Aisha K Lofters, Jacqueline L Bender, Sarah Swayze, Shabbir Alibhai, Anthony Henry, Kenneth Noel, Geetanjali D Datta
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引用次数: 0
Abstract
Background: Prostate cancer incidence has been associated with various sociodemographic factors, such as race, income and age, but the association with immigrant status in Canada is unclear. In this population-based study in Ontario, Canada, we compared age-standardized incidence rates for immigrant males from various regions of origin with the rates of long-term residents.
Methods: In this retrospective cohort study, we linked several provincial-level databases available at ICES, an independent, non-profit research institute. We included all males aged 20 years and older in the province of Ontario eligible for health care for each fiscal year (Apr. 1 to Mar. 31) in 2008-2016. We determined age-standardized prostate cancer incidence rates, stratifying by immigrant status (a binary variable) and region of origin. We used a log-binomial model to estimate adjusted incidence rate ratios, with long-term residents (Canadian-born Ontarians as well as those who immigrated before 1985, when available data on immigration starts) as the reference group. We included age, neighbourhood income and time since landing in the models. Additional models limited to immigrant males in the cohort included immigration admission category (economic class, family class, refugee, other) and time since landing in Canada.
Results: There were 74594 incident cases of prostate cancer in the study period, 6742 of which were among immigrant males. Males who had immigrated from West Africa and the Caribbean had significantly higher incidence of prostate cancer than other immigrants and long-term residents: adjusted rate ratios of 2.71 (95% confidence interval [CI] 2.41-3.05) and 1.91 (95% CI 1.78-2.04), respectively. Immigrants from other regions, including East Africa and Middle-Southern Africa, had lower or similar incidence rates to long-term residents. Males from South Asia had the lowest adjusted rate ratio (0.47, 95% CI 0.45-0.50).
Interpretation: The age-standardized incidence rate of prostate cancer from 2008 to 2016 was consistently and significantly higher among immigrants from West African and Caribbean countries than among other immigrants and long-term residents of the province. Future research in Canada should focus on further understanding heterogeneity in prostate cancer risk and epidemiology, including stage of diagnosis and mortality, for immigrants.
背景:前列腺癌的发病率与各种社会人口因素有关,如种族、收入和年龄,但与加拿大移民身份的关系尚不清楚。在加拿大安大略省的这项基于人群的研究中,我们比较了来自不同原籍地区的移民男性的年龄标准化发病率与长期居民的发病率。方法:在这项回顾性队列研究中,我们将独立的非营利性研究机构ICES提供的几个省级数据库联系起来。我们纳入了2008-2016年安大略省每个财政年度(4月1日至3月31日)有资格享受医疗保健的所有20岁及以上男性。我们确定了年龄标准化的前列腺癌发病率,按移民身份(二元变量)和原籍地区分层。我们使用对数二项模型来估计调整后的发病率比,以长期居民(加拿大出生的安大略省居民以及1985年之前移民的人,当时有移民数据开始)作为参照组。我们在模型中包括了年龄、邻里收入和落地时间。其他仅限于男性移民的模型包括移民入境类别(经济阶层、家庭阶层、难民、其他)和抵达加拿大后的时间。结果:研究期间共发生前列腺癌74594例,其中男性移民6742例。来自西非和加勒比地区的男性移民前列腺癌的发病率明显高于其他移民和长期居民:调整后的比率分别为2.71(95%可信区间[CI] 2.41-3.05)和1.91 (95% CI 1.78-2.04)。来自其他地区的移民,包括东非和中非南部,与长期居民的发病率较低或相似。南亚男性校正后的发病率比最低(0.47,95% CI 0.45-0.50)。解释:2008年至2016年,来自西非和加勒比国家的移民的年龄标准化前列腺癌发病率持续且显著高于该省其他移民和长期居民。加拿大未来的研究应集中于进一步了解移民前列腺癌风险和流行病学的异质性,包括诊断阶段和死亡率。