysed 134,302 haematological cancer registrations with ethnicity obtained by linkage to the Hospital Episodes Statistics database. Mid-year population estimates from 2001 to 2007 were used. Incidence rate ratios adjusted for age, sex and income were calculated, comparing the six ethnic groups to Whites and to each other. Whites had the highest rates for most subtypes. However, Blacks experienced more than double the incidence of plasma cell and mature T-cell neoplasms compared to other ethnic groups. There were also significant differences in incidence between Indians, Pakistanis and Bangladeshis for Hodgkin lymphoma and mature B-cell neoplasms and between Black African and Black Caribbeans for mature B-cell and other lymphoid neoplasms (all P < 0.001). Our results show that the risk of haematological cancers varies greatly by ethnic group, including within those groups that have traditionally been grouped together (South Asians and Blacks) with many of these differences not explicable by known risk factors.
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A comparative overview of general risk factors associated with the incidence of colorectal cancer. Tumour Biol 2013; 34:2469-76. [PMID: 23832537 DOI: 10.1007/s13277-013-0876-y] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2013] [Accepted: 05/16/2013] [Indexed: 12/14/2022] Open
Abstract
Cancers found in colorectal region remain largely localized to the large intestine and rectum. They are derived from the epithelium and are considered to be among the most frequently detected cancers. They are known to occur in approximately 5 % population of the Western world. After metastasis, a patient's 5-year postsurgical survival chances unfortunately fall from 90 to 10 % or even less. Adenocarcinoma, the most common cell type of colon cancer, alone constitutes 95 % of the cases. Lymphoma and squamous cell carcinoma can also be found in some cases. Because 5 % of persons are predisposed to development of colorectal cancer, this disease has often been addressed as an important public health issue. Factors that are known in particular to increase a person's risk to develop this cancer are as follows: an individual's age, dietary habits, any complaint of obesity, diabetes, previous history of cancer or intestinal polyps, personal habit of alcohol consumption and smoking, family history of colon cancer, race, sex, and ethnicity. Since the risk of colorectal cancer is increasing steadily in Kashmir, India, like in some other corners of Asia, exhaustive efforts are being made to find the association of above given and other risk factors with the development of this gastrointestinal tract cancer. Adoption of Western life style, diet mimicry, together with a habit of having physically inactive life style and consumption of red meat in particular can be blamed as being active players to a considerable extent.
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Bang CH, Bae JM, Kim HS, Kim GM, Yu DS, Park HJ, Oh ST, Kang H, Park CJ, Lee JD, Lee JY, Kim HO, Park YM. Recent trends (1991-2010) of metastatic skin cancers in Korea. J Korean Med Sci 2013; 28:1083-8. [PMID: 23853494 PMCID: PMC3708082 DOI: 10.3346/jkms.2013.28.7.1083] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2012] [Accepted: 05/14/2013] [Indexed: 11/20/2022] Open
Abstract
The incidence of overall cancer has increased over time. The incidence of top-ranking cancers has changed in the 1990s and the 2000s. However, few studies have evaluated the trends in metastatic skin cancers during this period. We evaluated the recent trends in incidence, peak age and location of metastatic skin cancers from 1991 to 2010. This 20-yr survey was divided into two decades to determine the trends by comparing the statistics. Out of 694,466 outpatients (1991-2010), 174 (0.025%) were diagnosed with metastatic skin cancer. The incidence of metastatic skin cancer increased significantly from 20.64 per 100,000 outpatients in the 1990s to 28.70 per 100,000 outpatients in the 2000s (P = 0.030). The peak age of skin metastasis shifted from the 40s to the 50s in women, and from the 50s to the 60s in men. The percentage of metastatic skin cancers originating from intra-abdominal organs increased from 10% in the 1990s to 23.1% in the 2000s (P = 0.027). The percentage of metastatic skin cancers located on the abdomen increased from 7.1% in the 1990s to 15.4% in the 2000s (P = 0.011). The higher proportion of metastatic skin cancers located on the abdomen may be related to the increase in skin metastases from intra-abdominal organs.
