Gastric Cancer Risk among Immigrants and Socioeconomic Groups in the Netherlands.

Background: Identification of groups at a high-risk of gastric cancer (GC) could facilitate targeted screening in countries with a low GC 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 2010-2022. GC incidence rates in the 14 largest immigrant populations were compared to those born in the Netherlands. Odds ratios (ORs) were computed per birthplace and controlled for age, sex and SES. Additionally, we investigated GC risk among second-generation immigrants and by SES.

Results: Immigrant populations at a significantly higher GC risk compared to 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. While low SES increased the odds of developing GC, first-generation immigrants remained at higher risk even after controlling for SES. Second-generation immigrants did not have a significantly higher risk of developing GC.

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

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