Background:

Identification of groups at a high risk of gastric cancer could facilitate targeted screening in countries with a low gastric cancer incidence. Our aim was to identify such high-risk groups based on individual-level population data on migration history and socioeconomic status (SES) in the Netherlands.

Methods:

In this retrospective cohort study, patient data from the Netherlands Cancer Registry were linked to demographic data of Statistics Netherlands in the period 2010 to 2022. Gastric cancer incidence rates in the 14 largest immigrant populations were compared with those born in the Netherlands. Odds ratios (OR) were computed per birthplace and controlled for age, sex, and SES. Additionally, we investigated gastric cancer risk among second-generation immigrants and by SES.

Results:

Immigrant populations at a significantly higher gastric cancer risk compared with the general population were identified. Specifically, foreign-born first-generation immigrants from Bosnia–Herzegovina (OR, 2.42), Turkey (OR, 2.22), and China (OR, 1.92) showed elevated risk. Whereas low SES increased the odds of developing gastric cancer, first-generation immigrants remained at higher risk even after controlling for SES. Second-generation immigrants did not have a significantly higher risk of developing gastric cancer.

Conclusions:

Certain first-generation immigrants remain at an elevated risk for gastric cancer despite migration to a low-risk region. Identification of these high-risk groups should be used to facilitate targeted gastric cancer prevention.

Impact:

Potential benefits of targeted Helicobacter pylori test-and-treat policy in immigrant populations should be explored in clinical and modeling studies. Primary care physicians should be cognizant of high-risk groups, facilitating the early detection of cancer within these populations.

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©2024 The Authors; Published by the American Association for Cancer Research
2024
American Association for Cancer Research
This open access article is distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) license.
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License .
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Supplementary data

Sup. Figure 1

Odds ratios of gastric cancer per country of birth compared to the general population, controlled for age and sex. The results are presented in totals and stratified by topographic location (non-cardia and cardia).

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Sup. Figure 2

Odds ratios of gastric cancer per region of birth compared to the general population, controlled for age and sex. The results are presented in totals and stratified by topographic location (non-cardia and cardia).

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Sup. Figure 3

Observed stage distribution at the time of diagnosis of GC patients per country of birth. The countries with fewer than 10 observations in any given category have been amalgamated. The results are presented in totals and stratified by topographic location (non-cardia and cardia).

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Sup. Figure 4

Odds ratios of gastric cancer per region of birth compared to the general population, controlled for age, sex and socioeconomic status. The results are presented in totals and stratified by topographic location (non-cardia and cardia). Countries with fewer than 10 cases have been omitted for privacy reasons.

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Sup. Figure 5

Odd ratios of gastric cancer for second generation migrants compared to the general population, controlled for age and sex. The results are presented in totals and stratified by topographic location (non-cardia and cardia). The countries with fewer than 10 observations in any given category have been amalgamated.

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Sup. Figure 6

Odd ratios of gastric cancer for second generation migrants compared to the general population, controlled for age and sex The results are presented in totals and stratified by topographic location (non-cardia and cardia). Countries with fewer than 10 cases have been omitted for privacy reasons.

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Sup. Figure 7

Observed stage distribution at the time of diagnosis of GC patients per level of socioeconomic status (I-V). The results are presented in totals and stratified by topographic location (non-cardia and cardia).

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Sup. Figure 8

Odd ratios of gastric cancer per socioeconomic status compared to the general population, controlled for age, sex and immigration status (first-generation and second-generation). The results are presented in totals and stratified by topographic location (non-cardia and cardia).

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Sup. Table 1

Crude and age-standardized incidence rates per 100,000 for immigrants from selected countries in the Netherlands in the period 2010 to 2021.

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Sup. Table 2

Age-specific incidence rates per 100,000 for immigrants from selected countries in the Netherlands in the period 2010 to 2021. *Numbers were too small for other countries.

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Sup. Table 3

Age-distributions of immigrants per country in the Netherlands in 2015. *Some data fields are empty, due to small samples.

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Sup. Table 4

Age-distributions of immigrants per region in the Netherlands in 2015. *Some data fields are empty, due to small samples.

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