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Affiliation(s)
- Chul Hwan Bang
- Department of Dermatology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jung Min Bae
- Department of Dermatology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hei Sung Kim
- Department of Dermatology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Gyeong Mun Kim
- Department of Dermatology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Dong Soo Yu
- Department of Dermatology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hyun Jeong Park
- Department of Dermatology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Shin Tack Oh
- Department of Dermatology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hoon Kang
- Department of Dermatology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Chul Jong Park
- Department of Dermatology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jeong Deuk Lee
- Department of Dermatology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jun Young Lee
- Department of Dermatology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hyung Ok Kim
- Department of Dermatology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Young Min Park
- Department of Dermatology, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Sayeed S, Barnes I, Cairns BJ, Finlayson A, Ali R. Childhood cancer incidence in British Indians & Whites in Leicester, 1996-2008. PLoS One 2013; 8:e61881. [PMID: 23613964 PMCID: PMC3629092 DOI: 10.1371/journal.pone.0061881] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2012] [Accepted: 03/18/2013] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND South Asians in England have an increased risk of childhood cancer but incidence by their individual ethnicities using self-assigned ethnicity is unknown. Our objective was to compare the incidence of childhood cancer in British Indians and Whites in Leicester, which has virtually complete, self-assigned, ethnicity data and the largest population of Indians in England. METHODS We obtained data on all cancer registrations from 1996 to 2008 for Leicester with ethnicity obtained by linkage to the Hospital Episodes Statistics database. Age-standardised incidence rates were calculated for childhood cancers in Indians and Whites as well as rate ratios, adjusted for age. RESULTS There were 33 cancers registered among Indian children and 39 among White children. The incidence rate for Indians was greater compared to Whites for all cancers combined (RR 1.82 (95% CI 1.14 to 2.89); p = 0.01), with some evidence of increased risk of leukaemia (RR 2.20 (0.95 to 5.07); p = 0.07), lymphoma (RR 3.96 (0.99 to 15.84); p = 0.04) and central nervous system tumours (RR 2.70 (1.00 to 7.26); p = 0.05). Rates were also higher in British Indian children compared to children in India. CONCLUSIONS British Indian children in Leicester had an increased risk of developing cancer compared to White children, largely due to a higher incidence of central nervous system and haematological malignancies.
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Affiliation(s)
- Shameq Sayeed
- Cancer Epidemiology Unit, University of Oxford, Richard Doll Building, Oxford, United Kingdom
| | - Isobel Barnes
- Cancer Epidemiology Unit, University of Oxford, Richard Doll Building, Oxford, United Kingdom
| | - Benjamin J. Cairns
- Cancer Epidemiology Unit, University of Oxford, Richard Doll Building, Oxford, United Kingdom
| | - Alexander Finlayson
- INDOX Cancer Research Network, Cancer Epidemiology Unit, Richard Doll Building, Oxford, United Kingdom
| | - Raghib Ali
- Cancer Epidemiology Unit, University of Oxford, Richard Doll Building, Oxford, United Kingdom
- Faculty of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates
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Jack RH, Konfortion J, Coupland VH, Kocher HM, Berry DP, Allum W, Linklater KM, Møller H. Primary liver cancer incidence and survival in ethnic groups in England, 2001-2007. Cancer Epidemiol 2012. [PMID: 23182222 DOI: 10.1016/j.canep.2012.10.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND The patterns of primary liver cancer incidence and survival are not known for detailed ethnic groups within the UK. METHODS Data on patients resident in England diagnosed with primary liver cancer (ICD-10 C22) between 2001 and 2007 were extracted from the National Cancer Data Repository. Age-standardised incidence rate ratios (IRRs) were calculated for different ethnic groups separately for males and females, using the White ethnic groups as baselines. Overall survival was analysed using Cox regression, adjusting sequentially for age, socioeconomic deprivation and co-morbidity. RESULTS Ethnicity data were available for 75% (13,139/17,458) of primary liver cancer patients. Compared with the White male baseline, Chinese males had the highest IRR. Black African, Bangladeshi, Pakistani and Indian men also had statistically significant high IRRs. Black Caribbean men had a marginally elevated incidence rate compared with White men. In comparison with White women, Pakistani women had the highest IRR. Bangladeshi, Chinese, Black African and Indian women also had high IRRs. As observed in men, Black Caribbean women had an incidence rate closer to that of White women. Pakistani men and women, Black African women and Chinese men had statistically significantly better survival compared with their White counterparts. CONCLUSION The variation found in the incidence of primary liver cancer, could be due to established risk factors such as hepatitis B and C infection being more prevalent among certain ethnic groups. Country of birth, age at migration and length of stay in England are likely to be important factors in this disease, and future research should examine these where possible.
