Investigating cervical, oesophageal and colon cancer risk and survival among migrants in The Netherlands

Eur J Public Health. 2013 Oct;23(5):867-73. doi: 10.1093/eurpub/cks146. Epub 2012 Oct 23.


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%).

Conclusion: 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.

MeSH terms

  • Colonic Neoplasms / epidemiology
  • Colonic Neoplasms / mortality*
  • Colonic Neoplasms / prevention & control
  • Esophageal Neoplasms / epidemiology
  • Esophageal Neoplasms / mortality*
  • Esophageal Neoplasms / prevention & control
  • Ethnic Groups / statistics & numerical data*
  • Female
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Netherlands / epidemiology
  • Risk Factors
  • Survival Analysis
  • Transients and Migrants*
  • Uterine Cervical Neoplasms / epidemiology
  • Uterine Cervical Neoplasms / mortality*
  • Uterine Cervical Neoplasms / prevention & control