Cancer Incidence and Mortality in Pakistanis, Bangladeshis and Their Descendants in England and Wales

Joseph Harrison , Univeristy of St Andrews
Frank Sullivan, University of St Andrews
Katherine Keenan, University of St Andrews
Hill Kulu, University of St Andrews

The migrant mortality advantage is a widely observed phenomenon, thought to occur due to positive selection of migrants and better health behaviours. This paper seeks to further understand health differentials between Pakistani and Bangladeshi immigrants, their descendants, and the native population in England and Wales. We focus on cancer as one of the leading causes of morbidity and mortality in developed countries. We apply survival analysis to the Office for National Statistics Longitudinal Study of England and Wales, to compare hazard ratios of cancer incidence between these groups. Moreover, we observe the ten-year period after diagnosis to identify differences in mortality following onset of cancer. We control for socioeconomic characteristics that have previously been found to influence health and mortality. Results show that the risk of cancer onset is substantially lower for Pakistani and Bangladeshi born immigrants. This advantage is also seen in British born descendants. However, following incidence of cancer there is no significant difference in mortality between these groups, for descendants this risk may even be elevated. We conclude that lower incidence of cancer and not better survival once diagnosed is the driver of the low cancer mortality observed in Pakistanis and Bangladeshis in England and Wales. We should investigate further how protective behaviours prevent the onset of cancer but fail to improve survivability. The use of detailed administrative data to investigate both incidence and onset of cancer simultaneously is a novel contribution and sheds light on the migrant mortality advantage and immigrant health, particularly around cancer.

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 Presented in Session 30. Migrant Health