Trends in mortality after cancer diagnosis: A nationwide cohort study over 45 years of follow-up in Sweden by country of birth.

Abstract:

BACKGROUND:Survival has steadily improved for major cancer types in most parts of the world. We compared all-cause mortality between foreign-born and Sweden-born residents of Sweden who were diagnosed with cancer of the colon, lung, stomach, prostate, breast, cervix, and all site. METHODS:We used Swedish national vital status and health registers to follow a cohort of 1,556,108 patients 45 years of age and older diagnosed with cancer between 1961 and 2009 in Sweden. Among them, 109,915 were born abroad. We estimated hazard ratios (HR) and 95% confidence interval (CI) using multivariable Cox proportional hazard models. RESULTS:We identified 604,035 and 540,138 deaths among men and women, respectively. Among them 33,595 men and 34,174 women were born abroad. At the time of diagnosis, patients born abroad were on average 4 years younger than patients born in Sweden. All-cause mortality was generally lower in the former than in the latter group of patients before 1990 but higher after 2000. The mortality trend was similar for prostate and breast cancer. CONCLUSIONS:Whilst national policy in Sweden aims at achieving equal access to health care, the mortality trend observed among cancer patients born in Sweden was different from that observed among patients born elsewhere. Mortality after diagnosis of major types of cancer has worsened among foreign-born after the year 2000. The possible determinants of disparities need be identified and investigated.

journal_name

Cancer Epidemiol

journal_title

Cancer epidemiology

authors

Abdoli G,Bottai M,Sidorchuk A,Moradi T

doi

10.1016/j.canep.2015.06.003

subject

Has Abstract

pub_date

2015-08-01 00:00:00

pages

633-40

issue

4

eissn

1877-7821

issn

1877-783X

pii

S1877-7821(15)00131-9

journal_volume

39

pub_type

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