International Journal of Cancer
Volume 123, Issue 11, 2008, Pages 2664-2670

Risk of cervical cancer among immigrants by age at immigration and follow-up time in Sweden, from 1968 to 2004 (Article)

Azerkan F.* , Zendehdel K. , Tillgren P. , Faxelid E. , Sparén P.
  • a Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden, Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, P.O. Box 281, SE-171 77 Stockholm, Sweden
  • b Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden, Cancer Institute Research Center, Tehran University of Medical Sciences, Tehran, Iran
  • c Department of Caring and Public Health Sciences, Mälardalen University, Västerås, Sweden, Division of Social Medicine, Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
  • d Division of International Health (ICHAR), Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
  • e Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden

Abstract

Because of great variation in the prevalence of human papilloma virus infection and other risk factors of cervical cancer worldwide, migrant studies may help further the understanding of the aetiology and improve prevention of cervical cancer. Our aim was to study the risk of invasive cervical cancer among immigrant women. We followed 758,002 immigrants from different countries who resided in Sweden between 1968 and 2004. Age-standardised incidence rates (ASRs) of immigrants were compared with that in their countries of origin. Poisson regression models estimated the relative risks of cervical cancer among immigrants, overall and stratified by age at migration and follow-up time, compared to Swedish-born women. Overall 1,991 of 19,542 observed cases of cervical cancer occurred among immigrants. Generally they had lower ASRs than in their countries of origin, with the exception of Nordic immigrants. Compared to Swedish-born women, we observed a higher relative risk of cervical cancer among immigrants overall (RR = 1.13, 95% CI 1.08-1.18), and particularly among women from Denmark (RR = 1.8, 95% CI 1.6-2.1), Norway (RR = 1.7, 95% CI 1.5-1.9) and Central America (RR = 2.5, 95% CI 1.3-4.9), while the relative risks were lower in immigrants from Eastern Africa (RR = 0.2, 95% CI 0.1-0.6), South Central Asia (RR = 0.4, 95% CI 0.2-0.6) and South Western Asia (RR = 0.5, 95% CI 0.4-0.7). Follow-up time and age at migration were important effect modifiers for cervical cancer risks. We suggest targeted prevention toward high-risk immigrants, specifically older women, in the first 10 years after arrival into their new homeland. © 2008 Wiley-Liss, Inc.

Author Keywords

Immigrant Risk Invasive cervical cancer Sweden

Index Keywords

immigrant Follow-Up Studies follow up human immigration middle aged Asia controlled study priority journal cancer risk Time Factors Aged Confidence interval Sweden Humans Adolescent female Aged, 80 and over Risk Factors Africa Article cancer invasion adult major clinical study migration uterine cervix cancer Uterine Cervical Neoplasms age distribution Emigration and Immigration Poisson distribution cancer incidence
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-57349119026&doi=10.1002%2fijc.23843&partnerID=40&md5=592375c8eb8893dee4df05293bbace4a
DOI: 10.1002/ijc.23843
ISSN: 00207136
Cited by: 28
Original Language: English