European Journal of Gastroenterology and Hepatology
Volume 21, Issue 4, 2009, Pages 319-326
Stomach cancer mortality in two large cohorts of migrants from the former soviet union to israel and Germany: Are there implications for prevention? (Article)
Ronellenfitsch U.* ,
Kyobutungi C. ,
Ott J.J. ,
Paltiel A. ,
Razum O. ,
Schwarzbach M. ,
Winkler V. ,
Becher H.
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a
Department of Surgery, University Medicine Mannheim, Ruprecht-Karls-University Heidelberg, Germany
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b
African Population and Health Research Centre, Nairobi, Kenya
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c
Department of Tropical Hygiene and Public Health, University Hospital Heidelberg, Ruprecht-Karls-University Heidelberg, Heidelberg, Germany
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d
Central Bureau of Statistics, Rehov Kanfei Nesharim, Jerusalem, Israel
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e
Department of Epidemiology and International Public Health, School of Public Health, University of Bielefeld, Bielefeld, Germany
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f
Department of Surgery, University Medicine Mannheim, Ruprecht-Karls-University Heidelberg, Germany
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g
Department of Tropical Hygiene and Public Health, University Hospital Heidelberg, Ruprecht-Karls-University Heidelberg, Heidelberg, Germany
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h
Department of Tropical Hygiene and Public Health, University Hospital Heidelberg, Ruprecht-Karls-University Heidelberg, Heidelberg, Germany
Abstract
Objectives Prevention and early detection are key elements for the reduction of stomach cancer mortality. To apply pertinent measures effectively, high-risk groups need to be identified. With this aim, we assessed stomach cancer mortality among migrants from the Former Soviet Union (FSU), a high-risk area, to Germany and Israel. Methods We calculated standardized mortality ratios (SMRs) comparing stomach cancer mortality in two retrospective migrant cohorts from the FSU to Germany (n=34393) and Israel (n=589388) to that in the FSU and the host country. The study period ranges from 1990 to 2005 in Germany and from 1990 to 2003 in Israel. Vital status and cause of death were retrieved from municipal and state registries. To assess secular mortality trends, we calculated annual age-standardized mortality rates in the cohorts, the FSU, and the two host countries and conducted Poisson regression modeling. Results SMRs (95% confidence intervals) for men in the German migrant cohort were 0.51 (0.36-0.70) compared with the FSU population and 1.44 (1.04-1.99) compared with the German population, respectively. For women, SMRs were 0.73 (0.49-1.03) compared with the FSU population and 1.40 (0.98-1.99) compared with the German population. SMRs for men in the Israeli migrant cohort were 0.49 (0.45-0.53) compared with the FSU population and 1.79 (1.65-1.94) compared with the Israeli population. SMRs for women in the Israeli cohort were 0.65 (0.59-0.72) compared with the FSU population and 1.82 (1.66-1.99) compared with the Israeli population. Poisson modeling showed a secular decrease in all populations with a time lag of 4-5 years between migrants and ʼnatives’ in Germany and converging rates between migrants and the general population in Israel. Conclusion Stomach cancer mortality in migrants from the FSU remains elevated after migration to Germany and Israel but is much lower than in the FSU. Due to a secular decline, it can be expected that mortality among migrants from the FSU reaches within a few years levels similar to those of the host countries today. Therefore, migrant-specific prevention and early detection measures cannot be recommended. Detailed risk factor profiles, however, need to be obtained through further studies. © 2009 Lippincott Williams & Wilkins, Inc.
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https://www.scopus.com/inward/record.uri?eid=2-s2.0-67649618665&doi=10.1097%2fMEG.0b013e3283155220&partnerID=40&md5=907611ecc4c6b3339437dc418980b77f
DOI: 10.1097/MEG.0b013e3283155220
ISSN: 0954691X
Cited by: 19
Original Language: English