Risk of localized and advanced prostate cancer among immigrants versus native-born Swedish men: A nation-wide population-based study Journal Article


Authors: Loeb, S.; Drevin, L.; Robinson, D.; Holmberg, E.; Carlsson, S.; Lambe, M.; Stattin, P.
Article Title: Risk of localized and advanced prostate cancer among immigrants versus native-born Swedish men: A nation-wide population-based study
Abstract: Purpose: Prostate cancer (PCa) incidence and prognosis vary geographically. We examined possible differences in PCa risk by clinical risk category between native-born and immigrant populations in Sweden. Our hypothesis was that lower PSA-testing uptake among foreign-born men would result in lower rates of localized disease, and similar or higher risk of metastatic disease. Methods: Using the Prostate Cancer database Sweden, we identified 117,328 men with PCa diagnosed from 1991 to 2008, of which 8,332 were foreign born. For each case, 5 cancer-free matched controls were randomly selected from the population register. Conditional logistic regression was used to compare low risk, intermediate risk, high risk, regionally metastatic, and distant metastatic PCa based upon region of origin. Results: Across all risk categories, immigrants had significantly lower PCa risk than native-born Swedish men, except North Americans and Northern Europeans. The lowest PCa risk was observed in men from the Middle East, Southern Europe, and Asia. Multivariable adjustment for socioeconomic factors and comorbidities did not materially change risk estimates. Older age at immigration and more recent arrival in Sweden were associated with lower PCa risk. Non-native men were less likely to be diagnosed with PCa through PSA testing during a health checkup. Conclusions: The risk for all stages of PCa was lower among first-generation immigrants to Sweden compared with native-born men. Older age at immigration and more recent immigration were associated with particularly low risks. Patterns of PSA testing appeared to only partly explain the differences in PCa risk, since immigrant men also had a lower risk of metastatic disease. © 2012 Springer Science+Business Media Dordrecht.
Keywords: adult; child; controlled study; school child; aged; major clinical study; case-control studies; cancer localization; advanced cancer; cancer risk; cancer staging; prostate specific antigen; incidence; patient assessment; risk assessment; risk; prostate cancer; sweden; prostatic neoplasms; social status; comorbidity; cancer registry; asia; high risk population; race difference; ethnic group; socioeconomic factors; geography; immigrants; emigrants and immigrants; middle east; immigrant; indigenous people; swedish; low risk population
Journal Title: Cancer Causes & Control
Volume: 24
Issue: 2
ISSN: 0957-5243
Publisher: Springer  
Date Published: 2013-02-01
Start Page: 383
End Page: 390
Language: English
DOI: 10.1007/s10552-012-0124-6
PROVIDER: scopus
PUBMED: 23266834
PMCID: PMC4968041
DOI/URL:
Notes: --- - "Export Date: 1 July 2013" - "CODEN: CCCNE" - "Source: Scopus"
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  1. Sigrid Viktoria Carlsson
    220 Carlsson
  2. Par Erik Stattin
    47 Stattin