Dear all,

I hope it's not too late to wish everyone a Happy New Year one more time!

This blockbuster of a review article from the USA, which came out just 3 days ago, will be of interest to anyone who is interested in ethnic discrepancies in cancer incidence, prevention and treatment.

http://onlinelibrary.wiley.com/doi/10.3322/caac.21208/pdf

The analysis of ethnic differences is somewhat crude, but still fascinating. There's probably not much here that the specialists amongst us won't know already, but seeing it all summarised (p. 17 onwards) is quite impressive! Some quotes:
  • Black men have the highest cancer incidence and death rates – about double those of Asian Americans, who have the lowest rates.
  • Blacks are less likely than whites to be diagnosed with cancer at a localized stage, when treatment is more successful. 
  • Even among Medicare-insured patients, blacks are less likely than whites to receive standard cancer therapies for lung, breast, colorectal, and prostate cancers.
  • Cancers associated with infectious agents (e.g. those of the uterine cervix, stomach, and liver) are generally more common in non-white populations.
Some good news, however:
  • Cancer incidence and death rates are lower among Asian Americans/Pacific Islanders, American Indians/Alaska Natives, and Hispanics than whites for all cancer sites combined and for the 4 most common cancer sites. 
  • Among men, incidence rates declined between 1.6% and 2.0% per year for all groups except American Indians/Alaska Natives. Declines in death rates among men were of a similar magnitude, and were highest among blacks (2.5% per year).
  • As in men, black women had the largest annual decline in cancer death rates (1.7%).
Quite apart from these ethnic differences, the staggering wave of deaths from lung cancer in the 20th century (and the recent decline) is perhaps the most striking feature of Fig. 6. The WHO estimates that tobacco caused 100 million deaths in the 20th century, which puts it in the same league as war (?150-250 million).

It would be interesting to know how this report compares with data available in Europe. Of course direct comparisons are not possible because the ethnic categories people use over here - if they use them at all - are different. A good thing too, some would say!

Best wishes,
David