Cancer risk in first generation migrants in NorthHollandFlevoland, The Netherlands, 19952004

1
Cancer risk in first generation migrants in
North-Holland/Flevoland, The Netherlands,
1995-2004

• Otto Visser Floor van Leeuwen
• Comprehensive Cancer Centre Amsterdam
• Netherlands Cancer Institute

2
Introduction

• Large variation in worldwide cancer incidence
• Comparison of incidence rates may offer important
  information regarding the aetiology of cancer
• Migrant studies may add to this, for example by
  the study of the rate of convergence

3
Incidence of breast cancer in various countries
(females)
Source GLOBOCAN (IARC, 2002)
4
Incidence of liver cancer in various countries
(males)
Source GLOBOCAN (IARC, 2002)
5
Introduction

• Due to massive immigration during the past
  decades one fifth of the population of the
  Netherlands belongs to the migrant population
• Even 50 in the larger cities, including Amsterdam

6
Population of the Netherlands according to origin
7
Research question

• What is the cancer risk in first generation
  migrants in the Netherlands?

8
Methods

• We selected all cancer cases diagnosed 1995-2004
  from the regional cancer registry of the
  Comprehensive Cancer Centre Amsterdam (n122,127)
• Cases with unknown country of birth were excluded
  (n15,712), leaving 106,415 cases for the
  analysis
• 97,144 cases were born in the Netherlands
  (91.3), 9,271 cases were foreign-born (8.7)

9
Methods

• Annual population data according to country of
  birth were available from Statistics Netherlands
  (but for age groups 0-14, 15-29, 30-44, 45-64 and
  65 only)
• The cancer risk for each country of birth was
  calculated for those 5 age groups and sex using
  the age group and sex-specific incidence of
  residents born in the Netherlands as a reference

10
Foreign-born cancer patients according to country
of birth, North-Holland/Flevoland 95-04
11
Cancer risk according to country of
birth North-Holland/Flevoland 95-04
EU (14) Germany United Kingdom Belgium Italy form
er Yugoslavia USA Indonesia Surinam Netherlands
Antilles China Latin-America Turkey Morocco oth
er Middle-East/N-Africa sub-Sahara Africa
12
Cancer risk according to country of birth by
site North-Holland/Flevoland 95-04
nasopharynx
Country of birth Indonesia Surinam Netherlands
Antilles Turkey Morocco other Middle-East/N-Afric
a EU (14) China sub-Sahara Africa
13
Cancer risk according to country of
birth North-Holland/Flevoland 95-04
colon rectum
Country of birth Indonesia Surinam Netherlands
Antilles Turkey Morocco other Middle-East/N-Afric
a EU (14) China sub-Sahara Africa
14
Cancer risk according to country of
birth North-Holland/Flevoland 95-04
liver
Country of birth Indonesia Surinam Netherlands
Antilles Turkey Morocco other Middle-East/N-Afric
a EU (14) China sub-Sahara Africa
15
Cancer risk according to country of
birth North-Holland/Flevoland 95-04
lung, males
Country of birth Indonesia Surinam Netherlands
Antilles Turkey Morocco other Middle-East/N-Afric
a EU (14) China sub-Sahara Africa
16
Cancer risk according to country of
birth North-Holland/Flevoland 95-04
melanoma
Country of birth Indonesia Surinam Netherlands
Antilles Turkey Morocco other Middle-East/N-Afric
a EU (14) China sub-Sahara Africa
17
Cancer risk according to country of
birth North-Holland/Flevoland 95-04
breast
Country of birth Indonesia Surinam Netherlands
Antilles Turkey Morocco other Middle-East/N-Afric
a EU (14) China sub-Sahara Africa
18
Cancer risk according to country of
birth North-Holland/Flevoland 95-04
cervix
Country of birth Indonesia Surinam Netherlands
Antilles Turkey Morocco other Middle-East/N-Afric
a EU (14) China sub-Sahara Africa
19
Cancer risk according to country of
birth North-Holland/Flevoland 95-04
testis
Country of birth Indonesia Surinam Netherlands
Antilles Turkey Morocco other Middle-East/N-Afric
a EU (14) China sub-Sahara Africa
20
Cancer risk according to country of
birth North-Holland/Flevoland 95-04
prostate
Country of birth Indonesia Surinam Netherlands
Antilles Turkey Morocco other Middle-East/N-Afric
a EU (14) China sub-Sahara Africa
21
Cancer risk according to country of
birth North-Holland/Flevoland 95-04
thyroid
Country of birth Indonesia Surinam Netherlands
Antilles Turkey Morocco other Middle-East/N-Afric
a EU (14) China sub-Sahara Africa
22
Conclusions I

• The overall cancer risk in migrants from
  non-western countries was low in comparison to
  the population born in the Netherlands
• This was mainly due to low cancer risks for
  cancers which are mainly life-style related, such
  as cancer of the breast, colon rectum, lung,
  prostate and skin

23
Conclusions II

• Exceptions to this general pattern were prostate
  cancer in males born in Surinam and lung cancer
  in Turkish males
• Cancers which were relatively common among
  migrants from non-western countries were mostly
  related to infectious disease nasopharynx,
  stomach, liver, cervix, Kaposi sarcoma