Philipp Jaehn1, Bernd Holleczek, Heiko Becher, Volker Winkler. 1. aInstitute of Public Health, Heidelberg University, Heidelberg bInstitute of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg cSaarland Cancer Registry, Saarbrücken, Germany.
Abstract
OBJECTIVE: The incidence of gastric cancer (GC) is high among migrants from Eastern Europe and Asia, but a detailed picture of disease characteristics is missing. Our study examined the incidence of histologic types among resettlers from the former Soviet Union and the general population in Germany to draw conclusions on risk factors and possible prevention strategies. METHODS: Between 1990 and 2009, all GC diagnoses among a cohort of 18 619 resettlers residing in the Saarland were identified in the Saarland Cancer Registry database. Age-standardized incidence rates (ASRs) of the entire Saarland population and standardized incidence ratios (SIRs) of resettlers compared with the Saarland population were calculated for types according to Laurén. In addition, ASRs and SIRs were modeled using Poisson's regression to investigate time trends. RESULTS: The ASR of intestinal GC in the Saarland population decreased over time, whereas the ASR of diffuse GC remained unchanged. Resettlers' incidence of intestinal GC was elevated among men [SIR: 3.04, 95% confidence interval (CI): 2.05-4.50] and women (SIR: 2.78, 95% CI: 1.61-4.79), whereas diffuse GC was elevated only among women (SIR: 1.98, 95% CI: 1.07-3.69). No time trends for SIRs could be observed in regression analysis. CONCLUSION: Different trends of diffuse GC incidence in Germany and the USA underline the importance of environmental risk factors. The continuously elevated risk of GC among male resettlers is probably associated with risk factors affecting exclusively the intestinal type such as a low intake of fruit and vegetables and heavy alcohol consumption. Future prevention programs for resettlers should include dietary measures.
OBJECTIVE: The incidence of gastric cancer (GC) is high among migrants from Eastern Europe and Asia, but a detailed picture of disease characteristics is missing. Our study examined the incidence of histologic types among resettlers from the former Soviet Union and the general population in Germany to draw conclusions on risk factors and possible prevention strategies. METHODS: Between 1990 and 2009, all GC diagnoses among a cohort of 18 619 resettlers residing in the Saarland were identified in the Saarland Cancer Registry database. Age-standardized incidence rates (ASRs) of the entire Saarland population and standardized incidence ratios (SIRs) of resettlers compared with the Saarland population were calculated for types according to Laurén. In addition, ASRs and SIRs were modeled using Poisson's regression to investigate time trends. RESULTS: The ASR of intestinal GC in the Saarland population decreased over time, whereas the ASR of diffuse GC remained unchanged. Resettlers' incidence of intestinal GC was elevated among men [SIR: 3.04, 95% confidence interval (CI): 2.05-4.50] and women (SIR: 2.78, 95% CI: 1.61-4.79), whereas diffuse GC was elevated only among women (SIR: 1.98, 95% CI: 1.07-3.69). No time trends for SIRs could be observed in regression analysis. CONCLUSION: Different trends of diffuse GC incidence in Germany and the USA underline the importance of environmental risk factors. The continuously elevated risk of GC among male resettlers is probably associated with risk factors affecting exclusively the intestinal type such as a low intake of fruit and vegetables and heavy alcohol consumption. Future prevention programs for resettlers should include dietary measures.
Authors: Roman Rüdiger; Franziska Geiser; Manuel Ritter; Peter Brossart; Mignon-Denise Keyver-Paik; Andree Faridi; Hartmut Vatter; Friedrich Bootz; Jennifer Landsberg; Jörg C Kalff; Ulrich Herrlinger; Glen Kristiansen; Torsten Pietsch; Stefan Aretz; Daniel Thomas; Lukas Radbruch; Franz-Josef Kramer; Christian P Strassburg; Maria Gonzalez-Carmona; Dirk Skowasch; Markus Essler; Matthias Schmid; Jennifer Nadal; Nicole Ernstmann; Amit Sharma; Benjamin Funke; Ingo G H Schmidt-Wolf Journal: BMC Cancer Date: 2021-05-10 Impact factor: 4.430
Authors: Anna Lindblad; Simone Kaucher; Philipp Jaehn; Hiltraud Kajüter; Bernd Holleczek; Lauren Lissner; Heiko Becher; Volker Winkler Journal: Int J Environ Res Public Health Date: 2020-12-09 Impact factor: 3.390