Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway.
Faculty of Medicine, University of Oslo, Institute of Basic Medical Sciences, Oslo, Norway.
Acta Oncol. 2020 Apr;59(4):376-383. doi: 10.1080/0284186X.2019.1711167. Epub 2020 Jan 10.
There are concerns about timely access to appropriate cancer treatment for the growing immigrant population in Norway. This study aims to compare waiting times between cancer diagnosis and start of cancer treatment, as well as treatment patterns between immigrants in Norway and the host population. We performed a nationwide, registry-based study with individual-level data, including 213,320 Norwegians and 8324 immigrants diagnosed with breast, colorectal, lung or prostate cancer in 1990-2014. Differences in time from diagnosis to treatment and in treatment patterns were described for the selected cancer sites. The Cox and logistic regressions were used to adjust for patient and tumour characteristics. After adjustment for covariates, hazard ratios for time from diagnosis to treatment for non-Western immigrants compared to Norwegians were 0.88 (95% confidence interval (CI): 0.82-0.95) for breast cancer and 0.84 (95% CI: 0.75-0.95) for lung cancer, indicating longer waiting times. Treatment patterns in the four major cancer sites were similar among immigrants and the Norwegian host population, except for breast cancer, where women from East and South Asia received less breast-conserving surgery than the Norwegian host population (adjusted odds ratios 0.65 (95% CI: 0.46-0.93) for East Asians and 0.75 (95% CI: 0.50-1.13) for South Asians). The present study reports delayed treatment for lung and breast cancer among immigrants from non-Western countries in Norway. Systematic differences in cancer treatment were not detected. However, less breast-conserving surgery among breast cancer patients from Asia compared to Norwegians was observed.
人们担心挪威不断增长的移民群体能否及时获得适当的癌症治疗。本研究旨在比较挪威移民和本地人群癌症诊断后开始治疗的时间以及治疗模式的差异。我们开展了一项全国性的基于登记的个体水平数据研究，纳入了 1990 年至 2014 年间诊断为乳腺癌、结直肠癌、肺癌或前列腺癌的 213320 名挪威人和 8324 名移民。描述了所选癌症部位的诊断后治疗时间和治疗模式的差异。采用 Cox 和逻辑回归来调整患者和肿瘤特征。调整协变量后，非西方国家移民与挪威人相比，诊断后至治疗的时间风险比为乳腺癌 0.88（95%置信区间：0.82-0.95），肺癌 0.84（95%置信区间：0.75-0.95），表明等待时间更长。在四大癌症部位，移民与挪威本地人群的治疗模式相似，除了乳腺癌，东亚和南亚的女性接受保乳手术的比例低于挪威本地人群（调整后的优势比为 0.65（95%置信区间：0.46-0.93）和 0.75（95%置信区间：0.50-1.13））。本研究报告了挪威非西方国家移民的肺癌和乳腺癌治疗延迟。未发现癌症治疗的系统差异。然而，与挪威人相比，亚洲乳腺癌患者的保乳手术较少。
