Are male immigrants in Denmark at lower or higher risk of tobacco-related cancers? A Danish nationwide cohort study

Abstract

Background. Tobacco-related cancers (TRC) represent approximately a third of the cancer incidence in Denmark. However, tobacco consumption levels in immigrants may differ to the native population. We compared incidence rates of nine TRCs among male immigrants of first and second generation in Denmark with those among males of the native population.

Material and methods. We used an established cohort of all Danish men (1978–2010) and calculated standardized incidence ratios (SIR) with 95% confidence intervals (CI) to compare incidence by immigration status and region of birth for nine TRCs.

Results. We identified 131 317 incident cases of TRCs among 3 508 204 men (280 526 first generation and 129 056 second generation immigrants). Overall, immigrants of both generations experienced approximately 15% lower incidence of TRC than natives, however, with large variations by country of birth and type of TRC. Compared to natives, lung cancer incidence in first and second generation immigrants was 10% and 27% lower, respectively. However, lung cancer incidence increased in first generation immigrants reaching the level of native Danes in the late 2000s. First generation immigrants experienced approximately 50% lower incidence of lower urinary tract cancer than natives. However, only liver and stomach cancer had higher SIRs in immigrants.

Conclusion. Overall TRC incidence was lower among immigrants than in native Danes. Lower urinary tract cancer among first generation immigrants warrants further investigation.