title: Investigating cervical, oesophageal and colon cancer risk and survival among migrants in The Netherlands.
abstract: BACKGROUND
  Studies on cancer in migrants can shed light on grey areas in cancer aetiology and can help assessing the effectiveness of prevention measures. In this study, we aimed to determine the impact of migration and different ethnic backgrounds on cervical, colon and oesophageal cancer risk and survival.
  
  
  METHODS
  Cancers diagnosed in 1996-2009 were selected from The Netherlands Cancer Registry. Besides standardized incidence ratios, differences in survival were explored using Cox regression and relative survival analysis.
  
  
  RESULTS
  All migrant women had increased risks for cervical cancer when compared with Dutch native women, ranging from standardized incidence ratio = 1.8 (95% confidence interval 1.6-2.2) in Surinamese women to 1.2 (0.9-1.5) in Turkish women. Relative survival was better among Moroccan, Surinamese and Antillean migrants [5-year relative survival rates (RSR) range: 71-73%] compared with that of native Dutch (66%); however, it was poorer in Indonesians (51%). Although oesophageal cancer risk was lower in all migrants with Standardized incidence ratios ranging from 0.1 to 0.6, survival was slightly lower relative to Dutch natives (1-year RSR: 21-32% compared with 37%; Turkish: 42%). Colon cancer was less common among migrants, particularly among Moroccans and Turkish. Five-year RSR from colon cancer was equal or better in all migrants (range: 48% in Indonesians to 62% in Turkish) compared with Dutch natives (48%).
  
  
  CONCLUSIONS
  Risk of cervical, oesophageal and colon cancer in migrants mainly reflects the risks in their countries of origin. Almost similar cancer survival rates in migrants and native Dutch individuals points towards successful and comprehensive health care in The Netherlands. Primary cancer prevention should target high-risk groups and involve migration-sensitive approaches.
authors.affiliation: 1 Department of Public Health, Erasmus Medical Centre, Rotterdam, The Netherlands.
authors.forename: Melina
authors.initials: M
authors.lastname: Arnold
authors.forename: Mieke Josepha
authors.initials: MJ
authors.lastname: Aarts
authors.forename: Maaike
authors.initials: M
authors.lastname: van der Aa
authors.forename: Otto
authors.initials: O
authors.lastname: Visser
authors.forename: Jan Willem
authors.initials: JW
authors.lastname: Coebergh
mesh_terms: D003110:Colonic Neoplasms / Q000453:epidemiology / Q000401:mortality* / Q000517:prevention & control; D004938:Esophageal Neoplasms / Q000453:epidemiology / Q000401:mortality* / Q000517:prevention & control; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D012307:Risk Factors; D016019:Survival Analysis; D014171:Transients and Migrants; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology / Q000401:mortality* / Q000517:prevention & control