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

Abstract

This study investigates the difference in cancer mortality rates between migrant groups and the native Dutch population, and determines the extent of convergence of cancer mortality rates according to migrants' generation, age at migration and duration of residence. Data were obtained from the national cause of death and population registries in the period 1995-2000. We used Poisson regression to compare the cancer mortality rates of migrants originating from Turkey, Morocco, Surinam, Netherlands Antilles and Aruba to the rates for the native Dutch. All-cancer mortality among all migrant groups combined was significantly lower when compared to that of the native Dutch population (RR 5 0.55, CI: 0.52-0.58). For a large number of cancers, migrants had more than 50% lower risk of death, while elevated risks were found for stomach and liver cancers. Mortality rates for all cancers combined were higher among second generation migrants, among those with younger age at migration, and those with longer duration of residence. This effect was particularly pronounced in lung cancer and colorectal cancer. For most cancers, mortality among second generation migrants remained lower compared to the native Dutch population. Surinamese migrants showed the most consistent pattern of convergence of cancer mortality. The generally low cancer mortality rates among migrants showed some degree of convergence but did not yet reach the levels of the native Dutch population. This convergence implies that current levels of cancer mortality among migrants will gradually increase in future years if no specific preventive measurements are taken. ' 2006 Wiley-Liss, Inc.Key words: cancer; generation; convergence; migrant population; mortality; The Netherlands While molecular epidemiology has identified several examples of genetically determined differences between races, classical epidemiology has shown that the environment and lifestyle predominates in determining cancer incidence.1,2 The role of the environment and behavior is particularly visible in the changing incidence and mortality rates of cancer among migrant populations. Many migrant studies on cancer have shown that the initially different levels of cancer incidence and mortality of migrant groups gradually converge toward the levels of the new host population.3-16 At present, it is still not known how quickly the convergence develops, and how the pace of convergence may differ according to migrant group and type of cancer. This information would better position the role of environmental factors as well as provide knowledge for more rational planning of specific preventive and curative health services for migrant populations.About 10% of the population of the Netherlands is currently of nonwestern foreign origin. 17 The largest migrant groups originate from Turkey, Morocco, and the former Dutch colonies in South America and the Caribbean (Surinam and Netherlands Antilles/ Aruba). Turkish and Moroccans are mostly labor migrants followed by their immediate family and descendants for ...

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

“…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.…”

Cancer incidence in South Asian migrants to England, 1986–2004: Unraveling ethnic from socioeconomic differentials

“…Similar transitional trends in breast cancer incidence have been reported among Japanese migrants to the United States 1 and migrants to the Netherlands. 23 This recent increase in breast cancer is likely to persist, because fertility rates in South Asians were half those observed in South Asian countries. 24,25 Similar patterns were also observed for other hormone-related cancers such as uterus, ovary and testis (data not shown).…”

Rates of Cancer Incidence Across Terciles of the Foreign-born Population in Canada From 2001–2006

“…Risk convergence for these cancers to host country has been observed for second-generation persons, and those who migrated at young ages. 41 If effects of reduced cancer risk are conferred by factors related to having been foreign-born, then had information been available to directly measure this at the individual level, the magnitude of variation in area cancer incidence according to concentration foreignborn could possibly be greater than these results suggest. Our results may demonstrate conservative differences since, even within highconcentration foreign-born areas, Canadian-born persons comprised 36% of the population, therefore reported ASIRs reflect composite cancer risks for both foreign-and non-foreign-born population groups.…”