Breast cancer risk among first-generation migrants in the Netherlands

Visser, Otto; Kooy, K. van der; Peppen, A M van; Öry, Ferko; Leeuwen, Flora E. van

doi:10.1038/sj.bjc.6601821

Cited by 26 publications

(26 citation statements)

References 6 publications

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“…This demonstrates the importance of using a regional or national correction factor for self-selection, where possible. Factors which could be associated with lower breast cancer risk factors in unscreened women in Limburg are unclear, but could for example be due to a lower number of relatives with a history of breast cancer, to differences in socio-economic status, to ethnicity, or to screening outside the screening program in unscreened women [13,14,[21][22][23][24]. Further research should explore the background of the lower baseline risk for breast cancer death in unscreened women in the IKL-region.…”

Section: Number Of Case-referent Setsmentioning

confidence: 89%

A remarkable reduction of breast cancer deaths in screened versus unscreened women: a case-referent study

Paap

Holland

Heeten

et al. 2010

Cancer Causes Control

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Section: Number Of Case-referent Setsmentioning

confidence: 89%

A remarkable reduction of breast cancer deaths in screened versus unscreened women: a case-referent study

Paap

Holland

Heeten

et al. 2010

Cancer Causes Control

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“…33 Such evidence was consistent among Polish immigrants in France, 34 immigrants from England and Wales in New Zealand and vice versa, 35 African immigrants in UK, 30 France 28,29 and the Netherlands. 27 However, among Italian emigrants to South America, the risk of cervical cancer increased after migration to the high-risk areas. 36 The establishment of an efficient cervical cancer screening program in Sweden 9 also needs to be considered when interpreting our results.…”

Section: Discussionmentioning

confidence: 99%

“…[19][20][21][22][23][24][25][26][27][28][29][30][31] However, they mainly analysed cervical cancer mortality 22-24,28-31 and had no information about the exact migration date, age at migration [22][23][24]26,27,29,31 or SES 13,19,20,23,24,26,27 Moreover, the effect of time spent in the host country on risk of cervical cancer has not been studied conclusively to date. 32 Our findings support the overall conclusions of previous studies that cervical cancer risk or mortality is lower among immigrants than in their countries of origin.…”

Section: Discussionmentioning

confidence: 99%

Risk of cervical cancer among immigrants by age at immigration and follow‐up time in Sweden, from 1968 to 2004

Azerkan

Zendehdel

Tillgren

et al. 2008

Intl Journal of Cancer

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Because of great variation in the prevalence of human papilloma virus infection and other risk factors of cervical cancer worldwide, migrant studies may help further the understanding of the aetiology and improve prevention of cervical cancer. Our aim was to study the risk of invasive cervical cancer among immigrant women. We followed 758,002 immigrants from different countries who resided in Sweden between 1968 and 2004. Age-standardised incidence rates (ASRs) of immigrants were compared with that in their countries of origin. Poisson regression models estimated the relative risks of cervical cancer among immigrants, overall and stratified by age at migration and follow-up time, compared to Swedish-born women. Overall 1,991 of 19,542 observed cases of cervical cancer occurred among immigrants. Generally they had lower ASRs than in their countries of origin, with the exception of Nordic immigrants. Compared to Swedish-born women, we observed a higher relative risk of cervical cancer among immigrants overall (RR 5 1.13, 95% CI 1.08-1.18), and particularly among women from Denmark (RR 5 1.8, 95% CI 1.6-2.1), Norway (RR 5 1.7, 95% CI 1.5-1.9) and Central America (RR 5 2.5, 95% CI 1.3-4.9), while the relative risks were lower in immigrants from Eastern Africa (RR 5 0.2, 95% CI 0.1-0.6), South Central Asia (RR 5 0.4, 95% CI 0.2-0.6) and South Western Asia (RR 5 0.5, 95% CI 0.4-0.7). Follow-up time and age at migration were important effect modifiers for cervical cancer risks. We suggest targeted prevention toward high-risk immigrants, specifically older women, in the first 10 years after arrival into their new homeland.

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“…We found that significantly fewer immigrants were seen for cancer genetic counseling than would be expected from data on the general population. Next to possible confounding factors like lower socioeconomic status (Culver et al 2001;Chin et al 2005), low level of acculturation (Heck et al 2008) and traditional beliefs (Barlow-Stewart et al 2006), the low number of immigrants can partly be explained by the lower incidence of cancer and cancer mortality rates in different countries of origin (Turkey, Morocco, Surinam, Netherlands Antilles and Aruba) when compared to the Netherlands (Arnold et al 2011;Stirbu et al 2006;Visser et al 2004). However, since specific approaches to immigrant populations improve their access to genetic counseling, as shown for the enrolment of African-American families in a genetic research project in the USA (Spruill 2010), we still recommend future studies to look carefully at the reasons why immigrants are not referred for counseling.…”

Section: Discussionmentioning

confidence: 99%

Who is being referred to cancer genetic counseling? Characteristics of counselees and their referral

2012

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Both physician and patient play a role in the referral process for cancer genetic counseling. Access to such counseling is not optimal because some eligible patients are not being reached by current referral practice. We aimed to identify factors associated with the initiator of referral. During a 7-month period, we recorded demographic characteristics like gender, personal and family history of cancer, ethnicity and eligibility for genetic testing for 406 consecutive counselees using a specially designed questionnaire. Counselees were seen in a university hospital or a community hospital (n 07) in the Netherlands. We also recorded educational level of each counselee, clinical setting and who initiated referral. Descriptive statistics were used to describe the counselees' general characteristics. We analysed the association between counselee characteristics and the initiator of referral by logistic regression. The majority of counselees seemed to have initiated referral themselves but were indeed eligible for genetic testing. In comparison to the general population in the Netherlands, the counselees had a higher level of education, and there were fewer immigrants, although a higher level of education was not found to be a facilitating factor for referral. The clinical setting where a counselee was seen was associated with initiator of referral, although this relationship was not straightforward. There is a complex interaction between clinical setting and initiator of referral, which warrants further research to elucidate the factors involved in this relationship. Patients seen in cancer genetic counseling do not reflect the general population in terms of educational level or ethnicity.

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Breast cancer risk among first-generation migrants in the Netherlands

Cited by 26 publications

References 6 publications

A remarkable reduction of breast cancer deaths in screened versus unscreened women: a case-referent study

A remarkable reduction of breast cancer deaths in screened versus unscreened women: a case-referent study

Risk of cervical cancer among immigrants by age at immigration and follow‐up time in Sweden, from 1968 to 2004

Who is being referred to cancer genetic counseling? Characteristics of counselees and their referral

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