Colorectal Cancer among Resettlers from the Former Soviet Union and in the General German Population: Clinical and Pathological Characteristics and Trends

Melani Ratih Mahanani, Simone Kaucher, Hiltraud Kajüter, Bernd Holleczek, Heiko Becher and Volker Winkler
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Melani Ratih Mahanani: Epidemiology of Transition, Heidelberg Institute of Global Health, University Hospital Heidelberg, 69120 Heidelberg, Germany
Simone Kaucher: Epidemiology of Transition, Heidelberg Institute of Global Health, University Hospital Heidelberg, 69120 Heidelberg, Germany
Hiltraud Kajüter: Cancer Registry, 44801 Bochum, Germany
Bernd Holleczek: Saarland Cancer Registry, 66119 Saarbrücken, Germany
Heiko Becher: Institute for Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
Volker Winkler: Epidemiology of Transition, Heidelberg Institute of Global Health, University Hospital Heidelberg, 69120 Heidelberg, Germany

IJERPH, 2021, vol. 18, issue 9, 1-9

Abstract: This study examined time trends and clinical and pathological characteristics of colorectal cancer (CRC) among ethnic German migrants from the Former Soviet Union (resettlers) and the general German population. Incidence data from two population-based cancer registries were used to analyze CRC as age-standardized rates (ASRs) over time. The respective general populations and resettler cohorts were used to calculate standardized incidence ratios (SIRs) by time-period (before and after the introduction of screening colonoscopy in 2002), tumor location, histologic type, grade, and stage at diagnosis. Additionally, SIRs were modeled with Poisson regression to depict time trends. During the study period from 1990 to 2013, the general populations showed a yearly increase of ASR, but for age above 55, truncated ASR started to decline after 2002. Among resettlers, 229 CRC cases were observed, resulting in a lowered incidence for all clinical and pathological characteristics compared to the general population (overall SIR: 0.78, 95% CI 0.68–0.89). Regression analysis revealed an increasing SIR trend after 2002. Population-wide CRC incidence decreases after the introduction of screening colonoscopy. In contrast the lowered CRC incidence among resettlers is attenuating to the general population after 2002, suggesting that resettlers do not benefit equally from screening colonoscopy.

Keywords: incidence; colorectal cancer; young-onset; clinical characteristics; pathological characteristics; migrants; Former Soviet Union; Germany (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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