The pattern of incidence in South Asians has previously been
less clear. A similar incidence of liver cancer has been found in the
US between a combined Indian and Pakistani group and USWhites
[21], and between British Indians and British Whites in Leicester
[27]. Combining South Asian groups in England, men and women
were found to have incidence rates around twice as a high as their
White counterparts [14]. Due to the poor survival of liver cancer
patients, mortality can be used as a proxy for incidence [4].
Examining liver cancer mortality in England and Wales found
higher standardised mortality ratios for first generation Indian,
Pakistani and Bangladeshi men and women than the general
population [28]. Bangladeshi men and women had the highest
mortality, followed by Pakistani, and then Indian groups.
However, when examining second generation South Asians, these
groups had lower mortality than the England and Wales
population. The difference between first and second generation
populations highlights the possible importance of early life
exposure to factors, such as hepatitis B [6,29]. Differences in
hepatitis B and C infection between ethnic groups have been
found within the UK
 
The pattern of incidence in South Asians has previously been
less clear. A similar incidence of liver cancer has been found in the
US between a combined Indian and Pakistani group and USWhites
[21], and between British Indians and British Whites in Leicester
[27]. Combining South Asian groups in England, men and women
were found to have incidence rates around twice as a high as their
White counterparts [14]. Due to the poor survival of liver cancer
patients, mortality can be used as a proxy for incidence [4].
Examining liver cancer mortality in England and Wales found
higher standardised mortality ratios for first generation Indian,
Pakistani and Bangladeshi men and women than the general
population [28]. Bangladeshi men and women had the highest
mortality, followed by Pakistani, and then Indian groups.
However, when examining second generation South Asians, these
groups had lower mortality than the England and Wales
population. The difference between first and second generation
populations highlights the possible importance of early life
exposure to factors, such as hepatitis B [6,29]. Differences in
hepatitis B and C infection between ethnic groups have been
found within the UK
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