New analysis pinpoints ethnic differences in cancer incidence in England

BMJ 2009; 338 doi: (Published 25 June 2009) Cite this as: BMJ 2009;338:b2572
  1. Caroline White
  1. 1London

    Black and Asian people in England are significantly less likely to develop cancer overall than white people, finds the first comprehensive national analysis of cancer incidence by ethnicity.

    But Black and Asian people are particularly vulnerable to certain cancers, such as those of the stomach and prostate, and in some cases are likely to have poorer survival than their white counterparts, the findings show.

    The analysis is published by the National Cancer Intelligence Network in collaboration with the charity Cancer Research UK and brings together data on all new cases of cancer diagnosed in England between 2002 and 2006.

    The network was set up in 2008 to coordinate the collection of comparative national statistics on cancer, after a recommendation in the government’s Cancer Reform Strategy.

    The findings show that black people (defined as African, Caribbean, black British, and other African ancestry) and Asians (defined as Indian, Pakistani, Bangladeshi, or other Asian ethnicities) were about 40% less likely to develop cancer overall than white people.

    But the incidence of certain types of cancer was significantly higher. Rates of liver cancer among Asians were between 1.5 and three times those among white people, and the incidence of mouth and cervical cancers (ratios between 1.1 and 2.7) were significantly higher among Asian women aged 65 years and above.

    Survival rates for breast cancer among Asian women aged 15 to 64 were significantly lower at three years than they were for white women, although Asian women were significantly less likely to be diagnosed with the disease.

    Rates of stomach cancer were significantly higher among black than among white people (ratios between 1.1 and 2.5), and black men were about three times more likely to be diagnosed with prostate cancer.

    Black people were also three times more likely to develop multiple myeloma and had higher rates of liver cancer than white people, and black women aged over 65 were at greater risk of cervical cancer.

    The survival rates for black women aged 15 to 64 were also significantly lower at both one and three years after diagnosis of breast cancer than the rates for white women.

    “We don’t know why these differences exist,” commented Professor David Forman, information lead for the network. “The reasons could mainly be genetic, but we think that lifestyle factors could have a role to play.”

    The ethnicity of about a fifth of cancer patients was unknown, although ethnicity monitoring improved from 87% in 2002 to 92% in 2006.

    In her foreword to the report, Joanne Rule, who co-chairs the National Cancer Equalities Initiative, notes that “there are almost 10% of patients in the hospital system for whom no ethnicity information is recorded. NHS trusts need to strive toward even better collection of ethnicity data to allow more concise analyses.”

    Dr Lesley Walker, director of cancer information at Cancer Research UK, described the report as a “hugely important step forward.”

    “The next step is to think about how we can target health messages appropriately—making sure different communities are aware of the signs and symptoms of the cancers that are more likely to affect them,” she said.


    Cite this as: BMJ 2009;338:b2572


    • The report, Cancer Incidence and Survival by Major Ethnic Group, England 2002-2006 can be seen at

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