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Prostate cancer incidence and survival in immigrants to Sweden

Hemminki, Kari LU ; Ankerst, Donna P. ; Sundquist, Jan LU and Mousavi, Seyed Mohsen (2013) In World Journal of Urology 31(6). p.1483-1488
Abstract
The large international variation in the incidence of prostate cancer (PC) is well known but the underlying reasons are not understood. We want to compare PC incidence and survival among immigrants to Sweden in order to explain the international differences. Cancer data were obtained from the Swedish Cancer Registry. Standardized incidence ratios (SIRs) were calculated for PC in first-degree immigrants by country of birth. The immigrants were classified into four groups by SIR and area of origin. Survival in PC was assessed by hazard ratio (HR) in the four groups. In some analyses, clinical stage of PC was assessed by the tumor, node, and metastasis classification. The SIR was 0.47 (95 % confidence interval 0.43-0.51) for immigrants with... (More)
The large international variation in the incidence of prostate cancer (PC) is well known but the underlying reasons are not understood. We want to compare PC incidence and survival among immigrants to Sweden in order to explain the international differences. Cancer data were obtained from the Swedish Cancer Registry. Standardized incidence ratios (SIRs) were calculated for PC in first-degree immigrants by country of birth. The immigrants were classified into four groups by SIR and area of origin. Survival in PC was assessed by hazard ratio (HR) in the four groups. In some analyses, clinical stage of PC was assessed by the tumor, node, and metastasis classification. The SIR was 0.47 (95 % confidence interval 0.43-0.51) for immigrants with the lowest risk, constituting men from Turkey, Middle East, Asia, and Chile. The HR was 0.60 (0.45-0.81) for these men and it was 0.49 if they had stayed 20+ years in Sweden. The SIR in screening detected PC, T1c, was 0.55. Among these men, screening detected PC constituted 34.5 % of all PC, compared to 29.0 % among Swedes (p = 0.10). The results showed that the non-European immigrants, of mainly Middle East, Asian, and Chilean origin, with the lowest risk of PC, also had the most favorable survival in PC. As the available clinical features of PC at diagnosis or the distribution of known risk factors could not explain the differences, a likely biological mechanism through a favorable androgenic hormonal host environment is suggested as an explanation of the observed effects. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Immigrant, Incidence, Survival, Screening TNM
in
World Journal of Urology
volume
31
issue
6
pages
1483 - 1488
publisher
Springer
external identifiers
  • wos:000327130700025
  • scopus:84888290631
  • pmid:23306784
ISSN
1433-8726
DOI
10.1007/s00345-012-1021-z
language
English
LU publication?
yes
id
ef0130b2-1025-49a2-b99f-95a846fd993c (old id 4196625)
date added to LUP
2016-04-01 13:53:39
date last changed
2020-01-12 14:01:23
@article{ef0130b2-1025-49a2-b99f-95a846fd993c,
  abstract     = {The large international variation in the incidence of prostate cancer (PC) is well known but the underlying reasons are not understood. We want to compare PC incidence and survival among immigrants to Sweden in order to explain the international differences. Cancer data were obtained from the Swedish Cancer Registry. Standardized incidence ratios (SIRs) were calculated for PC in first-degree immigrants by country of birth. The immigrants were classified into four groups by SIR and area of origin. Survival in PC was assessed by hazard ratio (HR) in the four groups. In some analyses, clinical stage of PC was assessed by the tumor, node, and metastasis classification. The SIR was 0.47 (95 % confidence interval 0.43-0.51) for immigrants with the lowest risk, constituting men from Turkey, Middle East, Asia, and Chile. The HR was 0.60 (0.45-0.81) for these men and it was 0.49 if they had stayed 20+ years in Sweden. The SIR in screening detected PC, T1c, was 0.55. Among these men, screening detected PC constituted 34.5 % of all PC, compared to 29.0 % among Swedes (p = 0.10). The results showed that the non-European immigrants, of mainly Middle East, Asian, and Chilean origin, with the lowest risk of PC, also had the most favorable survival in PC. As the available clinical features of PC at diagnosis or the distribution of known risk factors could not explain the differences, a likely biological mechanism through a favorable androgenic hormonal host environment is suggested as an explanation of the observed effects.},
  author       = {Hemminki, Kari and Ankerst, Donna P. and Sundquist, Jan and Mousavi, Seyed Mohsen},
  issn         = {1433-8726},
  language     = {eng},
  number       = {6},
  pages        = {1483--1488},
  publisher    = {Springer},
  series       = {World Journal of Urology},
  title        = {Prostate cancer incidence and survival in immigrants to Sweden},
  url          = {http://dx.doi.org/10.1007/s00345-012-1021-z},
  doi          = {10.1007/s00345-012-1021-z},
  volume       = {31},
  year         = {2013},
}