Division of Molecular Genetic Epidemiology, German Cancer Research Centre (DKFZ), 69120 Heidelberg, Germany.
Eur J Cancer. 2010 Mar;46(5):926-31. doi: 10.1016/j.ejca.2009.12.031. Epub 2010 Feb 8.
The changes of cancer incidence upon immigration can be used as an estimator of environmental influence on cancer risk. We studied site-specific liver and biliary cancers in first-generation immigrants to Sweden with an aim to search for aetiological clues and to find evidence for indigenous incidence rates.
We used the nation-wide Swedish Family-Cancer Database to calculate standardised incidence ratios (SIRs) in immigrants compared to native Swedes.
A total of 1428 cancers were identified in immigrants whose median ages (years) at immigration were 27 for men and 26 for women and whose median diagnostic ages were 64 and 66, respectively. The highest SIRs of 6.7 for primary liver cancer were observed for men from East Asia and sub-Saharan Africa. Increased SIRs were recorded for male immigrants from previous Yugoslavia (1.78), Southern Europe (2.91), Turkey (2.15) and Asian Arab countries (2.89). For gallbladder cancer, only women from the Indian subcontinent (3.84) and Chile (2.34) had increased risk while some Northern European immigrants showed decreased risks.
Primary liver cancer was increased in immigrants from endemic regions of hepatitis B virus infection but also from large regions lacking cancer incidence data, North Africa, Asian Arab countries, Turkey and previous Yugoslavia; these are probably intermediary risk regions for this infection. The consideration of these regions as risk areas would justify active diagnostic and vaccination programs. The increase in gallbladder cancer in Chileans and Indians suggests that some persistent damage was inflicted before emigration, characterisation of which will be a challenge for aetiological studies.
移民癌症发病率的变化可用作环境对癌症风险影响的估算器。我们研究了第一代移民到瑞典的特定部位肝癌和肝胆管癌，旨在寻找病因线索，并找到本土发病率的证据。
我们使用全国性的瑞典家族癌症数据库，计算移民与瑞典本地人相比的标准化发病比（SIR）。
共确定了 1428 例移民癌症病例，其移民时的中位年龄（岁）分别为男性 27 岁和女性 26 岁，诊断时的中位年龄分别为 64 岁和 66 岁。原发性肝癌的最高 SIR 为 6.7，观察到来自东亚和撒哈拉以南非洲的男性移民。前南斯拉夫（1.78）、南欧（2.91）、土耳其（2.15）和亚洲阿拉伯国家（2.89）的男性移民 SIR 升高。对于胆囊癌，只有来自印度次大陆（3.84）和智利（2.34）的女性移民风险增加，而一些北欧移民则显示出较低的风险。
来自乙型肝炎病毒感染流行地区的移民中原发性肝癌增加，但也来自缺乏癌症发病率数据的北非、亚洲阿拉伯国家、土耳其和前南斯拉夫等大型地区；这些地区可能是该感染的中间风险地区。将这些地区视为风险地区将证明积极的诊断和疫苗接种计划是合理的。智利人和印度人胆囊癌的增加表明，在移民前可能已经造成了一些持续的损害，对其特征的描述将是病因学研究的一个挑战。
