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Cancer mortality patterns among Turkish immigrants in four European countries and in Turkey
Authors:Jacob Spallek  Melina Arnold  Oliver Razum  Knud Juel  Grégoire Rey  Patrick Deboosere  Johan Pieter Mackenbach  Anton Eduard Kunst
Institution:1. Department of Epidemiology and International Public Health, School of Public Health, Bielefeld University, PO Box 100131, 33501, Bielefeld, Germany
2. Department of Public Health, Erasmus University Medical Centre, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
3. National Institute of Public Health, University of Southern Denmark, ?ster Farimagsgade 5A, 2. Sal, 1353, Copenhagen, Denmark
4. INSERM, CépiDc, 80 Rue du Général Leclerc, 94270, Le Kremlin-Bicêtre Cedex, France
5. Interface Demography, Department of Social Research, Free University of Brussels, Pleinlaan 5, 1050, Brussel, Belgium
6. Department of Public Health, Academic Medical Centre, University of Amsterdam, PO Box 22660, 1100 DD, Amsterdam, The Netherlands
Abstract:The aim of this study on cancer mortality among Turkish immigrants, for the first time, traditional comparisons in migrant health research have been extended simultaneously in two ways. First, comparisons were made to cancer mortality from the immigrants’ country of origin and second, cancer mortality among Turkish immigrants across four host countries (Belgium, Denmark, France and the Netherlands) was compared. Population-based cancer mortality data from these countries were included. Age-standardized mortality rates were computed for the local-born and Turkish population of each country. Relative differences in cancer mortality were examined by fitting country-specific Poisson regression models. Globocan data on cancer mortality in Turkey from 2008 were used in order to compare mortality rates of Turkish immigrants with those from their country of origin. Turkish immigrants had lower all-cancer mortality than the local-born populations of their host countries, and mortality levels comparable to all-cancer mortality rates in Turkey. In the Netherlands and France breast cancer mortality was consistently lower in Turkish immigrants women than among local-born women. Lung cancer mortality was slightly lower in Turkish immigrants in the Netherlands and France but varied considerably between migrants in these two host countries. Stomach cancer mortality was significantly higher in Turkish immigrants when compared to local-born French and Dutch. Our findings indicate that exposures both in the country of origin and in the host country can have an effect on the cancer mortality of immigrants. Despite limitations affecting any cross-country comparison of mortality, the innovative multi-comparison approach is a promising way to gain further insights into determinants of trends in cancer mortality of immigrants.
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