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CMAJ : Canadian Medical Association Journal logoLink to CMAJ : Canadian Medical Association Journal
. 1999 Jul 27;161(2):132–138.

Cardiovascular and cancer mortality among Canadians of European, south Asian and Chinese origin from 1979 to 1993: an analysis of 1.2 million deaths

T Sheth 1, C Nair 1, M Nargundkar 1, S Anand 1, S Yusuf 1
PMCID: PMC1230461  PMID: 10439820

Abstract

BACKGROUND: Cardiovascular disease and cancer are important health problems worldwide, yet our knowledge of these conditions is derived principally from populations of European descent. To investigate ethnic variations in major causes of death in Canada, the authors examined total and cause-specific mortality among European, south Asian, and Chinese Canadians. METHODS: Canadians of European, south Asian and Chinese origin were identified in the Canadian Mortality Database by last name and country of birth and in the population census by self-reported ethnicity. Age-standardized death rates by cause, per 100,000 population, were calculated for ages 35 to 74 years from 1979 to 1993 and in 5-year intervals grouped around census years (1979/83, 1984/88 and 1989/93). RESULTS: Rates of death from ischemic heart disease were highest among Canadians of south Asian origin (men 320.2, women 144.5) and European origin (men 319.6, women 109.9) and were markedly lower among Canadians of Chinese origin (men 107.0, women 40.0); the rates declined significantly in all 3 groups over the study period. Rates of death from cerebrovascular disease were relatively low and showed less ethnic variation (Canadian men of European, south Asian and Chinese origin 49.5, 47.0 and 45.8 respectively; Canadian women of European, south Asian and Chinese origin 34.8, 39.0 and 42.2 respectively) and declined similarly in all groups over time. Rates of death from cancer were highest among Canadians of European origin (men 343.6, women 236.2), intermediate among those of Chinese origin (men 258.1, women 161.6) and lowest among those of south Asian origin (men 122.3, women 131.3). Over time, cancer mortality increased in Canadians of European origin but remained constant or declined in those of south Asian and Chinese origin. INTERPRETATION: Substantial differences exist in rates of death from ischemic heart disease and cancer among European, south Asian and Chinese Canadians.

