University of Groningen Cancer by migrant background in Belgium Van Hemelrijck, Wanda

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University of Groningen

Cancer by migrant background in Belgium

Van Hemelrijck, Wanda

DOI:

10.33612/diss.170347004

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Publication date: 2021

Link to publication in University of Groningen/UMCG research database

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Van Hemelrijck, W. (2021). Cancer by migrant background in Belgium: a registry-based study on patterns and determinants. University of Groningen. https://doi.org/10.33612/diss.170347004

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Cancer by migrant background in Belgium

A registry-based study on patterns and determinants

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Cancer by migrant background in Belgium. A registry-based study on patterns and determinants

The author gratefully acknowledges the financial support by the Vrije Universiteit Brussel (OZR-Grant 2818).

Layout: Wanda Van Hemelrijck Printing: Ridderprint, the Netherlands Cover: Ridderprint, the Netherlands

ISBN: 978-94-6416-569-2

All rights reserved. No part of this book may be reproduced, stored, or transmitted in any way or by any means without the prior permission of the author, or when applicable, of the publishers of the scientific papers.

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Cancer by migrant background in Belgium

A registry-based study on patterns and determinants

PhD thesis

to obtain the degree of PhD of the University of Groningen

on the authority of the Rector Magnificus Prof. C. Wijmenga

and in accordance with the decision by the College of Deans

and

to obtain the degree of doctor of Sociology at Vrije Universiteit Brussel

Double PhD degree

This thesis will be defended in public on Thursday 10 June 2021 at 14.30

by

Wanda Monika Johanna Van Hemelrijck

born on 21 June 1991 in Anderlecht, Belgium

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Supervisors

Prof. Helga A.G. de Valk Prof. Hadewijch Vandenheede

Assessment Committee

Prof. C.O. Agyemang Prof. P. Bracke Prof. L.B. Meijering Prof. C. Vanroelen

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List of Figures

Figure 1.1 Composition of the resident population by migrant background in Belgium, October 1st_{, 2001 ... 20}

Figure 1.2 The cancer (control) continuum ... 24 Figure 1.3 The social determinants of cancer in the country of destination ... 32 Figure 1.4 Structure of the Census-linked Registry Data used for the mortality analyses ... 43 Figure 1.5 Structure of the Census-Belgian Cancer Registry Data used for the incidence analyses ... 44 Figure 1.6 Structure of the Census-Belgian Cancer Registry Data used for the survival analyses ... 44 Figures S4.1a-f Age distribution of the study population by migrant

background ... 143 Figures S4.2a-f Age distribution of the study population by migrant

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List of Tables

Table 2.1 Background characteristics: Percentages for urbanisation,

educational level, housing comfort, and employment status by migrant

background and total numbers ... 55

Table 2.2 Indirectly standardized cancer mortality rates per 100,000

person years, 95% confidence intervals and observed numbers of deaths by migrant background for men aged 40-69 ... 57

Table 2.3 Indirectly standardized cancer mortality rates per 100,000

person years, 95% confidence intervals and observed numbers of deaths by migrant background for women aged 40-69 ... 59

Table 2.4 Cancer mortality rate ratios and 95% confidence intervals by

migrant background for men aged 40-69 ... 61

Table 2.5 Cancer mortality rate ratios and 95% confidence intervals by

migrant background for women aged 40-69 ... 63

Table 3.1 Characteristics of the study population at baseline (2001) by

migrant origin group, listed as percentages unless otherwise stated ... 82

Table 3.2a Tobacco-related and lung cancer mortality rate ratios for

same-group presence by migrant origin with 95% confidence intervals,

continuous indicators for same-group presence ... 85

Table 3.2b Tobacco-related and lung cancer mortality rate ratios for

same-group presence by migrant origin with 95% confidence intervals,

categorical indicators for same-group presence ... 87

Table 3.3 Tobacco-related cancer mortality rate ratios for the product

terms between same-group presence and generational status and their

basic effects, by migrant origin with 95% confidence intervals ... 96

Table 3.4 Tobacco-related cancer mortality rate ratios for the product

terms between same-group presence and educational level and their basic effects, by migrant origin with 95% confidence intervals ... 98

