Abraham Hadassah, Sluggett Larine, Huber Dezene, Olson Robert
BC Cancer- Prince George, Prince George, BC, Canada.
School of Health Sciences, University of Northern, Prince George, BC, Canada.
BMC Public Health. 2025 May 19;25(1):1849. doi: 10.1186/s12889-025-23117-0.
With increasing immigration in Canada and strained cancer treatment infrastructure, there's a pressing need for long-term data on immigrant health and cancer incidence. This information is crucial for planning future cancer services and to alleviate the burden on both the population and healthcare system.
Statistics Canada data were linked from the 1991 Canadian Census, Canadian Cancer Registry, and Canadian Vital Statistics Database to follow a cohort from 1992 to 2015 and compare cancer incidence between immigrants and the Canadian-born for any cancer and specific types of cancers. Immigrants were further classified based on time spent in Canada.
Immigrants had lower odds of developing any cancer (OR = 0.92, 95% CI [0.92-0.93], p < 0.001) compared to non-immigrants. However, for stomach cancer and non-cervical gynecological cancers, the odds of cancer incidence were greater for immigrants than for the Canadian-born. Cox regression showed that recent immigrants (0-4 years in Canada) had a lower hazard ratio (HR = 0.77, 95% CI [0.71-0.84], p < 0.001) compared to non-immigrants. Those who lived 5-9 years and 10-19 years in Canada had a higher hazard ratio (HR = 0.82, 95% CI [0.75-0.89], p < 0.001; HR = 0.90, 95% CI [0.82-0.98], p = 0.011), respectively. Immigrants who had been in Canada for 20 years or longer had the highest hazard ratio (HR = 0.98, 95% CI [0.90-1.07], p = 0.632), indicating that the so-called "healthy immigrant effect" lessens over time.
Results demonstrated the healthy immigrant effect lessens over time spent in Canada. However, this effect was not uniform across countries of origin and cancer types. Therefore, this research, provides a deeper understanding of immigrant cancer outcomes and will be useful for cancer planning services and cancer control strategies.
随着加拿大移民数量的增加以及癌症治疗基础设施的紧张，迫切需要有关移民健康和癌症发病率的长期数据。这些信息对于规划未来的癌症服务以及减轻人口和医疗系统的负担至关重要。
将加拿大统计局1991年人口普查、加拿大癌症登记处和加拿大人口动态统计数据库的数据相链接，以追踪1992年至2015年的队列，并比较移民与加拿大出生者在任何癌症和特定类型癌症方面的癌症发病率。移民还根据在加拿大的居住时间进一步分类。
与非移民相比，移民患任何癌症的几率较低（比值比[OR]=0.92，95%置信区间[0.92 - 0.93]，p<0.001）。然而，对于胃癌和非宫颈癌，移民的癌症发病率几率高于加拿大出生者。Cox回归显示，近期移民（在加拿大0至4年）与非移民相比，风险比（HR）较低（HR = 0.77，95%置信区间[0.71 - 0.84]，p<0.001）。在加拿大居住5至9年和10至19年的移民风险比更高（HR = 0.82，95%置信区间[0.75 - 0.89]，p<0.001；HR = 0.90，95%置信区间[0.82 - 0.98]，p = 0.011）。在加拿大居住20年或更长时间的移民风险比最高（HR = 0.98，95%置信区间[0.90 - 1.07]，p = 0.632），这表明所谓的“健康移民效应”会随着时间推移而减弱。
结果表明，“健康移民效应”会随着在加拿大居住时间的延长而减弱。然而，这种效应在不同原籍国和癌症类型中并不一致。因此，本研究有助于更深入地了解移民的癌症结局，对癌症规划服务和癌症控制策略具有参考价值。