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Affiliation(s)
- Ruth H Jack
- King's College London, Thames Cancer Registry, 1st Floor Capital House, 42 Weston Street, London SE1 3QD, UK.
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Coupland VH, Lagergren J, Konfortion J, Allum W, Mendall MA, Hardwick RH, Linklater KM, Møller H, Jack RH. Ethnicity in relation to incidence of oesophageal and gastric cancer in England. Br J Cancer 2012; 107:1908-14. [PMID: 23059745 PMCID: PMC3504951 DOI: 10.1038/bjc.2012.465] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Revised: 09/04/2012] [Accepted: 09/18/2012] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND This study investigated the variation in incidence of all, and six subgroups of, oesophageal and gastric cancer between ethnic groups. METHODS Data on all oesophageal and gastric cancer patients diagnosed between 2001 and 2007 in England were analysed. Self-assigned ethnicity from the Hospital Episode Statistics dataset was used. Male and female age-standardised incidence rate ratios (IRRs) were calculated for each ethnic group, using White groups as the references. RESULTS Ethnicity information was available for 83% of patients (76 130/92 205). White men had a higher incidence of oesophageal cancer, with IRR for the other ethnic groups ranging from 0.17 95% confidence interval (CI) (0.15-0.20) (Pakistani men) to 0.58 95% CI (0.50-0.67) (Black Caribbean men). Compared with White women, Bangladeshi women (IRR 2.02 (1.24-3.29)) had a higher incidence of oesophageal cancer. For gastric cancer, Black Caribbean men (1.39 (1.22-1.60)) and women (1.57 (1.28-1.92)) had a higher incidence compared with their White counterparts. In the subgroup analysis, White men had a higher incidence of lower oesophageal and gastric cardia cancer compared with the other ethnic groups studied. Bangladeshi women (3.10 (1.60-6.00)) had a higher incidence of upper and middle oesophageal cancer compared with White women. CONCLUSION Substantial ethnic differences in the incidence of oesophageal and gastric cancer were found. Further research into differences in exposures to risk factors between ethnic groups could elucidate why the observed variation in incidence exists.
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Affiliation(s)
- V H Coupland
- King's College London, Thames Cancer Registry, 1st Floor Capital House, 42, Weston Street, London SE1 3QD, UK.
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Hebbar S, Fuggle WJ, Nevill AM, Veitch AM. Colorectal cancer incidence and trend in UK South Asians: a 20-year study. Colorectal Dis 2012; 14:e319-22. [PMID: 22284437 DOI: 10.1111/j.1463-1318.2012.02960.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
AIMS South Asians comprise 13.6% of the Wolverhampton population. We aimed to compare the incidence and trend of colorectal cancer in this subgroup with the non South Asian population over a 20-year period. METHOD Patients of South Asian origin diagnosed with colorectal cancer from 1989 to 2008 were identified from the hospital histopathology database and compared with those of non South Asian origin. 1991 and 2001 census data were used to standardize for differing age and sex distributions in the two study populations. RESULTS The median unadjusted incidence of colorectal cancer from 1989 to 2008 was 6.17 per 100,000 per year in South Asians compared with 71.70 per 100,000 per year in non South Asians (77.79% white British). The age and sex adjusted odds ratio for colorectal cancer in South Asians was 0.2 (P < 0.001). There was an equal increased trend in the incidence in both the South Asians and non South Asians over the study period (0.8% per year). In patients < 50 years, the gender difference in the incidence of cancer was not significant, but as age increased this rose significantly (males > females). CONCLUSION There was a markedly lower incidence of colorectal cancer in South Asians compared with non South Asians, maintained over 20 years. Colorectal cancer incidence increased by a small and similar amount over the period in both groups. There was a male preponderance of colorectal cancer in both populations over 50 years.
