Epidemiology of Transition, Heidelberg Institute of Global Health, University Hospital Heidelberg, 69120 Heidelberg, Germany.
Cancer Registry, 44801 Bochum, Germany.
Int J Environ Res Public Health. 2021 Apr 25;18(9):4547. doi: 10.3390/ijerph18094547.
This study examined time trends and clinical and pathological characteristics of colorectal cancer (CRC) among ethnic German migrants from the Former Soviet Union (resettlers) and the general German population. Incidence data from two population-based cancer registries were used to analyze CRC as age-standardized rates (ASRs) over time. The respective general populations and resettler cohorts were used to calculate standardized incidence ratios (SIRs) by time-period (before and after the introduction of screening colonoscopy in 2002), tumor location, histologic type, grade, and stage at diagnosis. Additionally, SIRs were modeled with Poisson regression to depict time trends. During the study period from 1990 to 2013, the general populations showed a yearly increase of ASR, but for age above 55, truncated ASR started to decline after 2002. Among resettlers, 229 CRC cases were observed, resulting in a lowered incidence for all clinical and pathological characteristics compared to the general population (overall SIR: 0.78, 95% CI 0.68-0.89). Regression analysis revealed an increasing SIR trend after 2002. Population-wide CRC incidence decreases after the introduction of screening colonoscopy. In contrast the lowered CRC incidence among resettlers is attenuating to the general population after 2002, suggesting that resettlers do not benefit equally from screening colonoscopy.
本研究考察了前苏联移民（定居者）和德国普通人群中德国裔移民的结直肠癌（CRC）的时间趋势和临床病理特征。利用两个基于人群的癌症登记处的发病数据，按时间（2002 年结肠镜筛查引入前和引入后）分析结直肠癌的年龄标准化发病率（ASR）。分别使用普通人群和定居者队列，通过时间区间（2002 年结肠镜筛查引入前和引入后）、肿瘤位置、组织学类型、分级和诊断时的分期计算标准化发病比（SIR）。此外，还采用泊松回归模型来描绘时间趋势。在 1990 年至 2013 年的研究期间，普通人群的 ASR 每年都在增加，但在 55 岁以上的人群中，2002 年后，截断 ASR 开始下降。在定居者中，观察到 229 例 CRC 病例，与普通人群相比，所有临床病理特征的发病率均降低（总体 SIR：0.78，95%CI 0.68-0.89）。回归分析显示 2002 年后 SIR 呈上升趋势。结肠镜筛查引入后，人群 CRC 发病率下降。相比之下，2002 年后定居者的 CRC 发病率下降趋势趋于接近普通人群，这表明定居者并未平等受益于结肠镜筛查。
