Thøgersen Håvard, Møller Bjørn, Robsahm Trude Eid, Babigumira Ronnie, Aaserud Stein, Larsen Inger Kristin
Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway.
Faculty of Medicine, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway.
Int J Cancer. 2018 Dec 15;143(12):3097-3105. doi: 10.1002/ijc.31729. Epub 2018 Oct 3.
Cancer survival is an important indicator for quality of cancer care. We sought to determine if there are differences in cancer survival between immigrants and the host population in Norway. We performed a nationwide registry-based study comprising subjects diagnosed with cancer between 1990 and 2014, and followed until the end of 2016. Survival was estimated for 13 cancer sites with cause-specific survival. Adjustments were made for common confounders (age, sex, year of diagnosis and place of residence) and defined mediators (stage at diagnosis, comorbidity and socioeconomic factors). A total of 500,255 subjects were available for analysis, of which 11,252 were Western and 8,701 non-Western immigrants. We did not find differences in cancer survival between Western immigrants and Norwegians, while non-Western immigrants, with some exceptions, had similar or better survival. Better lung cancer survival in non-Western immigrants than Norwegians was notable (hazard ratio (95% confidence interval): 0.78 (0.71-0.85)), and not explained by defined mediators. Immigrants from Eastern Europe and Balkan with melanoma (hazard ratio: 1.54 (1.12-2.12)) and prostate cancer (hazard ratio: 1.34 (1.08-1.67)), and possibly from sub-Saharan Africa with breast cancer (hazard ratio: 1.41 (0.94-2.12)) had worse survival than Norwegians. The results suggest that immigrants in Norway have good cancer survival relative to the host population. Poor survival in immigrants from Eastern Europe and Balkan with melanoma and prostate cancer, and sub-Saharan Africa with breast cancer might be a concern.
癌症生存率是癌症护理质量的重要指标。我们试图确定挪威移民与当地居民在癌症生存率上是否存在差异。我们进行了一项基于全国登记处的研究，研究对象为1990年至2014年间被诊断患有癌症并随访至2016年底的人群。对13个癌症部位进行了特定病因生存率的估计。对常见的混杂因素（年龄、性别、诊断年份和居住地点）以及确定的中介因素（诊断时的分期、合并症和社会经济因素）进行了调整。共有500255名受试者可供分析，其中11252名是西方移民，8701名是非西方移民。我们没有发现西方移民和挪威人在癌症生存率上存在差异，而非西方移民在某些例外情况下，生存率相似或更高。值得注意的是，非西方移民的肺癌生存率高于挪威人（风险比（95%置信区间）：0.78（0.71 - 0.85）），且无法用确定的中介因素来解释。来自东欧和巴尔干地区的移民患黑色素瘤（风险比：1.54（1.12 - 2.12））和前列腺癌（风险比：1.34（1.08 - 1.67）），以及可能来自撒哈拉以南非洲的移民患乳腺癌（风险比：1.41（0.94 - 2.12））的生存率低于挪威人。结果表明，相对于当地居民，挪威的移民癌症生存率良好。来自东欧和巴尔干地区患黑色素瘤和前列腺癌的移民以及撒哈拉以南非洲患乳腺癌的移民生存率较低可能是一个问题。
