Department of Epidemiology and International Public Health, School of Public Health, Bielefeld University, PO Box 100131, 33501, Bielefeld, Germany.
Eur J Epidemiol. 2012 Dec;27(12):915-21. doi: 10.1007/s10654-012-9746-y. Epub 2012 Nov 20.
The aim of this study on cancer mortality among Turkish immigrants, for the first time, traditional comparisons in migrant health research have been extended simultaneously in two ways. First, comparisons were made to cancer mortality from the immigrants' country of origin and second, cancer mortality among Turkish immigrants across four host countries (Belgium, Denmark, France and the Netherlands) was compared. Population-based cancer mortality data from these countries were included. Age-standardized mortality rates were computed for the local-born and Turkish population of each country. Relative differences in cancer mortality were examined by fitting country-specific Poisson regression models. Globocan data on cancer mortality in Turkey from 2008 were used in order to compare mortality rates of Turkish immigrants with those from their country of origin. Turkish immigrants had lower all-cancer mortality than the local-born populations of their host countries, and mortality levels comparable to all-cancer mortality rates in Turkey. In the Netherlands and France breast cancer mortality was consistently lower in Turkish immigrants women than among local-born women. Lung cancer mortality was slightly lower in Turkish immigrants in the Netherlands and France but varied considerably between migrants in these two host countries. Stomach cancer mortality was significantly higher in Turkish immigrants when compared to local-born French and Dutch. Our findings indicate that exposures both in the country of origin and in the host country can have an effect on the cancer mortality of immigrants. Despite limitations affecting any cross-country comparison of mortality, the innovative multi-comparison approach is a promising way to gain further insights into determinants of trends in cancer mortality of immigrants.
本研究旨在探讨土耳其移民的癌症死亡率,这是首次在移民健康研究中同时以两种方式进行传统比较。首先,将移民原籍国的癌症死亡率与移民的癌症死亡率进行比较,其次,将四个东道国(比利时、丹麦、法国和荷兰)的土耳其移民的癌症死亡率进行比较。这些国家的基于人口的癌症死亡率数据均包括在内。为每个国家的本地出生人口和土耳其人口计算了年龄标准化死亡率。通过拟合特定国家的泊松回归模型来检查癌症死亡率的相对差异。为了将土耳其移民的死亡率与原籍国的死亡率进行比较,使用了 2008 年全球癌症死亡率数据库中有关土耳其癌症死亡率的数据。与东道国的本地出生人口相比,土耳其移民的所有癌症死亡率较低,且死亡率水平与土耳其的所有癌症死亡率相当。在荷兰和法国,土耳其移民女性的乳腺癌死亡率始终低于本地出生女性。荷兰和法国的土耳其移民的肺癌死亡率略低,但在这两个东道国的移民之间差异很大。与本地出生的法国和荷兰人相比,土耳其移民的胃癌死亡率明显更高。我们的研究结果表明,原籍国和东道国的暴露都可能对移民的癌症死亡率产生影响。尽管任何国家间死亡率比较都存在局限性,但这种创新的多比较方法是深入了解移民癌症死亡率趋势决定因素的一种有前途的方法。