Abstract
BackgroundImmigrants make up an important share of European populations which has led to a growing interest in research on migrants’ health. Many studies have assessed migrants’ cancer mortality patterns, yet few have studied incidence differences. This paper will probe into histology-specific lung cancer incidence by migrant origin aiming to enhance the knowledge on lung cancer aetiology and different risk patterns among population groups.MethodsWe used data on all lung cancer diagnoses during 2004–2013 delivered by the Belgian Cancer Registry individually linked with the 2001 Belgian Census and the Crossroads Bank for Social Security. Absolute and relative inequalities in overall and histology-specific lung cancer incidence have been calculated for first-generation Italian, Turkish and Moroccan migrant men aged 50–74 years compared to native Belgian men.ResultsMoroccan men seemed to be the most advantaged group. Both in absolute and relative terms they consistently had lower overall and histology-specific lung cancer incidence rates compared with native Belgian men, albeit less clear for adenocarcinoma. Turkish men only showed lower overall lung cancer incidence when adjusting for education. On the contrary, Italian men had higher incidence for overall lung cancer and squamous cell carcinoma, which was explained by adjusting for education.ConclusionsSmoking habits are likely to explain the results for Moroccan men who had lower incidence for smoking-related histologies. The full aetiology for adenocarcinoma is still unknown, yet the higher incidence among Italian men could point to differences in occupational exposures, e.g. to carcinogenic radon while working in the mines.
Highlights
Immigrants make up an important share of European populations which has led to a growing interest in research on migrants’ health
We look into three research questions: First, do overall and histology-specific lung cancer incidence rates among male Belgian residents differ by migrant group as compared to native Belgian men? Second, are there differences in tumour characteristics between migrant groups and native Belgian men, taking the histological subtype into account? For instance, are there differences in stage at diagnosis, which is an important prognostic factor [42]
Turkish and Moroccan men were on average a bit younger than their Belgian and Italian counterparts and had on average arrived about 6 to 7 years later in Belgium than the Italian migrants
Summary
Immigrants make up an important share of European populations which has led to a growing interest in research on migrants’ health. Despite their often more disadvantaged living situation, migrants tend to have lower mortality compared with the host population This advantage is especially pronounced for lifestyle-related diseases whereas migrants’ mortality from infectious diseases tends to be higher than that of the native population [1, 3, 4]. Mortality can be considered as the ‘ultimate inequality outcome’ [8] It often remains unclear whether the observed patterns reflect inequalities in incidence or in casefatality (survival) [9]. Studies on migrants’ incidence, survival and mortality can produce additional knowledge on disease aetiology which is important for prevention and treatment programs, and to identify migrants’ health care needs [1, 3, 4, 10,11,12,13,14,15,16]. As migrants have been exposed to multiple environments before, during and after migration, they are a apt group to study health differences in order to reveal novel insights on the causes of diseases [1, 15, 17,18,19]
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