Elsevier

European Journal of Cancer

Volume 46, Issue 14, September 2010, Pages 2647-2659
European Journal of Cancer

Cancer risk diversity in non-western migrants to Europe: An overview of the literature

https://doi.org/10.1016/j.ejca.2010.07.050Get rights and content

Abstract

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.

Methods

We included 37 studies published in the English language between 1990 and April 2010 focussing on cancer in adult migrants from non-western countries, living in the industrialised countries of the European Union. Migrants were defined based on their country of birth, ethnicity and name-based approaches. We conducted a between-country comparison of age-adjusted cancer incidence and mortality in immigrant populations with those in autochthonous populations.

Findings

Across the board migrants from non-western countries showed a more favourable all-cancer morbidity and mortality compared with native populations of European host countries, but with considerable site-specific risk diversity: Migrants from non-western countries were more prone to cancers that are related to infections experienced in early life, such as liver, cervical and stomach cancer. In contrast, migrants of non-western origin were less likely to suffer from cancers related to a western lifestyle, e.g. colorectal, breast and prostate cancer.

Discussion

Confirming the great cancer risk diversity in non-western migrants in and between different European countries, this overview reaffirms the importance of exposures experienced during life course (before, during and after migration) for carcinogenesis. Culturally sensitive cancer prevention programmes should focus on individual risk patterns and specific health care needs. Therefore, continuously changing environments and subsequently changing risks in both migrant and autochthonous populations need to be observed carefully in the future.

Section snippets

Background

Studies on cancer risk in migrant populations have recently gained increased recognition, but still have rather heterogeneous study populations and methods applied. However, insights into risk diversity deduced from such studies contribute to our understanding of carcinogenesis and might help answer unclear aetiology questions.

Migration has become an important phenomenon in Western Europe in terms of population changes and the composition of society during the past decades. In 2005, Western and

Inclusion criteria of studies

We included studies focussing mainly or partly on cancer incidence and mortality in adult migrants from non-western countries, living in the industrialised countries of the European Union, published in English between 1990 and April 2010. Studies were identified by searching pubmed and other established scientific databases in combination with the following keywords: cancer + ethnicity/ethnic minority/(im)migrant(s)/foreign(ers)/country of birth. A further inclusion criterion was a comparison of

Findings

Table 2 provides an overview of all findings according to country of study, population of interest and cancer site, expressed in tendencies.

The all-cancer comparison of most studies showed in particular on average a lower cancer risk for first-generation migrants from non-western countries in terms of incidence and mortality, although there were some studies that did not reveal significant differences, sometimes obviously due to small study cohorts. However, male subjects originating from West

Discussion

Our findings suggest that migrants from non-western countries were more likely to develop cancers that are related to infectious diseases, compared with the general population of their industrialised host country. This is especially true for cancers of the oral cavity, nasopharynx, stomach, liver, gallbladder, cervix uteri, prostate and lymphomas. In contrast, almost all studies found lower risks for cancers that are strongly related to a ‘western’ lifestyle (poor diet, physical inactivity,

Conflict of interest statement

None declared.

Acknowledgement

Melina Arnold’s work has partly been funded by EU SANCO (MEHO project: Migrant and Ethnic Minorities Health Observatory; Contract number: 2005122).

References (52)

  • O. Visser et al.

    Cancer risk in first generation migrants in North-Holland/Flevoland, The Netherlands, 1995–2004

    Eur J Cancer

    (2007)
  • World Migration 2008: managing labour mobility in the evolving global economy;...
  • RS. Bhopal
    (2007)
  • J. Spallek et al.

    Health of migrants: deficiencies in the field of prevention

    Med Klin (Munich)

    (2007)
  • A.R. Omran

    The epidemiologic transition. A theory of the epidemiology of population change

    Milbank Mem Fund Q

    (1971)
  • M. Marmot

    Changing places changing risks: the study of migrants

    Public Health Rev

    (1993)
  • O. Razum et al.

    Time travel with Oliver Twist – towards an explanation for a paradoxically low mortality among recent immigrants

    Trop Med Int Health

    (2002)
  • O. Razum et al.

    The healthy migrant effect: role of selection and late entry bias

    Gesundheitswesen

    (2002)
  • H. Zeeb et al.

    Epidemiological perspectives of migration research: the example of cancer

    Psychother Psychosom Med Psychol

    (2008)
  • J. Spallek et al.

    Erklärungsmodelle für die gesundheitliche Situation von Migrantinnen und Migranten

  • K. Stronks et al.

    The utility of ‘country of birth’ for the classification of ethnic groups in health research: the Dutch experience

    Ethn Health

    (2009)
  • K. Hemminki et al.

    Cancer risks in second-generation immigrants to Sweden

    Int J Cancer

    (2002)
  • C. Myrup et al.

    Testicular cancer risk in first- and second-generation immigrants to Denmark

    J Natl Cancer Inst

    (2008)
  • I. Stirbu et al.

    Cancer mortality rates among first and second generation migrants in the Netherlands: convergence toward the rates of the native Dutch population

    Int J Cancer

    (2006)
  • R.M. Barker et al.

    Incidence of cancer in Bradford Asians

    J Epidemiol Community Health

    (1990)
  • R.H. Jack et al.

    Breast cancer incidence, stage, treatment and survival in ethnic groups in South East England

    Br J Cancer

    (2009)
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