'Department of Obstetrics and Gynecology, Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel.
Israel Center for Disease Control, Ministry of Health, Gertner Institute, Sheba Medical Center, Ramat Gan, Israel.
Int J Gynecol Cancer. 2019 Mar;29(3):492-496. doi: 10.1136/ijgc-2018-000053. Epub 2019 Jan 4.
To clarify the effect of mass migration from a high-risk area (former Soviet Union) to a low-risk area (Israel) on cervical cancer incidence and mortality in Israel and the modifying effect of age at immigration.
All women who immigrated to Israel from the former Soviet Union between January 1, 1990 and December 31, 2000 (N=345 202) and all Jewish Israeli-born women who were 0-80 years old on January 1, 1990 (N=1 141 236) were included. Follow-up ended at December 31, 2010 or date of death or date of cervical cancer diagnosis, whatever occurred earlier. Crossing data from the computerized population registry of the Ministry of Interior, the Israel National Cancer Registry and the Central Bureau of Statistics, cervical cancer incidence and mortality and adjusted hazard ratios (aHR) with 95% confidence intervals (95% CI) were calculated.
1595 new cases (crude incidence rate 29.71: 100 000 person years) of cervical cancer were diagnosed in immigrants as compared with 6159 cases (crude incidence rate 27.21: 100 000 person years) diagnosed in Israel-born Jewish women. Immigration at an age older than 12 years was hazardous (aHR 1.27, 95% CI 1.19 to 1.35; P<0.001) while immigration at a younger age was protective (aHR 0.62, 95% CI 0.51 to 0.75; P<0.001) for cervical cancer incidence compared with native Israeli women. Cervical cancer mortality was also significantly higher in immigrants compared with Israel-born women with incidence density rates of 1.15 and 0.35 per 100 person years, respectively (P<0.0001).
Factors related to the acquired causes of the disease at the country of origin are probably at the root of the low incidence of cervical cancer in Israel. Adult immigrants from the former Soviet Union should be managed as a high-risk group.
明确大量人群从高风险地区（前苏联）移民至低风险地区（以色列）对以色列宫颈癌发病率和死亡率的影响，以及移民年龄对此的调节作用。
纳入 1990 年 1 月 1 日至 2000 年 12 月 31 日期间从前苏联移民至以色列的所有女性（n=345202），以及 1990 年 1 月 1 日时年龄在 0-80 岁的所有以色列出生的犹太女性（n=1141236）。随访于 2010 年 12 月 31 日或死亡日期或宫颈癌诊断日期结束，以先发生者为准。通过内政部、以色列国家癌症登记处和中央统计局的计算机化人口登记处交叉数据，计算宫颈癌发病率和死亡率以及调整后的危险比（aHR）及其 95%置信区间（95%CI）。
移民中诊断出 1595 例新宫颈癌病例（粗发病率为 29.71：100000 人年），而以色列出生的犹太女性中诊断出 6159 例（粗发病率为 27.21：100000 人年）。移民年龄大于 12 岁时宫颈癌发病风险较高（aHR 1.27，95%CI 1.19-1.35；P<0.001），而移民年龄较小时宫颈癌发病风险较低（aHR 0.62，95%CI 0.51-0.75；P<0.001），与以色列出生的女性相比。移民的宫颈癌死亡率也明显高于以色列出生的女性，其发病率密度分别为 1.15 和 0.35/100 人年（P<0.0001）。
与疾病获得原因相关的原籍国因素可能是以色列宫颈癌发病率低的根源。应将前苏联成年移民视为高危人群。
