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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., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

In 2010, cancer deaths accounted for more than 15% of all deaths worldwide, and this fraction is estimated to rise in the coming years. Increased cancer mortality has been observed in immigrant populations, but a comprehensive analysis by country of birth has not been conducted. We followed all individuals living in Sweden between 1961 and 2009 (7,109,327 men and 6,958,714 women), and calculated crude cancer mortality rates and age-standardized rates (ASRs) using the world population for standardization. We observed a downward trend in all-site ASRs over the past two decades in men regardless of country of birth but no such trend was found in women. All-site cancer mortality increased with decreasing levels of education regardless of sex and country of birth (p for trend <0.001). We also compared cancer mortality rates among foreign-born (13.9%) and Sweden-born (86.1%) individuals and determined the effect of education level and sex estimated by mortality rate ratios (MRRs) using multivariable Poisson regression. All-site cancer mortality was slightly higher among foreign-born than Sweden-born men (MRR = 1.05, 95% confidence interval 1.04-1.07), but similar mortality risks was found among foreign-born and Sweden-born women. Men born in Angola, Laos, and Cambodia had the highest cancer mortality risk. Women born in all countries except Iceland, Denmark, and Mexico had a similar or smaller risk than women born in Sweden. Cancer-specific mortality analysis showed an increased risk for cervical and lung cancer in both sexes but a decreased risk for colon, breast, and prostate cancer mortality among foreign-born compared with Sweden-born individuals. Further studies are required to fully understand the causes of the observed inequalities in mortality across levels of education and countries of birth.

Objectives: This study investigated the risk of cancer among dry cleaners, launderers, and pressers in a large record-linkage study in Sweden., Methods: The Swedish Cancer Register III contains nationwide data on cancer incidence between 1971 and 1989, by occupation and industry of employment, as reported in the 1960 and 1970 censuses. Dry cleaners, launderers, and pressers were compared with the remaining part of the employed population using multivariable Poisson regression models and standardized incidence ratios., Results: Dry cleaners, launderers, and pressers employed in the laundry, ironing, or dyeing industry in both censuses showed an increased risk of Hodgkin's disease [relative risk (RR) 2.69,95% confidence interval (95% CI) 1.01-7.19], an elevated risk of leukemia among women (RR 2.53,95% CI 1.44-4.46), and increased risks of stomach (RR 1.80,95% CI 1.05-3.11) and laryngeal (RR 2.42, 95% CI 0.91-6.45) cancers among men. The results of the analyses of launderers and dry cleaners as a separate occupational group reflected those of the whole exposure group, while pressers showed an elevated lung cancer risk (RR 1.67, 95% CI 0.75-3.72)., Conclusions: If they are not due to chance or confounding, the results of this study reflect either the potentiation of other carcinogens by solvents or direct effects. The results are limited by the use of job and industry titles as proxies for occupational exposures.

Using data from the 1960 and 1970 Swedish censuses and the Swedish Cancer Register for 1971 to 1989, this study investigated variations in cancer risk by gender associated with employment in painting trades and paint manufacturing. Among men, standardized incidence ratios were significantly increased for lung cancer among painters and lacquerers; bladder cancer among artists; and pancreas cancer, lung cancer, and nonlymphocytic leukemia among paint and varnish plant workers. Risks for women were elevated for cancers of the esophagus, larynx, and oral cavity among lacquerers and for oral cancer among glaziers. These findings are consistent with the report of the International Agency for Research on Cancer that classified painting as an occupationally related cause of cancer and provide further evidence that the risk of certain cancers is increased by exposures in the paint manufacturing process.