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Affiliation(s)
- S Hebbar
- Royal Wolverhampton Hospitals NHS Trust, Wolverhampton, UK
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Iqbal G, Johnson MRD, Szczepura A, Wilson S, Gumber A, Dunn JA. UK ethnicity data collection for healthcare statistics: the South Asian perspective. BMC Public Health 2012; 12:243. [PMID: 22452827 PMCID: PMC3339513 DOI: 10.1186/1471-2458-12-243] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2011] [Accepted: 03/27/2012] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Ethnicity data collection has been proven to be important in health care but despite government initiatives remains incomplete and mostly un-validated in the UK. Accurate self-reported ethnicity data would enable experts to assess inequalities in health and access to services and help to ensure resources are targeted appropriately. The aim of this paper is to explore the reasons for the observed gap in ethnicity data by examining the perceptions and experiences of healthy South Asian volunteers. South Asians are the largest ethnic minority group accounting for 50% of all ethnic minorities in the UK 2001 census. METHODS Five focus groups, conducted by trained facilitators in the native language of each group, recruited 36 South Asian volunteers from local community centres and places of worship. The topic guide focused on five key areas:1) general opinions on the collection of ethnicity, 2) experiences of providing ethnicity information, 3) categories used in practice, 4) opinions of other indicators of ethnicity e.g. language, religion and culture and 5) views on how should this information be collected. The translated transcripts were analysed using a qualitative thematic approach. RESULTS The findings of this Cancer Research UK commissioned study revealed that participants felt that accurate recording of ethnicity data was important in healthcare with several stating the increased prevalence of certain diseases in minority ethnic groups as an appropriate justification to improve this data. The overwhelming majority raised no objections to providing this data when the purpose of data collection is fully explained. CONCLUSIONS This study confirmed that the collection of patients' ethnicity data is deemed important by potential patients but there remains uncertainty and unease as to how the data may be used. A common theme running through the focus groups was the willingness to provide these data, strongly accompanied by a desire to have more information with regard to its use.
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Affiliation(s)
- Gulnaz Iqbal
- Warwick Clinical Trials Unit, Division of Health Sciences, Warwick Medical School, The University of Warwick, Coventry, UK
| | - Mark RD Johnson
- Centre for Evidence in Ethnicity Health and Diversity, University of Warwick, Coventry, UK
- Mary Seacole Research Centre, De Montfort University, Leicester, UK
| | - Ala Szczepura
- Centre for Evidence in Ethnicity Health and Diversity, University of Warwick, Coventry, UK
| | - Sue Wilson
- Primary Care Clinical Sciences, University of Birmingham, Birmingham, UK
| | - Anil Gumber
- Centre for Evidence in Ethnicity Health and Diversity, University of Warwick, Coventry, UK
| | - Janet A Dunn
- Warwick Clinical Trials Unit, Division of Health Sciences, Warwick Medical School, The University of Warwick, Coventry, UK
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Baade PD, Meng X, Sinclair C, Youl P. Estimating the future burden of cancers preventable by better diet and physical activity in Australia. Med J Aust 2012; 196:337-40. [DOI: 10.5694/mja11.11082] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Peter D Baade
- Viertel Centre for Research in Cancer Control, Cancer Council Queensland, Brisbane, QLD
| | - Xingqiong Meng
- Viertel Centre for Research in Cancer Control, Cancer Council Queensland, Brisbane, QLD
| | - Craig Sinclair
- Cancer Prevention Centre, Cancer Council Victoria, Melbourne, VIC
| | - Philippa Youl
- Viertel Centre for Research in Cancer Control, Cancer Council Queensland, Brisbane, QLD
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Bansal N, Bhopal RS, Steiner MFC, Brewster DH. Major ethnic group differences in breast cancer screening uptake in Scotland are not extinguished by adjustment for indices of geographical residence, area deprivation, long-term illness and education. Br J Cancer 2012; 106:1361-6. [PMID: 22415231 PMCID: PMC3326672 DOI: 10.1038/bjc.2012.83] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Background: Breast cancer screening data generally show lower uptake in minority ethnic groups. We investigated whether such variations occur in Scotland. Methods: Using non-disclosive computerised linkage we combined Scottish breast screening and Census 2001 data. Non-attendance at first breast-screening invitation (2002–2008) was compared between 11 ethnic groups using age-adjusted risk ratios (RR) with 95% confidence intervals (CI), multiplied by 100, using Poisson regression. Results: Compared with the White Scottish (RR=100), non-attendance was similar for Other White British (99.5, 95% CI 96.1–103.2) and Chinese (112.8, 95% CI 96.3–132.2) and higher for Pakistani (181.7, 95% CI 164.9–200.2), African (162.2, 95% CI 130.8–201.1), Other South Asian (151.7, 95% CI 118.9–193.7) and Indian (141.7, 95% CI 121.1–165.7) groups. Adjustment for rural vs urban residence, long-term illness, area deprivation and education, associated with risk of non-attendance, increased the RR for non-attendance except for Pakistani women where it was modestly attenuated (RR=164.9, 149.4–182.1). Conclusion: Our data show important inequality in breast cancer screening uptake, not attenuated by potential confounding factors. Ethnic inequalities in breast screening attendance are of concern especially given evidence that the traditionally lower breast cancer rates in South Asian groups are converging towards the risks in the White UK population. Notwithstanding the forthcoming review of breast cancer screening, these data call for urgent action.
