Diverging breast and stomach cancer incidence and survival in migrants in The Netherlands, 1996–2009

Figures & data

Table I. Description of cohort of newly diagnosed breast and stomach cancer cases in the Netherlands according to country of birth (1996–2009).

	Country of birth
	Native Dutch	Antilles/ Aruba	Indonesia	Morocco	Suriname	Turkey
Breast cancer
Total (n)	92 197	366	1964	325	888	386
Mean age (y)	63	53	67	46	54	49
SES high (%)	29	25	37	12	22	12
SES mid (%)	34	25	26	17	16	13
SES low (%)	37	49	37	71	62	75
SES unknown (%)	0.1	0.8	0.3	0.0	0.2	0.3
Stage* (n included)	45 927	221	1253	196	664	242
Stage 1 (%)	38	38	36	21	33	27
Stage 2 (%)	44	46	44	49	49	47
Stage 3 (%)	11	11	11	21	11	19
Stage 4 (%)	5.6	4.1	6.0	4.6	5.6	5.0
Stage unknown (%)	1.9	1.4	2.8	3.1	1.5	2.5
Median FU (y)	4.6	4.1	4.7	3.9	4.5	4.5
Stomach cancer
Total (n)	24 443	83	279	154	263	274
Females (%)	36	46	37	32	41	30
Mean age (y)	71	57	70	57	61	56
Cardia (%)	16	38	13	28	11	14
Non-cardia (%)	84	62	87	72	89	86
SES high (%)	24	19	35	8	15	5
SES mid (%)	35	16	28	19	16	13
SES low (%)	41	65	37	72	68	81
SES unknown (%)	0	0	0	0	0.4	0.0
Stage cardia (n included)	6869	13	105	20	30	38
Stage 1 (%)	9.0	0	6.7	20	6.7	13
Stage 2 (%)	12	0	16	0	3.3	18
Stage 3 (%)	16	31	16	10	27	11
Stage 4 (%)	41	46	31	50	33	45
Stage unknown (%)	22	23	30	20	30	13
Stage non-cardia (n included)	17 574	70	174	134	233	236
Stage 1 (%)	13	7.1	10	16	17	17
Stage 2 (%)	11	5.7	7.5	14	9.4	13
Stage 3 (%)	15	14	11	19	16	19
Stage 4 (%)	38	57	38	41	39	37
Stage unknown (%)	23	16	33	10	18	13
Median FU (y)	0.5	0.9	0.6	0.7	0.9	1.0
Median FU (y), cardia	0.6	0.9	0.6	0.5	0.6	0.7
Median FU (y), non-cardia	0.5	0.9	0.5	0.9	1.0	1.1

FU, follow-up; SES, socioeconomic status. *data on stage distribution of breast cancer are based on the former regions of Comprehensive Centres Amsterdam, West and Stedendriehoek Twente.

Table II. Standardized Incidence Ratios (SIRs) for breast and stomach cancer with 95% confidence intervals (CI) for males (M) and females (F) according to country of birth (1996–2009)*.

	Country of birth
	Antilles/ Aruba	Indonesia	Morocco	Suriname	Turkey
	SIR 95%CI	SIR 95%CI	SIR 95%CI	SIR 95%CI	SIR 95%CI
Breast cancer
F	1.0 (0.9–1.1)	0.9 (0.9–1.0)	0.6 (0.5–0.6)	0.7 (0.7–0.8)	0.5 (0.4–0.5)
Stomach cancer
F	1.6 (1.2–2.3)	0.5 (0.4–0.5)	1.5 (1.1–2.0)	1.3 (1.1–1.6)	1.8 (1.5–2.3)
M	1.2 (0.9–1.7)	0.5 (0.4–0.5)	0.9 (0.8–1.1)	1.2 (1.0–1.4)	1.7 (1.4–1.9)
Cardia
F	1.3 (0.6–2.9)	0.6 (0.4–0.9)	0.5 (0.1–1.4)	0.9 (0.5–1.5)	0.8 (0.4–1.6)
M	0.5 (0.2–1.0)	0.6 (0.5–0.8)	0.4 (0.3–0.7)	0.3 (0.2–0.5)	0.7 (0.5–1.0)
Non-cardia
F	1.7 (1.2–2.4)	0.4 (0.3–0.5)	1.7 (1.3–2.3)	1.4 (1.2–1.7)	2.1 (1.7–2.6)
M	1.7 (1.2–2.4)	0.4 (0.3–0.4)	1.2 (1.0–1.5)	1.7 (1.5–2.0)	2.2 (1.9–2.6)

*Native Dutch = Reference (SIR = 1.0); bold numbers are significant at p ≤ 0.05 level.

Table III. Relative excess mortality risk ratios (RERs) for breast and stomach cancer according to country of birth (1996–2009).

	Country of birth
	Antilles / Aruba	Indonesia	Morocco	Suriname	Turkey
Breast cancer*
5-year RER^# (95% CI)	0.9 (0.6–1.3)	1.0 (0.8–1.2)	1.3 (0.9–1.8)	1.2 (1.0–1.5)	1.0 (0.7–1.4)
Age < 50	1.3 (0.7–2.2)	1.1 (0.7–1.8)	1.4 (1.0–2.1)	1.2 (0.9–1.6)	1.1 (0.8–1.7)
Age ≥ 50	0.6 (0.3–1.3)	1.0 (0.8–1.2)	0.7 (0.3–1.7)	1.3 (1.0–1.7)	0.7 (0.4–1.4)
Stomach cancer
1-year RER^$ (95% CI)	0.7 (0.5–1.0)	1.0 (0.8–1.1)	1.0 (0.8–1.2)	0.8 (0.6–0.9)	0.7 (0.6–0.9)
Cardia	0.9 (0.4–2.0)	1.0 (0.8–1.3)	1.2 (0.7–2.0)	0.9 (0.6–1.5)	0.9 (0.6–1.4)
Non-cardia	0.7 (0.5–0.9)	0.9 (0.8–1.1)	0.9 (0.7–1.2)	0.7 (0.6–0.9)	0.7 (0.6–0.9)

CI, confidence interval; FU, follow-up; RER, relative excess mortality risk ratio.

Bold numbers are significant at p ≤ 0.05 level; ref (RER = 1) = native Dutch.

*for the breast cancer survival analyses 48 503 patients were included.

^#adjusted for age at diagnosis, incidence year, socioeconomic status, stage and country of birth.

^$adjusted for age at diagnosis, sex, incidence year, socioeconomic status, stage, country of birth and stomach site (cardia/non-cardia).