Sociology Department, Interface Demography, Vrije Universiteit Brussel, Pleinlaan 2, 1050, Brussels, Belgium.
Research Department, Belgian Cancer Registry, Koningsstraat 215, 1210, Brussels, Belgium.
Soc Sci Med. 2021 Jan;269:113591. doi: 10.1016/j.socscimed.2020.113591. Epub 2020 Dec 8.
Recent research has shown a generally lower cancer risk and mortality among migrants from less-industrialised country origin. However, while rates are usually lower for 'lifestyle-related' cancers (e.g. breast, prostate, lung, colorectal), they are typically elevated for 'infection-related' ones such as liver and stomach cancer. Although these observations appear in line with the theory of 'migration as a rapid epidemiological transition', changes in cancer risk after migration have yet to be investigated, effectively testing if migration also entails a 'rapid cancer risk transition'. This study therefore examines cancer risk among migrants in Belgium, focusing on colorectal cancer as a typically lifestyle-related cancer on the one hand, and infection-related cancers on the other hand. We subdivide migrant groups of more and less industrialised country origin according to duration of stay, and calculate absolute and relative incidence rates between 2004 and 2013. Our findings corroborate the transition assumptions for men from Turkey and Morocco, but cannot support them for women. Italian male immigrants have an in-between position: their colorectal cancer risk does not differ from that of Belgian men, but infection-related and non-cardia stomach cancer risks are higher and remain so with longer duration of stay. The fact that rates for migrants from the Netherlands and France generally do not differ from those of Belgians further strengthens support for a cancer transition among male migrants. Further examinations should focus on changes in health-related behaviour that can explain persistently low colorectal cancer risks among Turkish and Moroccan migrants and can inform preventive strategies for other population subgroups. Knowledge about the higher non-cardia stomach cancer risk among Turkish, Moroccan, and Italian men can support early detection strategies by primary care providers when patients present with gastric symptoms, especially because this cancer tends to have unfavourable prognosis.
最近的研究表明，来自欠工业化国家的移民患癌症的风险和死亡率普遍较低。然而，虽然“与生活方式相关”的癌症（如乳腺癌、前列腺癌、肺癌、结直肠癌）的发病率通常较低，但“与感染相关”的癌症（如肝癌和胃癌）的发病率则较高。尽管这些观察结果似乎符合“移民是快速的流行病学转变”的理论，但在移民后癌症风险的变化仍有待研究，实际上是在检验移民是否也会带来“快速的癌症风险转变”。因此，本研究考察了比利时移民的癌症风险，一方面关注结直肠癌，这是一种典型的与生活方式相关的癌症，另一方面关注与感染相关的癌症。我们根据逗留时间将来自较工业化国家和欠工业化国家的移民群体进行细分，并计算 2004 年至 2013 年期间的绝对和相对发病率。我们的研究结果证实了土耳其和摩洛哥男性移民的转变假设，但不能支持女性移民的转变假设。意大利男性移民则处于中间位置：他们的结直肠癌风险与比利时男性相同，但与感染相关的非贲门胃癌风险更高，且随着逗留时间的延长而持续升高。荷兰和法国移民的比率与比利时人一般没有差异，这进一步支持了男性移民的癌症转变假设。进一步的研究应该集中在可能解释土耳其和摩洛哥移民持续较低的结直肠癌风险的健康相关行为的变化上，并为其他人群亚组提供预防策略。了解土耳其、摩洛哥和意大利男性的非贲门胃癌风险较高的情况，可以支持初级保健提供者在患者出现胃部症状时采取早期检测策略，因为这种癌症的预后往往较差。