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Selected References

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  1. Adelstein A. M., Marmot M. G., Bulusu L. Migrant studies in Britain. Br Med Bull. 1984 Oct;40(4):315–319. doi: 10.1093/oxfordjournals.bmb.a071997. [DOI] [PubMed] [Google Scholar]
  2. Armstrong B. The epidemiology of cancer in the Peoples Republic of China. Int J Epidemiol. 1980 Dec;9(4):305–315. doi: 10.1093/ije/9.4.305. [DOI] [PubMed] [Google Scholar]
  3. Balarajan R. Ethnic differences in mortality from ischaemic heart disease and cerebrovascular disease in England and Wales. BMJ. 1991 Mar 9;302(6776):560–564. doi: 10.1136/bmj.302.6776.560. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Chen Z., Peto R., Collins R., MacMahon S., Lu J., Li W. Serum cholesterol concentration and coronary heart disease in population with low cholesterol concentrations. BMJ. 1991 Aug 3;303(6797):276–282. doi: 10.1136/bmj.303.6797.276. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Disler P. B., Epstein L., Buchanan-Lee B., Rip M. R., Derry C. W., Whittaker S., Taylor S. P., Sayed A. R., Bourne D. E., Klopper J. M. Variations in mortality of the coloured, white and Asian population groups in the RSA, 1978-1982. Part II. Cerebrovascular disease. S Afr Med J. 1987 Sep 19;72(6):408–411. [PubMed] [Google Scholar]
  6. Frerichs R. R., Chapman J. M., Maes E. F. Mortality due to all causes and to cardiovascular diseases among seven race-ethnic populations in Los Angeles County, 1980. Int J Epidemiol. 1984 Sep;13(3):291–298. doi: 10.1093/ije/13.3.291. [DOI] [PubMed] [Google Scholar]
  7. Hu H. H., Sheng W. Y., Chu F. L., Lan C. F., Chiang B. N. Incidence of stroke in Taiwan. Stroke. 1992 Sep;23(9):1237–1241. doi: 10.1161/01.str.23.9.1237. [DOI] [PubMed] [Google Scholar]
  8. Lam T. H., Kung I. T., Wong C. M., Lam W. K., Kleevens J. W., Saw D., Hsu C., Seneviratne S., Lam S. Y., Lo K. K. Smoking, passive smoking and histological types in lung cancer in Hong Kong Chinese women. Br J Cancer. 1987 Nov;56(5):673–678. doi: 10.1038/bjc.1987.264. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Marmot M. G., Adelstein A. M., Bulusu L. Lessons from the study of immigrant mortality. Lancet. 1984 Jun 30;1(8392):1455–1457. doi: 10.1016/s0140-6736(84)91943-3. [DOI] [PubMed] [Google Scholar]
  10. Mather H. M., Keen H. The Southall Diabetes Survey: prevalence of known diabetes in Asians and Europeans. Br Med J (Clin Res Ed) 1985 Oct 19;291(6502):1081–1084. doi: 10.1136/bmj.291.6502.1081. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. McKeigue P. M., Adelstein A. M., Marmot M. G., Henly P. J., Owen R. W., Hill M. J., Thompson M. H. Diet and fecal steroid profile in a South Asian population with a low colon-cancer rate. Am J Clin Nutr. 1989 Jul;50(1):151–154. doi: 10.1093/ajcn/50.1.151. [DOI] [PubMed] [Google Scholar]
  12. McKeigue P. M., Marmot M. G., Adelstein A. M., Hunt S. P., Shipley M. J., Butler S. M., Riemersma R. A., Turner P. R. Diet and risk factors for coronary heart disease in Asians in northwest London. Lancet. 1985 Nov 16;2(8464):1086–1090. doi: 10.1016/s0140-6736(85)90684-1. [DOI] [PubMed] [Google Scholar]
  13. McKeigue P. M., Shah B., Marmot M. G. Relation of central obesity and insulin resistance with high diabetes prevalence and cardiovascular risk in South Asians. Lancet. 1991 Feb 16;337(8738):382–386. doi: 10.1016/0140-6736(91)91164-p. [DOI] [PubMed] [Google Scholar]
  14. Millar W. J. Place of birth and ethnic status: factors associated with smoking prevalence among Canadians. Health Rep. 1992;4(1):7–24. [PubMed] [Google Scholar]
  15. Miller G. J., Kotecha S., Wilkinson W. H., Wilkes H., Stirling Y., Sanders T. A., Broadhurst A., Allison J., Meade T. W. Dietary and other characteristics relevant for coronary heart disease in men of Indian, West Indian and European descent in London. Atherosclerosis. 1988 Mar;70(1-2):63–72. doi: 10.1016/0021-9150(88)90100-1. [DOI] [PubMed] [Google Scholar]
  16. Mumford J. L., He X. Z., Chapman R. S., Cao S. R., Harris D. B., Li X. M., Xian Y. L., Jiang W. Z., Xu C. W., Chuang J. C. Lung cancer and indoor air pollution in Xuan Wei, China. Science. 1987 Jan 9;235(4785):217–220. doi: 10.1126/science.3798109. [DOI] [PubMed] [Google Scholar]
  17. Murray C. J., Lopez A. D. Mortality by cause for eight regions of the world: Global Burden of Disease Study. Lancet. 1997 May 3;349(9061):1269–1276. doi: 10.1016/S0140-6736(96)07493-4. [DOI] [PubMed] [Google Scholar]
  18. Pais P., Pogue J., Gerstein H., Zachariah E., Savitha D., Jayprakash S., Nayak P. R., Yusuf S. Risk factors for acute myocardial infarction in Indians: a case-control study. Lancet. 1996 Aug 10;348(9024):358–363. doi: 10.1016/s0140-6736(96)02507-x. [DOI] [PubMed] [Google Scholar]
  19. Steinberg W. J., Balfe D. L., Küstner H. G. Decline in the ischaemic heart disease mortality rates of South Africans, 1968-1985. S Afr Med J. 1988 Dec 3;74(11):547–550. [PubMed] [Google Scholar]
  20. Tao S. C., Huang Z. D., Wu X. G., Zhou B. F., Xiao Z. K., Hao J. S., Li Y. H., Cen R. C., Rao X. X. CHD and its risk factors in the People's Republic of China. Int J Epidemiol. 1989;18(3 Suppl 1):S159–S163. [PubMed] [Google Scholar]
  21. Willett W. C., Stampfer M. J., Colditz G. A., Rosner B. A., Speizer F. E. Relation of meat, fat, and fiber intake to the risk of colon cancer in a prospective study among women. N Engl J Med. 1990 Dec 13;323(24):1664–1672. doi: 10.1056/NEJM199012133232404. [DOI] [PubMed] [Google Scholar]
  22. Yu T. S., Wong S. L., Lloyd O. L., Wong T. W. Ischaemic heart disease: trends in mortality in Hong Kong, 1970-89. J Epidemiol Community Health. 1995 Feb;49(1):16–21. doi: 10.1136/jech.49.1.16. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Zhou B., Rao X., Dennis B. H., Li Y., Zhuo Q., Folsom A. R., Yang J., Li Y., Stamler J., Cao T. The relationship between dietary factors and serum lipids in Chinese urban and rural populations of Beijing and Guangzhou. PRC-USA Cardiovascular and Cardiopulmonary Research Group. Int J Epidemiol. 1995 Jun;24(3):528–534. doi: 10.1093/ije/24.3.528. [DOI] [PubMed] [Google Scholar]
  24. Zimmet P., Taylor R., Ram P., King H., Sloman G., Raper L. R., Hunt D. Prevalence of diabetes and impaired glucose tolerance in the biracial (Melanesian and Indian) population of Fiji: a rural-urban comparison. Am J Epidemiol. 1983 Nov;118(5):673–688. doi: 10.1093/oxfordjournals.aje.a113678. [DOI] [PubMed] [Google Scholar]

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