Aston Olivia, Sutradhar Rinku, Rabeneck Linda, Paszat Lawrence
Sunnybrook Health Sciences Centre, Toronto, ON.
Institute for Clinical Evaluative Sciences, Toronto, ON.
J Obstet Gynaecol Can. 2019 Jan;41(1):21-28. doi: 10.1016/j.jogc.2018.01.031. Epub 2018 Oct 10.
The risk of invasive cervical cancer (ICC) varies throughout the world. We aimed to compare the risk of this invasive disease among immigrants arriving in Ontario with that of the general female population of Ontario.
We used an exposure-control matched design. We identified females from the Immigration, Refugees, and Citizenship Canada (IRCC) database with arrival in Ontario, and whose first eligibility for the Ontario Health Insurance Plan according to its Registered Persons Database fell between July 1, 1991, and June 30, 2008, at age 20 years or older, and matched two female controls on year of birth. We identified cases of ICC between the index date and December 31, 2014. Crude rates and relative rates of ICC were calculated. Multivariable extended Cox regression models were then implemented.
The crude rate of ICC was 0.032 per 100 000 person-years for immigrants and 0.037 for controls. Immigrants who were born in certain countries showed a higher risk of ICC; Russia had a relative rate of 1.736 compared with a relative rate of 0.221 among those born in Iran. Among immigrants, the age-adjusted HR was 0.76 (95% CI 0.63-0.92) after 10 years of residency when compared with controls. Immigrants aged 20 to 39 years had a lower risk of ICC compared with controls of equivalent age, and immigrants aged ≥40 years had a higher risk of ICC.
The risk of ICC among immigrants in Ontario varies by age, country of birth, and time since immigration.
浸润性宫颈癌（ICC）的风险在全球各地有所不同。我们旨在比较抵达安大略省的移民中这种浸润性疾病的风险与安大略省普通女性人群的风险。
我们采用了暴露对照匹配设计。我们从加拿大移民、难民和公民身份部（IRCC）数据库中识别出抵达安大略省的女性，根据其注册人员数据库，她们首次符合安大略省医疗保险计划资格的时间在1991年7月1日至2008年6月30日之间，年龄在20岁及以上，并按出生年份匹配两名女性对照。我们确定了索引日期至2014年12月31日期间的ICC病例。计算了ICC的粗发病率和相对发病率。然后实施多变量扩展Cox回归模型。
移民的ICC粗发病率为每10万人年0.032，对照为0.037。在某些国家出生的移民患ICC的风险较高；俄罗斯的相对发病率为1.736，而在伊朗出生的人的相对发病率为0.221。在移民中，与对照相比，居住10年后年龄调整后的HR为0.76（95%CI 0.63 - 0.92）。20至39岁的移民患ICC的风险低于同龄对照，而年龄≥40岁的移民患ICC的风险较高。
安大略省移民中ICC的风险因年龄、出生国家和移民后的时间而异。
