Abstract
BackgroundThe aetiology of urological cancers is poorly understood and variations in incidence by ethnic group may provide insights into the relative importance of genetic and environmental risk factors. Our objective was to compare the incidence of four urological cancers (kidney, bladder, prostate and testicular) among six ‘non-White’ ethnic groups in England (Indian, Pakistani, Bangladeshi, Black African, Black Caribbean and Chinese) to each other and to Whites.MethodsWe obtained Information on ethnicity for all urological cancer registrations from 2001 to 2007 (n = 329,524) by linkage to the Hospital Episodes Statistics database. We calculated incidence rate ratios adjusted for age, sex and income, comparing the six ethnic groups (and combined ‘South Asian’ and ‘Black’ groups) to Whites and to each other.ResultsThere were significant differences in the incidence of all four cancers between the ethnic groups (all p < 0.001). In general, ‘non-White’ groups had a lower incidence of urological cancers compared to Whites, except prostate cancer, which displayed a higher incidence in Blacks. (IRR 2.55) There was strong evidence of differences in risk between Indians, Pakistanis and Bangladeshis for kidney, bladder and prostate cancer (p < 0.001), and between Black Africans and Black Caribbeans for all four cancers (p < 0.001).ConclusionsThe risk of urological cancers in England varies greatly by ethnicity, including within groups that have traditionally been analysed together (South Asians and Blacks). In general, these differences are not readily explained by known risk factors, although the very high incidence of prostate cancer in both black Africans and Caribbeans suggests increased genetic susceptibility. g.Electronic supplementary materialThe online version of this article (doi:10.1186/s12885-015-1771-2) contains supplementary material, which is available to authorized users.
Highlights
The aetiology of urological cancers is poorly understood and variations in incidence by ethnic group may provide insights into the relative importance of genetic and environmental risk factors
Data collection Data were obtained from the National Cancer Intelligence Network (NCIN) for all cancer registrations from January 2001 to December 2007 in England: cancer site coded to the International Classifications of Diseases, 10th Revision (ICD-10) [17]; morphology coded to the International Classifications of Diseases of Oncology, 2nd and 3rd Revisions (ICD-O-2 and ICD-O-3) [18, 19]; deprivation assessed from the income domain of the Index of Multiple Deprivation 2007 (IMD 2007) [20]; age at diagnosis of cancer; sex and ethnicity
There is significant heterogeneity between ethnic groups (p < 0.001), with a lower incidence for all ethnic groups compared to Whites, for all cancers except prostate cancer, where Blacks had by far the highest incidence
Summary
The aetiology of urological cancers is poorly understood and variations in incidence by ethnic group may provide insights into the relative importance of genetic and environmental risk factors. Our objective was to compare the incidence of four urological cancers (kidney, bladder, prostate and testicular) among six ‘non-White’ ethnic groups in England (Indian, Pakistani, Bangladeshi, Black African, Black Caribbean and Chinese) to each other and to Whites. There is significant international variation in incidence and the aetiology of urological cancers remains poorly understood. British (South) Asians - Indians, Pakistanis and Bangladeshis—form the largest group of about 6 %, and British Blacks - Black Africans (mainly from Nigeria, South Africa, Ghana and Somalia) and Black Caribbeans (predominantly from Jamaica)—are second at about 3 %, with Chinese (mainly from Hong Kong) about 1 % [3]. Studies have shown South Asians in the U.S to have lower rates of kidney, bladder, prostate
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