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Cancer, cardiovascular disease, and all-cause mortality in Iraqi- and Swedish-born individuals in Sweden : the MEDIM cohort study

Dhaher, Nadine Fadhel LU ; Pikkemaat, Miriam LU orcid ; Shaat, Nael LU orcid ; Nilsson, Anton LU and Bennet, Louise LU orcid (2023) In Scientific Reports 13(1). p.13-13
Abstract

Immigrants from the Middle East to Sweden have a twice as high prevalence of type 2 diabetes (T2D) and obesity as native-born Swedes. Both obesity and T2D have been linked to increased incidence of cancer, cardiovascular disease (CVD) and all-cause mortality (ACM); however, data on differences between ethnicities are scarce. In a population-based cohort we aimed to study the impact of Middle Eastern and European ethnicity on ACM, cancer- and CVD related mortality, incidence of cancer and CVD in an eight-year follow-up study. Methods: People born in Iraq or Sweden, who were 30-75 years of age, were invited from 2010 to 2012 to participate in the population based MEDIM study including a health exam, fasting blood sampling, assessment of... (More)

Immigrants from the Middle East to Sweden have a twice as high prevalence of type 2 diabetes (T2D) and obesity as native-born Swedes. Both obesity and T2D have been linked to increased incidence of cancer, cardiovascular disease (CVD) and all-cause mortality (ACM); however, data on differences between ethnicities are scarce. In a population-based cohort we aimed to study the impact of Middle Eastern and European ethnicity on ACM, cancer- and CVD related mortality, incidence of cancer and CVD in an eight-year follow-up study. Methods: People born in Iraq or Sweden, who were 30-75 years of age, were invited from 2010 to 2012 to participate in the population based MEDIM study including a health exam, fasting blood sampling, assessment of insulin secretion and action (through oral glucose tolerance test) and questionnaires assessing history of CVD, cancer and T2D. Register data were retrieved from baseline until the 31st of December 2018 from the Swedish National Patient Register and Cause of Death register regarding CVD diagnosis, cancer diagnosis and cause of death. Information regarding diabetes diagnosis was retrieved from the National Diabetes Register. Individuals with a history of cancer or CVD at baseline were excluded. Cox regression analysis was assessed to study the adjusted hazard ratios (HR) for the relationships between ethnicity and ACM, cancer events, CVD events, death from cancer, and death from CVD, with adjustments for age, sex, anthropometrical measures, T2D and lifestyle. A total of 1398 Iraqi- and 757 Swedish-born residents participated in the study. ACM was considerably lower in Iraqi- compared to Swedish-born individuals HR 0.32 (95% CI 0.13-0.79) (p < 0.05). Furthermore, cancer related morbidity and mortality HR 0.39 (0.22-0.69) (p < 0.01) as well as CVD related morbidity and mortality HR 0.56 (0.33-0.95) (p < 0.05) were lower in the Iraqi-born group compared to the Swedish-born group for. The differences in mortality and cancer rates across ethnicities are not fully explained by anthropometric, environmental or metabolic measures but lie elsewhere. Further studies are needed to increase the understanding of contributing mechanisms.

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author
; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Humans, Sweden/epidemiology, Iraq/epidemiology, Diabetes Mellitus, Type 2, Cardiovascular Diseases/epidemiology, Cohort Studies, Follow-Up Studies, Obesity, Neoplasms/epidemiology, Risk Factors
in
Scientific Reports
volume
13
issue
1
article number
6129
pages
13 - 13
publisher
Nature Publishing Group
external identifiers
  • scopus:85152575513
  • pmid:37061557
ISSN
2045-2322
DOI
10.1038/s41598-023-33379-6
language
English
LU publication?
yes
additional info
© 2023. The Author(s).
id
cea6931e-1a92-47c5-9d9c-af845a419a8d
date added to LUP
2023-04-20 13:50:09
date last changed
2024-06-15 02:00:41
@article{cea6931e-1a92-47c5-9d9c-af845a419a8d,
  abstract     = {{<p>Immigrants from the Middle East to Sweden have a twice as high prevalence of type 2 diabetes (T2D) and obesity as native-born Swedes. Both obesity and T2D have been linked to increased incidence of cancer, cardiovascular disease (CVD) and all-cause mortality (ACM); however, data on differences between ethnicities are scarce. In a population-based cohort we aimed to study the impact of Middle Eastern and European ethnicity on ACM, cancer- and CVD related mortality, incidence of cancer and CVD in an eight-year follow-up study. Methods: People born in Iraq or Sweden, who were 30-75 years of age, were invited from 2010 to 2012 to participate in the population based MEDIM study including a health exam, fasting blood sampling, assessment of insulin secretion and action (through oral glucose tolerance test) and questionnaires assessing history of CVD, cancer and T2D. Register data were retrieved from baseline until the 31st of December 2018 from the Swedish National Patient Register and Cause of Death register regarding CVD diagnosis, cancer diagnosis and cause of death. Information regarding diabetes diagnosis was retrieved from the National Diabetes Register. Individuals with a history of cancer or CVD at baseline were excluded. Cox regression analysis was assessed to study the adjusted hazard ratios (HR) for the relationships between ethnicity and ACM, cancer events, CVD events, death from cancer, and death from CVD, with adjustments for age, sex, anthropometrical measures, T2D and lifestyle. A total of 1398 Iraqi- and 757 Swedish-born residents participated in the study. ACM was considerably lower in Iraqi- compared to Swedish-born individuals HR 0.32 (95% CI 0.13-0.79) (p &lt; 0.05). Furthermore, cancer related morbidity and mortality HR 0.39 (0.22-0.69) (p &lt; 0.01) as well as CVD related morbidity and mortality HR 0.56 (0.33-0.95) (p &lt; 0.05) were lower in the Iraqi-born group compared to the Swedish-born group for. The differences in mortality and cancer rates across ethnicities are not fully explained by anthropometric, environmental or metabolic measures but lie elsewhere. Further studies are needed to increase the understanding of contributing mechanisms.</p>}},
  author       = {{Dhaher, Nadine Fadhel and Pikkemaat, Miriam and Shaat, Nael and Nilsson, Anton and Bennet, Louise}},
  issn         = {{2045-2322}},
  keywords     = {{Humans; Sweden/epidemiology; Iraq/epidemiology; Diabetes Mellitus, Type 2; Cardiovascular Diseases/epidemiology; Cohort Studies; Follow-Up Studies; Obesity; Neoplasms/epidemiology; Risk Factors}},
  language     = {{eng}},
  month        = {{04}},
  number       = {{1}},
  pages        = {{13--13}},
  publisher    = {{Nature Publishing Group}},
  series       = {{Scientific Reports}},
  title        = {{Cancer, cardiovascular disease, and all-cause mortality in Iraqi- and Swedish-born individuals in Sweden : the MEDIM cohort study}},
  url          = {{http://dx.doi.org/10.1038/s41598-023-33379-6}},
  doi          = {{10.1038/s41598-023-33379-6}},
  volume       = {{13}},
  year         = {{2023}},
}