Printed In Great Britain Cancer Mortality in Migrant Populations within Italy (original) (raw)
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Background: Migrant studies offer a unique opportunity to analyze variation in disease occurrence due to background factors. The role of environmental and lifestyle exposures are of particular interest in cancer research, and migrant studies can be considered as "natural experiments" in epidemiological research. Large numbers of immigrants from different regions of the world and the availability of comprehensive demographic and health-related registers in Sweden have prompted us to conduct migrant studies on the epidemiology of cancer. Breast cancer and genital tract cancers were selected for study since the role of environmental and lifestyle risk factors are debated for these disorders. Objectives: To compare the risk and survival of the female breast, cervical, ovarian and endometrial cancers and male prostate and testicular cancers among immigrants to those among Swedish-born individuals to elucidate the importance and the potential timing of environmental and genetic factors in cancer etiology. Methods: We established different cohorts by linkages between Swedish national registers, including Cancer and Cause of Death registers, through personal identity number. The main exposure variable was country of birth with Swedish-born persons with both parents born in Sweden as reference group. Each cohort was followed from start date of follow-up period, date of birth or first immigration date, whichever occurred last, until exit date from the cohort, which was diagnosis of primary outcomes of interest, first emigration, or end of follow-up, whichever came first. We calculated incidence rate ratios and hazard ratios with 95% confidence intervals adjusted for age and calendar period of follow-up using Poisson and Cox proportional hazards regression models. Results: First-generation immigrants in Sweden had an overall lower risk of cancers studied compared with Swedish-born people. However, we found remarkable variations in cancer risks and survival by country of birth. Age at immigration and duration of residence of first-generation immigrants were important factors affecting risk of cervical, breast, prostate, and testis seminomas. An increasing trend in incidence of prostate cancer among first-generation immigrants similar to either Sweden or country of birth was observed. Secondgeneration immigrants showed a risk converging toward the risk in Sweden for testicular and breast cancers. Education, as an indicator of socio-economic position, differentially affected the risk of cervical cancer among first-generation immigrants and Swedish-born women. Among both immigrants and Swedish-born women, breast cancer risk increased, while its mortality decreased with increasing level of education. Conclusions: Country of birth was a major determinant for cancer risk. Variation of risk by age at immigration or duration of residence highlights the effect of environmental and lifestyle factors on cancer risk. The observed patterns of prostate cancer risk imply the importance of both genetic and environmental factors in the etiology of this cancer. Patterns of testicular cancer risk indicate the importance of early environmental risk factors acting even after the intrauterine period.
European Journal of Cancer, 1995
This study analyses the relationship between migration and mortality for lung and stomach cancer, these diseases being those considered susceptible to changes in environmental conditions and individual habits that usually follow migration. Mortality rate of the province of bii was used as the index of risk related to migration. Data were analysed using the Poisson regression model for grouped data. Results indicate that migration determines modifications in the mortality rates of the migrant populations for the diseases under study. For lung cancer, the analysis showed a greater risk for migrants originating from areas with high rates and that migrants had a reduced risk in comparison with natives of Genoa. With regard to stomach cancer, the study revealed that migrants originating from high risk areas had higher relative risks than the Genoa natives, even if these were lower than expected when compared to the risks of the populations in the regions from which the migrants originated.
Cancer Causes and Control, 1991
Migration of Italians to other parts of the world has a long history and has involved very large numbers of individuals. The study of the health consequences of this migration is made possible by the availability of statistics on mortality and morbidity, both in Italy and in the host countries, and of social and economic information on the various Italian communities abroad. The results of the major studies are reviewed, comparing the rates in immigrants with those in the host countries and in Italy. The differences in cancer rates between Italian and local-born populations-for stomach cancer in both sexes, and for cancer of the colon, lung, and breast in females, and for prostate cancer-are consistent with the direction of differences between rates in Italy and those in the host countries. For colon and rectum cancer in males, there are unexpected findings in most of the United States' studies. Analysis by duration of residence shows changes in the risk for several sites in males, hut not in females, according to length of stay in the host country. This finding possibly reflects greater stability of habits and lifestyle in females compared to males.
