Ethnic differences in the incidence of cancer in Norway

Abstract

Article category: Research ArticleNovelty and Impact: Traditionally there have been large differences in cancer incidence across geographic regions, and even though this picture is changing with changes in lifestylerelated cancers in low-income countries, geographic differences still exist. We have compared cancer incidence in immigrant groups with that in individuals born in Norway, and have found surprisingly large differences for some cancers. The Norwegian setting is well suited for these studies because of the complete cancer registration and universal public health care. 3 AbstractTraditionally there have been differences in cancer incidence across geographic regions.When immigrants have moved from low-income to high-income countries, their incidence have changed as they have adapted to the lifestyle in the new host country. Given worldwide changes in lifestyle factors over time, we decided to examine cancer incidence in immigrant groups in Norway, a country with a recent immigration history, complete cancer registration and universal public health care. We linked immigration history for the complete population to information on cancer diagnosis from the Cancer Registry of Norway for the period 1990-2012. Age-standardized (world) overall and site-specific cancer incidence were estimated for different immigrant groups and compared to incidence among individuals born in Norway.Among 850 008 immigrants, 9158 men and 10 334 women developed cancer, and among 5 508 429 Norwegian-born, 263 316 men and 235 020 women developed cancer. While incidence of breast and colorectal cancer were highest among individuals born in Norway and other high-income countries, other cancer types were higher in immigrants from low-income countries. Lung cancer incidence was highest in Eastern European men, and men and women from Eastern Europe had high incidence of stomach cancer. Incidence of liver cancer was substantially higher in immigrants from low-income countries than in individuals born in Norway and other high-income countries. Our results mirror known cancer challenges across the world. Although cancer incidence overall is lower in immigrants from low-income countries, certain cancers, such as lung, liver and stomach cancer, represent major challenges in specific immigrant groups.4

Differences in cancer survival between immigrants in Norway and the host population

“…6 A previous study, investigating cancer stage distribution in immigrants compared to the Norwegian host population, showed that non-Western women had higher risk of being diagnosed with a more advanced stage of breast cancer. 6 A previous study, investigating cancer stage distribution in immigrants compared to the Norwegian host population, showed that non-Western women had higher risk of being diagnosed with a more advanced stage of breast cancer.…”

“…Historically, immigrants in Norway have had lower incidence of lifestyle-related cancers and higher incidence of certain cancers caused by infections than the host population. 6 A previous study, investigating cancer stage distribution in immigrants compared to the Norwegian host population, showed that non-Western women had higher risk of being diagnosed with a more advanced stage of breast cancer. 7 Non-Western immigrants have also been shown to have lower attendance rate to both cervical and mammography screening.…”

Kreftutvikling og befolkningssammensetning i Norge 1990–2016

“…I de siste tiårene har også andelen av innvandrere økt, fra 2,5 % i 1984 til naer 14 % i 2017 (1). Vi har nylig vist at innvandrere har lavere forekomst av alle kreftformer samlet, men samtidig høyere risiko for leverkreft hos begge kjønn og lungekreft hos menn (2). Vi har altså etter hvert fått en økende andel av befolkningen som har ulik risiko for kreft, og det er derfor interessant å se på om dette har påvirket de nasjonale kreftratene som publiseres årlig av Kreftregisteret i Cancer in Norway (3).…”

“…Et eksempel er leverkreft. Her har vi sett en økning i forekomsten, og innvandring har vaert fremsatt som en forklaring på denne økningen (3), siden flere innvandrergrupper har økt forekomst (2).…”

The Quality of Working Life Questionnaire for Cancer Survivors: Sufficient responsiveness for use as a patient-reported outcome measurement

“…Sufficient responsiveness and interpretability outcomes are presented in bold.of the cancer population, as the incidence of cancer is lower among non-European immigrants compared to native European people in general. Especially for colorectal, breast and gynaecological cancer(Hjerkind et al, 2017), which was the main cancer population of our study. The second number is not representative of the general Dutch working population nor representative of the cancer population as the prevalence of cancer among female working population is only slightly higher compared to males and as more males than females have paid work (Netherlands Cancer Registery; Statistics Netherlands).…”