Objective: To investigate the risk of cancer among workers exposed to diesel emissions in a large record-linkage study from Sweden., Methods: The Swedish Cancer Environment Register III contains nationwide data on cancer incidence during 1971-1989, by occupation and industry of employment as reported in the 1960 and 1970 censuses. After excluding farmers, we classified job and industry titles according to estimated probability and intensity of exposure to diesel emissions. Exposed men in the 1960 census contributed over 7,400,000 person-years, and exposed women contributed over 240,000. We compared them to the remainder of the employed population, using indirect standardization and multivariate Poisson regression analysis., Results: Men exposed in the 1960 census experienced an increased risk of lung cancer: the relative risks (RRs) were 0.95 (95% confidence interval [CI] 0.9-1.0), 1.1 (1.1-1.2) and 1.3 (1.3-1.4) for low, medium, and high intensity of exposure. Corresponding results for probability of exposure were 1.1 (1.0-1.1), 0.9 (0.86-0.94) and 1.2 (1.1-1.2). The risk was higher for squamous cell carcinoma of the lung than for other histological types. Results in women were not suggestive of an effect (RR in the category of medium or high intensity of exposure 1.1, 95% CI 0.6-1.8). A small but significant increase in risk of cancers of the stomach (SIR 1.06), pancreas (SIR 1.05), larynx (SIR 1.09), and the kidney (SIR 1.06) was present among men exposed to diesel emissions, without a clear trend according to either probability or intensity of exposure. The SIR among women was non-significantly increased for stomach, pancreatic, and laryngeal cancers, but not for kidney cancer. Furthermore, a significantly increased risk of oral/pharyngeal (SIR 1.64) and cervical (SIR 1.48) cancers was present among women, with a suggestion of a dose-response relationship. There was no increased risk of bladder cancer in either gender., Conclusions: The results of this study provide evidence of a positive exposure-response relationship between exposure to diesel emissions and lung cancer risk among men. The positive results for other neoplasms, such as stomach, pancreatic, oral/pharyngeal, and cervical cancers, cannot be attributed to diesel exposure, but they deserve attention in future investigations.

Background: Our aim was to evaluate whether there is a healthy worker effect (HWE) for cancer incidence among women. HWE is a bias found in occupational studies that compare rates of disease among employed people to disease rates for the general population, which includes unemployed people (who may be less healthy than those who are employed)., Methods: Data from the 1960 and 1970 Swedish censuses were used to identify all 1,659,940 Swedish women who were employed in either year. They were followed during 1971-1989 through linkages to the national cancer and death registers. Standardized incidence ratios (SIRs) were computed comparing employed women to the 1,627,873 women who were not employed in either 1960 or 1970., Results: For the 545,857 women employed in both 1960 and 1970, the SIR for all cancers combined was 1.05 (1.04-1.06). When specific cancer sites were analyzed separately, the highest cancer risks were for cancers of the lung and bladder (SIR = 1.2) and reproductive organs (breast, ovary, endometrium, and cervix SIR = 1.1). Overall cancer risks were highest among full-time workers, younger workers, urban workers, and workers with the highest socioeconomic status (based on the woman's job title)., Conclusions: These results show no general HWE for cancer incidence among employed Swedish women.

Studies of migrants can generate hypotheses on the aetiology of cancer. Such studies are most informative when cancer incidence data are available both in the source and host country. We compared the incidence rate ratio of cancers (stomach, lung, female breast, colorectal and prostate) in Scandinavian immigrants to the US to US-born whites, using data from the SEER registry, 1973-89. Odds ratios (OR) for cancer sites in relation to birthplace were estimated using logistic regression. We also compared rate ratios (RR) for Scandinavian and US residents, using Poisson regression. Compared with US whites, most Scandinavian migrant groups had elevated OR for stomach cancer (1.58 to 3.92), and lower OR for lung cancer (0.38 to 0.88). Similarly, compared with US whites, residents of most Scandinavian countries had elevated RR for stomach cancer (1.47 to 3.33) and lower RR for lung cancer (0.27 to 0.97). Therefore, risk factors for lung and stomach cancers, such as smoking habits and Helicobacter pylori infection, respectively, may have been retained upon migration. Risks for breast, colorectal and prostate cancer among immigrants approached risks in the US (contrasting Scandinavian risks) suggesting assimilation of environmental and/or lifestyle factors.