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IJE Advance Access originally published online on December 19, 2007
International Journal of Epidemiology 2008 37(1):147-160; doi:10.1093/ije/dym219
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Published by Oxford University Press on behalf of the International Epidemiological Association © The Author 2007; all rights reserved.

Cancer incidence rates among South Asians in four geographic regions: India, Singapore, UK and US

Tanuja Rastogi1, Susan Devesa1, Punam Mangtani2, Aleyamma Mathew3, Nicola Cooper4, Roy Kao5 and Rashmi Sinha1,*

1Division of Cancer Epidemiology & Genetics (DCEG), National Cancer Institute (NCI), NIH, DHHS, Rockville, MD, USA.
2London School of Hygiene and Tropical Medicine, London, UK.
3Regional Cancer Center, Trivandrum, India.
4Office for National Statistics, London, UK.
5Alfred I. duPont Hospital for Children, Wilmington, DE, USA.

* Corresponding author. Division of Cancer Epidemiology and Genetics, National Cancer Institute, 6120 Executive Blvd, Rm 3046, EPS, Rockville, MD 20852, USA. E-mail: sinhar{at}nih.gov


  Abstract

Background: Data are limited regarding cancer incidence among Indians residing in different geographic regions around the world. Examining such rates may provide us with insights into future aetiological research possibilities as well as screening and prevention.

Methods: Incidence rates for all cancers combined and 19 specific cancers were obtained for India from Globocan 2002, for Indians in Singapore from Cancer Incidence in Five Continents (VIII), and from national data sources for South Asians (SA) in the United Kingdom (UK) and for Asian Indians/Pakistanis (AIP) and whites in the United States (US).

Results: We observed the lowest total cancer incidence rates in India (111 and 116 per 100 000 among males and females, respectively, age-standardized to the 1960 world population) and the highest among US whites (362 and 296). Cancer incidence rates among Indians residing outside of India were: intermediate Singapore (102 and 132), UK (173 and 179) and US ranges 152–176 and 142–164. A similar pattern was observed for cancers of the colorectum, prostate, thyroid, pancreas, lung, breast and non-Hodgkin lymphoma. In contrast, rates for cancers of the oral cavity, oesophagus, larynx and cervix uteri were highest in India. Although little geographic variability was apparent for stomach cancer incidence, Indians in Singapore had the highest rates compared with any other region. The UK SA and the US AIP appear with adopt the cancer patterns of their host country.

Conclusion: Variations in environmental exposures such as tobacco use, diet and infection, as well as better health care access and knowledge may explain some of the observed incidence differences.

Keywords Cancer incidence, India, Asian Indians, South Asians, Singapore Indians

Accepted 1 October 2007


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Int. J. Epidemiol., February 1, 2008; 37(1): 160 - 161.
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