Incidence of prostate and urological cancers in England by ethnic group, 2001-2007: a descriptive study.
BACKGROUND
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.


METHODS
We 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.


RESULTS
There 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).


CONCLUSIONS
The 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.
Green Templeton College, University of Oxford, Oxford, OX2 6HG, UK. m.maruthappu@gmail.com.
Mahiben
M
Maruthappu
Cancer Epidemiology Unit, University of Oxford, Richard Doll Building, Roosevelt Drive, Oxford, OX3 7LF, UK. Isobel.Barnes@ceu.ox.ac.uk.
Isobel
I
Barnes
Cancer Epidemiology Unit, University of Oxford, Richard Doll Building, Roosevelt Drive, Oxford, OX3 7LF, UK. Shameq.sayeed@ceu.ox.ac.uk.
Shameq
S
Sayeed
Cancer Epidemiology Unit, University of Oxford, Richard Doll Building, Roosevelt Drive, Oxford, OX3 7LF, UK. raghib.ali@ndm.ox.ac.uk.|New York University Abu Dhabi, Abu Dhabi, PO Box 129188, United Arab Emirates. raghib.ali@ndm.ox.ac.uk.
Raghib
R
Ali
D004739:England / Q000453:epidemiology; D005006:Ethnicity; D005260:Female; D049674:History, 21st Century; D006801:Humans; D015994:Incidence; D008297:Male; D016017:Odds Ratio; D011471:Prostatic Neoplasms / Q000453:epidemiology* / Q000266:history; D012042:Registries; D012307:Risk Factors; D012959:Socioeconomic Factors; D014571:Urologic Neoplasms / Q000453:epidemiology* / Q000266:history