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Affiliation(s)
- N Bansal
- Edinburgh Ethnicity Health Research Group, Centre for Population Health Sciences, University of Edinburgh, UK.
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Bhopal RS, Bansal N, Steiner M, Brewster DH. Does the 'Scottish effect' apply to all ethnic groups? All-cancer, lung, colorectal, breast and prostate cancer in the Scottish Health and Ethnicity Linkage Cohort Study. BMJ Open 2012; 2:bmjopen-2012-001957. [PMID: 23012329 PMCID: PMC3467629 DOI: 10.1136/bmjopen-2012-001957] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Although ethnic group variations in cancer exist, no multiethnic, population-based, longitudinal studies are available in Europe. Our objectives were to examine ethnic variation in all-cancer, and lung, colorectal, breast and prostate cancers. DESIGN, SETTING, POPULATION, MEASURES AND ANALYSIS: This retrospective cohort study of 4.65 million people linked the 2001 Scottish Census (providing ethnic group) to cancer databases. With the White Scottish population as reference (value 100), directly age standardised rates and ratios (DASR and DASRR), and risk ratios, by sex and ethnic group with 95% CI were calculated for first cancers. In the results below, 95% CI around the DASRR excludes 100. Eight indicators of socio-economic position were assessed as potential confounders across all groups. RESULTS For all cancers the White Scottish population (100) had the highest DASRRs, Indians the lowest (men 45.9 and women 41.2) and White British (men 87.6 and women 87.3) and other groups were intermediate (eg, Chinese men 57.6). For lung cancer the DASRRs for Pakistani men (45.0), and women (53.5), were low and for any mixed background men high (174.5). For colorectal cancer the DASRRs were lowest in Pakistanis (men 32.9 and women 68.9), White British (men 82.4 and women 83.7), other White (men 77.2 and women 74.9) and Chinese men (42.6). Breast cancer in women was low in Pakistanis (62.2), Chinese (63.0) and White Irish (84.0). Prostate cancer was lowest in Pakistanis (38.7), Indian (62.6) and White Irish (85.4). No socio-economic indicator was a valid confounding variable across ethnic groups. CONCLUSIONS The 'Scottish effect' does not apply across ethnic groups for cancer. The findings have implications for clinical care, prevention and screening, for example, responding appropriately to the known low uptake among South Asian populations of bowel screening might benefit from modelling of cost-effectiveness of screening, given comparatively low cancer rates.
