Cancer in Migrants: A Population-Based Study in Italy

Abstract

Background: Migrants are a vulnerable and neglected population. We aimed at investigating cancer proportionate rates in migrants in Sicily, Southern Italy. Methods: We extracted data on new cancer cases diagnosed between 2004 and 2019 from the Eastern Sicily cancer registry. We compared the adjusted proportionate morbidity ratio (PMR) for the most common cancer types among migrants and non-migrants. We fitted multivariate logistic regression models comparing one cancer to all other cancers to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for migration status. The analysis was stratified by region of origin. Results: Overall, 4726 new cancer cases occurred in migrants between 2004 and 2019, 63.5% of those among women and 224,211 in non-migrants, including 54.5% among men, with odds for migrants/non-migrants of 2.1%. Migrants had an increased proportion of cervical (PMR = 2.68, 95% CI = 2.29–3.10) and lung cancer (PMR = 1.20, 95% CI = 1.07–1.33). The highest OR in migrants was observed for cervical cancer (OR = 3.54, 95% CI = 2.99–4.20). Colorectal cancer was decreased among migrants (OR = 0.86, 95% CI = 0.77–0.96). Conclusions: Migrants to Sicily have higher odds of cervical cancer and a decreased risk of colorectal cancer compared to non-migrants. Increased odds were also detected for lung cancer, in particular in women. Different cancer patterns could be observed based on the region of origin. HPV-related cancers need targeted attention in migrants living in Sicily.

Cancer incidence in immigrants by geographical area of origin: data from the Veneto Tumour Registry, Northeastern Italy

“…We observed a higher risk of cervical cancer among women from Eastern Europe, which might be explained by the high prevalence of HPV infection in that region ( 28 ). This finding is in line with other Italian studies ( 10 , 11 ). In Italy was also reported that 58% Eastern European vs. 19% of Italy-born women are HPV-positive ( 29 ).…”

“…We observed a reduced risk of liver cancer in foreign-born men, especially those coming from South Central America and Eastern Europe, but not in women. These results are in line with another study conducted in Italy ( 10 ). Chronic infection with hepatitis B virus (HBV) or hepatitis C virus (HCV), alcohol abuse, and obesity are all risk factors associated with liver cancer, and they may be differently present in the foreign-born population, as well as according to sex.…”

“…Regarding colorectal cancer incidence rates, we observed lower rates for foreign-born males of all geographical areas, in particular from South Central America and Asia, similarly to other studies conducted in Italy and Canada ( 10 , 18 ). Sex differences emerged for this cancer site, since we found that, differently from males, females born in Eastern Europe and South Central America showed incidence rates similar to those of Italian natives.…”

“…Few studies have been conducted on cancer incidence in immigrants in Italy (10)(11)(12)(13). Most studies focused on the prevalence of cervical human papillomavirus infection and related cancer (12,13).…”

Understanding Reasons for Cancer Disparities in Italy: A Qualitative Study of Barriers and Needs of Cancer Patients and Healthcare Providers

“…Indeed, cancer patients who are at risk of experiencing greater disparities are those with lower socioeconomic status, who are frequently from ethnic minority backgrounds. 4 , 5 Secondly, differences in healthcare infrastructure and accessibility, variations in insurance coverage, cultural and language barriers, and disparities in cancer screening and prevention programs can all play a significant role in creating disparities. 6 , 7 Furthermore, it is important to recognize the geographic dimension of disparities in cancer, as evidenced by various studies.…”