South Asians, comprising 4% of the UK population, exhibit unique cancer patterns and survival rates. While common cancers like breast, prostate, lung, and colorectal show lower incidence rates among South Asians, recent trends indicate alignment with the general population. Despite residing in economically disadvantaged areas, South Asians demonstrate higher survival rates for breast and cervical cancers. However, survival rates for breast and prostate cancers have declined in recent years, while lung and liver cancer survival remains higher. Excess cancer mortality rates among South Asians follow a typical pattern, with higher hazards observed shortly after diagnosis, particularly among older patients and those diagnosed with specific cancers like NHL, lung, liver, and ovarian cancers. These trends underscore the importance of tailored interventions to address cancer disparities within this demographic group.

Regrettably, the lifestyle commonly adopted by South Asians encompasses many dietary and behavioral habits linked to heightened cancer risk. Both the World Cancer Research Fund (WCRF) and the American Institute for Cancer Research (AICR) advocate ten steps to mitigate cancer risk, a regimen equally pertinent for cancer survivors. Concurrently, quitting tobacco use remains imperative for those currently engaged in it.

Immigrant vs. Native South Asians

Studies reveal that South Asians residing in California exhibit higher cancer rates across most types, excluding cervical and head and neck cancers, compared to their counterparts in their home countries. Moreover, a discernible divergence in cancer patterns exists between native South Asians and those domiciled in California. For instance, while prostate, colon, and lung cancers dominate among South Asian men in California, head, neck, and stomach cancers prevail among their counterparts in India. Similarly, prevalent cancers among South Asian women in California differ from those in their native countries, highlighting the impact of environmental shifts, dietary alterations, and screening disparities.

Routine Cancer Screening

Routine cancer screening remains neglected by many South Asians, attributed to various factors including apprehensions about medical procedures, communication barriers, and a cultural inclination to seek medical attention solely in response to symptomatic presentations. Additionally, cultural perceptions surrounding pap smears among young females and familial responsibilities among older females deter regular screenings.

Oral, Throat, and Esophageal Cancers

High rates of tobacco consumption, encompassing practices such as bidi smoking, paan chewing, and areca nut consumption, contribute to elevated incidences of oral, throat, and esophageal cancers among native South Asians. Symptoms, including persistent mouth sores, abnormal patches in the mouth, and difficulty in swallowing, necessitate prompt medical attention. Esophageal cancer, further associated with alcohol use and acid reflux, manifests through symptoms like swallowing difficulties and unexplained weight loss.

Lowering Cancer Risk through Lifestyle Changes

The conventional South Asian lifestyle often encompasses dietary and behavioral patterns linked to heightened cancer risk. Adhering to the WCRF and AICR's ten-step guideline for cancer risk reduction, alongside tobacco cessation, represents pivotal measures for mitigating cancer risk and fostering overall well-being among South Asian communities.

Exploring Cancer Risks for South Asians Globally:

This study investigates the occurrence of cancer among South Asians residing in four different locations: India, Singapore, the United Kingdom, and the United States. The researchers gathered data from different sources:

India: National estimates were drawn from a global database (GLOBOCAN) and further adjusted to reflect regional and urban/rural variations based on data from nine population-based cancer registries within the country.

Singapore: Information was obtained from a comprehensive cancer registry covering the local population, including a significant South Asian subgroup.

United Kingdom: Since ethnicity isn't always accurately recorded, a specialized algorithm using South Asian names was employed to identify relevant cancer cases within national registries. Population data came from the national census.

United States: Data was collected from both national and state-level cancer registries, focusing on individuals who self-identified as being of Indian or Pakistani origin. Population estimates were derived from the national census, considering both single and multi-ethnic identifications.

India has the lowest total cancer incidence rates, with 111 per 100,000 among males and 116 among females. In contrast, US whites exhibit the highest rates, with 362 and 296 per 100,000 among males and females, respectively. Among Indians outside of India, cancer incidence rates are intermediate, ranging from 102 to 176 for males and 132 to 179 for females. Singapore and the UK fall in the mid-range, while the US ranges between 152-176 for males and 142-164 for females. Similar patterns are observed for colorectal, prostate, thyroid, pancreatic, lung, breast, and non-Hodgkin lymphoma cancers. However, rates for oral cavity, esophageal, laryngeal, and cervical cancers are highest in India. Stomach cancer incidence shows little geographic variability, though Indians in Singapore have the highest rates compared to other regions. The cancer patterns of Indian populations residing in the UK and the US appear to adopt those of their host countries.

Management of Cancer :

Across Southeast Asia, a staggering 2.3 million people are diagnosed with cancer annually, with 1.4 million tragically succumbing to the disease. Lung, breast, and cervical cancers alone claim over 400,000 lives each year. Delayed diagnoses and limited access to treatment contribute to these high mortality rates.

Fighting for Children's Futures:

Recognizing the need for urgent action, the Global Initiative for Childhood Cancer aims to empower countries in the region to offer high-quality care for children battling cancer. By prioritizing childhood cancer at national, regional, and global levels, they hope to spark change and save lives.

One initiative, the South-East Asia Regional Childhood Cancer Network (SEAR-CCN), fosters collaboration and knowledge sharing among healthcare institutions, promoting evidence-based best practices. Additionally, region-specific programs address urgent needs within individual countries.

Women's Health in Focus:

Breast cancer stands as the most prevalent cancer and the leading cause of cancer death among women in Southeast Asia, mirroring a global trend. The World Health Organization's Global Breast Cancer Initiative (GBCI), launched in 2021, unites stakeholders worldwide to tackle this challenge. Their shared goal: significantly reduce breast cancer mortality.

Combating Cervical Cancer:

Cervical cancer ranks second among female cancers in the region. To address this public health concern, the World Health Assembly adopted a Global Strategy in 2020, urging countries to achieve specific goals by 2030 for its elimination. Southeast Asia has developed an implementation framework aligned with this strategy.

Pakistan, India, Sri Lanka, Bangladesh, Nepal, and Bhutan, collectively comprising over 1,500 million people, form the South Asian subcontinent. Despite diverse cultures, there are notable similarities in chronic disease patterns, including cancer prevalence. Oral and lung cancer rank at the top for males in most areas, except for Quetta, Larkana, and Chennai. Pharyngeal and/or laryngeal cancers are also prevalent, with prostate cancer emerging in more developed cities. Breast and cervical cancers typically lead, except in Muslim-majority Pakistan where oral cancer follows breast cancer. Ovarian cancer often ranks among the top five. Rising breast cancer rates and shifting distributions of other cancers indicate a growing burden, particularly with increasing obesity and aging populations. Coordinated efforts within South Asia are crucial for effective cancer control in the region.

While the current statistics paint a concerning picture, initiatives like these offer hope for a brighter future. By prioritizing access to quality care, fostering collaboration, and implementing targeted strategies, we can move towards a Southeast Asia where cancer no longer claims millions of lives each year.