Table S3.1a Lung cancer mortality rate ratios for the product terms

between same-group presence and generational status as well as their

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Table S3.1b Lung cancer mortality rate ratios for the product terms

between same-group presence and educational level as well as their basic effects, by migrant origin with 95% confidence intervals ... 110

Table S3.2a Tobacco-related cancer mortality rate ratios excluding lung

cancer for the product terms between same-group presence and

generational status as well as their basic effects, by migrant origin with 95% confidence intervals ... 114

Table S3.2b Tobacco-related cancer mortality rate ratios excluding lung

cancer for the product terms between same-group presence and

educational level as well as their basic effects, by migrant origin with 95% confidence intervals ... 116

Table 4.1a Description of the population at risk in Belgium on January 1st_, 2004 by migrant background (in percentages unless indicated otherwise) ... 132

Table 4.1b Description of the breast cancer patients diagnosed between

2004 and 2013 in Belgium by migrant background (in percentages unless indicated otherwise) ... 133

Table 4.2 Truncated age-standardised incidence rates for breast cancer

and five-year relative survival for breast cancer patients with 95%

confidence intervals ... 136

Table 4.3 Adjusted incidence rate ratios for breast cancer diagnosed

between 2004 and 2013 with 95% confidence intervals... 136

Table 4.4 Five-year relative excess mortality risk ratios for breast cancer

diagnosed between 2004 and 2013 according to migrant background with 95% confidence intervals ... 137

Table 4.5 Truncated age-standardised incidence rates for premenopausal

breast cancer and relative survival for premenopausal breast cancer

patients with 95% confidence intervals ... 137

Table 4.6 Premenopausal breast cancer incidence rate ratios and relative

excess rates with 95% confidence intervals by migrant background split up by generational status ... 138

Table S4.1a Description of the population at risk of premenopausal cancer

in Belgium by migrant background split up by generational status (in

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Table S4.1b Description of the population diagnosed with premenopausal

cancer in Belgium by migrant background split up by generational status (in percentages unless indicated otherwise) ... 148

Table S4.2 Adjusted incidence rate ratios for breast cancer diagnosed

between 2004 and 2013 with 95% confidence intervals... 149

Table 5.1 Summary of cancer types included in the study and their

characteristics ... 157

Table 5.2 Description of the study population aged 50 to 74 years at the

start of follow-up (01/01/2004) based on information at census

(01/10/2001): native Belgians and first-generation migrants subdivided by duration of stay in Belgium ... 165

Table 5.3 Truncated age-standardised incidence rates, unadjusted

incidence rate ratios and 95% confidence intervals for Belgians and first-generation migrants aged 50 to 74 years, subdivided by gender and

duration of stay in Belgium, 2004-2013 ... 167

Table 5.4 Adjusted incidence rate ratio's and 95% confidence intervals for

first generation migrants aged 50 to 74 years, subdivided by gender and duration of stay in Belgium, 2004-2013 ... 169

Table 6.1a Estimated share of the population that uses tobacco,

overconsumes alcohol and consumes five fruits and vegetables a day by country of birth in percentages with 95% confidence intervals, ages 40-69, information from the Health Interview Survey (pooled

1997-2001-2004-2008-2013 waves) ... 215

Table 6.1b Estimated share of the population with overweight status,

physical activity, and screening attendance by migrant background in percentages with 95% confidence intervals (CI), ages 40-69 or target ages for screening, information from the Health Interview Survey (pooled 1997-2001-2004-2008-2013 waves)... 217

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List of Co-authors

Name

Affiliation

H. De Schutter _{Research Department, Belgian Cancer Registry, Belgium} H.A.G. de Valk Netherlands Interdisciplinary Demographic

Institute/KNAW, University of Groningen, the Netherlands M. Rosskamp _{Research Department, Belgian Cancer Registry, Belgium} G. Silversmit _{Research Department, Belgian Cancer Registry, Belgium} H. Vandenheede Interface Demography, Sociology Department, Vrije

Universiteit Brussel, Belgium

K. Vanthomme Interface Demography, Sociology Department, Vrije Universiteit Brussel, Belgium

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University of Groningen Cancer by migrant background in Belgium Van Hemelrijck, Wanda