White people at much higher risk of most cancers in England, study finds

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Black, Asian and mixed-heritage people are much less likely to develop cancer than white people, in England, an analysis suggests.

But there are exceptions – prostate and blood cancer are two to three times more common in black people.

The Cancer Research UK study said many cancers were preventable.

Higher obesity rates in Black, Asian and mixed-heritage compared with white primary-age children could lead to a rise in cancers in those groups.

Cancer Research UK’s analysis, published in the British Journal of Cancer, is based on three million cancer cases in England from 2013-17.

Overall, compared to the white population, cancer rates were 38% lower in Asian people, 4% lower in black people and 40% lower in mixed-heritage people.

The study shows “there are disparities in cancer rates across different ethnicities”, author Dr Katrina Brown, a Cancer Research UK statistician, said.

The risk of developing cancer is based on many different factors, including someone’s age and the genes they inherit – but about 40% of cases in the UK are preventable and due to lifestyle choices.

And these affected some groups more than others and created inequalities, CRUK chief executive Michelle Mitchell said.

Improve survival

“We already know that the burden of cancer weighs heaviest on the most deprived in the UK,” she said.

“More research is needed to understand the challenges faced by different ethnic groups and how the cancer journey differs for people.”

Equal access to stop-smoking services and advice on how to manage weight, as well as early diagnosis and treatment, was essential to improve survival from the disease, she added.

The analysis found white people in England more than twice as likely to develop skin cancer (melanoma), oesophageal, bladder and lung cancers than Black, Asian or mixed-heritage people.

Skin cancer is more common because white-skinned people are more likely to burn and cause damage to their skin in the sun.

But black people are more likely to develop stomach and liver cancers.

Previous studies suggest there is a genetic explanation for black men being twice as likely to get prostate cancer than white men, and three times as likely to develop blood cancer (myeloma).

Cancer types linked to infections, such as hepatitis, are more common among people belonging to some ethnic minorities and this could be why Asian people are more likely to develop liver cancer.

Asian is defined in the study as people from Bangladeshi, Chinese, Indian, Pakistani, any other Asian background. Black is defined as Caribbean and any other black background and white means white British, white Irish and any other white background.

Other reasons for the variations in cancer rates between ethnic groups include access to:

  • screening
  • vaccines such as that the one against human papillomavirus (HPV), which protects against cervical cancer
  • support to maintain a healthy lifestyle

Lower levels of smoking among most black and Asian groups is one reason they are at lower risk of some lifestyle cancers – such as bowel, breast and lung – than white people, the study suggests.

But the researchers warn this could be changing.

A quarter of white children in the last year of primary school in England were obese in 2020-21, compared with 30% of Asian and 35% of black children.

And these higher proportions, combined with a slower fall in smoking rates, may lead to an increase in cancers in these children when they grow up.

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