Cancer Incidence in Turin: The Effect of Migration
Tumori Journal, 1993
Aims and Background Studies on migrant populations have been of great value in clarifying the role of environmental factors in cancer occurrence. Most of them consider migrants from other countries or continents. Turin, the target territory of this study, was an important area of Internal migration initially from the East, and more recently from southern Italy. Methods The study compared incidence rates (age-standardized) of the native population, of the migrants and incidence rates of the Cancer Registries located in the four main areas of origin. Results Overall incidence rates in migrants from southern Italy were intermediate compared with those of the stable populations of the South and the North. The same effect was not true for people from the North-East, who migrated in earlier decades. In this population, migration towards lower-incidence areas did not reduce cancer incidence. Migrants from the South showed a significant increase in intestinal, breast, and tobacco-related tu...
Diverging breast and stomach cancer incidence and survival in migrants in The Netherlands, 1996–2009
Acta Oncologica, 2013
Background. Migrant populations usually experience a health transition with respect to their cancer risk as a result from environmental changes and acculturation processes. We investigated potentially contrasting experiences with breast and stomach cancer risk and survival in migrants to the Netherlands in a retrospective cohort study. Methods . Invasive breast (n ϭ 96 126) and stomach cancer cases (n ϭ 24 496) diagnosed 1996 -2009 were selected from the population-based Netherlands Cancer Registry. Standardized Incidence Ratios (SIRs) were computed as the ratio of observed and expected cancers. Differences in survival were expressed as relative excess risk of mortality (RER). Results . Women from Morocco, Suriname and Turkey exhibited a signifi cantly lower risk for breast cancer than native Dutch women (SIR range 0.5 -0.9). Relative excess mortality was signifi cantly increased in Surinamese (RER ϭ 1.2, 95% CI 1.0 -1.5) patients. The incidence of non-cardia stomach cancer was signifi cantly elevated in all migrants, except in Indonesians, being highest in Turkish males (SIR ϭ 2.2, 1.9 -2.6). Cardia stomach cancer appeared to be less frequent in all migrants, being lowest in Surinamese males (SIR ϭ 0.3, 0.2 -0.5). Relative excess mortality was signifi cantly lower in patients from the Antilles (RER ϭ 0.7, 0.5 -1.0), Suriname (0.8, 0.6 -0.9) and Turkey (0.7, 0.6 -0.9). Conclusion . The lower incidence rates of breast and cardia stomach cancer in migrants as well as their higher non-cardia stomach cancer rates refl ect most likely early life exposures including pregnancy and/or dietary patterns during life-course. While higher relative excess mortality from breast cancer in migrant women might point toward inadequate access and treatment in this group, lower excess mortality from (especially non-cardia) stomach cancer remains to be explained.
Cancer risk diversity in non-western migrants to Europe: An overview of the literature
European Journal of Cancer, 2010
Background: Cancer risk varies geographically and across ethnic groups that can be monitored in cancer control to respond to observed trends as well as ensure appropriate health care. The study of cancer risk in immigrant populations has great potential to contribute new insights into aetiology, diagnosis and treatment of cancer. Disparities in cancer risk patterns between immigrant and autochthonous populations have been reported many times, but up to now studies have been heterogeneous and may be discordant in their findings. The aim of this overview was to compile and compare studies on cancer occurrence in migrant populations from non-western countries residing in Western Europe in order to reflect current knowledge in this field and to appeal for further research and culturally sensitive prevention strategies.
Cancer Mortality in Italian Migrants to Canada
Tumori Journal, 1994
The present study reports on the analysis of cancer mortality in Italian first-generation migrants resident in Canada, deceased in the period between 1964-1985 (5,801 males: 3,267 females). Mortality in migrants is compared to that of the host population as well as to that in the migrants’ country of origin. This is carried out both on a national level (Italy), and on a regional level with those regions that have made the greatest contribution to the Italian migratory flow (Southern Italy). Compared with the Canada-born population, significantly higher risks were evident for nasopharynx, stomach, liver and gallbladder tumors in migrants. Lower risks were observed for the oral cavity, esophagus, colon, rectum, pancreas (females), larynx, lung, melanoma, breast, ovary, prostate, bladder (females), and non-Hodgkin's lymphoma in migrants. This is consistent with that evidenced in the comparison between Italy and Canada. The data are discussed in relation to the results of other stud...