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Affiliation(s)
- Raj S Bhopal
- Edinburgh Ethnicity and Health Research Group, Centre for Population Health Sciences, University of Edinburgh, Edinburgh, UK
| | - Narinder Bansal
- Edinburgh Ethnicity and Health Research Group, Centre for Population Health Sciences, University of Edinburgh, Edinburgh, UK
| | - Markus Steiner
- Edinburgh Ethnicity and Health Research Group, Centre for Population Health Sciences, University of Edinburgh, Edinburgh, UK
- Environmental & Occupational Medicine, Section of Population Health, University of Aberdeen, Aberdeen, UK
| | - David H Brewster
- Edinburgh Ethnicity and Health Research Group, Centre for Population Health Sciences, University of Edinburgh, Edinburgh, UK
- Information Services Division, NHS Scotland National Services, Edinburgh, UK
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Jack RH, Davies EA, Møller H. Lung cancer incidence and survival in different ethnic groups in South East England. Br J Cancer 2011; 105:1049-53. [PMID: 21863024 PMCID: PMC3185928 DOI: 10.1038/bjc.2011.282] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Background: This study aimed to examine the incidence and survival of lung cancer patients from several different ethnic groups in a large ethnically diverse population in the United Kingdom. Methods: Data on residents of South East England diagnosed with lung cancer between 1998 and 2003 were extracted from the Thames Cancer Registry database. Age- and socioeconomic deprivation-standardised incidence rate ratios were calculated for males and females in each ethnic group. Overall survival was examined using Cox regression, adjusted for age, socioeconomic deprivation, stage of disease and treatment. Results are presented for White, Indian, Pakistani, Bangladeshi, Black Caribbean, Black African and Chinese patients, apart from female survival results where only the White, South Asian and Black ethnic groups were analysed. Results: Compared with other ethnic groups of the same sex, Bangladeshi men, White men and White women had the highest incidence rates. Bangladeshi men had consistently higher survival estimates compared with White men (fully adjusted hazard ratio 0.46; P<0.001). Indian (0.84; P=0.048), Black Caribbean (0.87; P=0.47) and Black African (0.68; P=0.007) men also had higher survival estimates. South Asian (0.73; P=0.006) and Black (0.74; P=0.004) women had higher survival than White women. Conclusion: Smoking prevention messages need to be targeted for different ethnic groups to ensure no groups are excluded. The apparent better survival of South Asian and Black patients is surprising, and more detailed follow-up studies are needed to verify these results.
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Affiliation(s)
- R H Jack
- King's College London, Thames Cancer Registry, 1st Floor Capital House, 42 Weston Street, London SE1 3QD, UK.
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Downing A, West RM, Gilthorpe MS, Lawrence G, Forman D. Using routinely collected health data to investigate the association between ethnicity and breast cancer incidence and survival: what is the impact of missing data and multiple ethnicities? ETHNICITY & HEALTH 2011; 16:201-212. [PMID: 21462016 DOI: 10.1080/13557858.2011.561301] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
OBJECTIVES The aims of this study were to: (1) investigate the relationship between ethnicity and breast cancer incidence and survival using cancer registry and Hospital Episode Statistics (HES) data; and (2) assess the impact of missing data and the recording of multiple ethnicities for some patients. DESIGN A total of 48,234 breast cancer patients diagnosed between 1997 and 2003 in two English regions were identified. Ethnicity was missing in 16% of cases. Multiple imputation (10 iterations) of missing ethnicity was undertaken using a range of predictor variables. Multiple ethnicities for a single patient were recorded in 4% of cases. Three methods of assigning ethnicity were used: 'most popular' code, 'last recorded' code, and proportions calculated using all recorded episodes for each patient. Age-standardised incidence rate ratios (IRR) and 5-year survival were calculated before and after imputation for the three methods of assigning ethnicity. RESULTS Breast cancer incidence was lower in the South Asian group (IRR=0.59, 95% confidence interval [CI] 0.51-0.69 compared to the White group). In unadjusted analyses, the South Asian group had consistently higher survival compared with the White group (hazard ratio [HR]=0.81, 95% CI 0.68-0.95). After adjustment for age and stage, there were no survival differences amongst the White, South Asian and Black groups. Survival was higher in the 'Other' ethnic group when using the 'last recorded' method to assign ethnicity (HR=0.62, 95% CI 0.45-0.85 compared with the White group). The results were similar before and after imputation, using all three methods of assigning ethnicity. CONCLUSIONS Breast cancer incidence was lower in the South Asian group than in the White group. After adjusting for casemix there were no consistent survival differences amongst the ethnic groups. Although the impact of missing data and multiple ethnicities was minimal in this study, researchers should always consider these issues, as the results may not be generalisable to other populations and datasets.
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Affiliation(s)
- Amy Downing
- Cancer Epidemiology Group, Centre for Epidemiology & Biostatistics, University of Leeds, Level 6 Bexley Wing, St. James' University Hospital, Leeds, UK.
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Colorectal cancer in India: controversies, enigmas and primary prevention. Indian J Gastroenterol 2011; 30:3-6. [PMID: 21222189 DOI: 10.1007/s12664-010-0076-2] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2010] [Accepted: 12/14/2010] [Indexed: 02/07/2023]
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