Cancer by migrant background in Belgium:a registry-based study on patterns and determinants

Cancer is a growing health issue with a high burden in northern and western Europe. Due to international migration, the group of people diagnosed with this disease is diversifying. Although evidence about differences in cancer mortality, risk, and survival between migrants and non-migrants has been expanding, less is known regarding how these differences come about and how they differ between migrants and their offspring, or migrants with different durations of stay. This thesis builds on and extends this line of research by examining site-specific cancer mortality, incidence, and survival during the 2000s in Belgium for adults of native Belgian and migrant origin, looking at differences by duration of stay and between migrants and migrant offspring, and taking socioeconomic position, demographic traits, and tumour stage at diagnosis into account. The empirical studies reveal that cancer by migrant background varies by cancer site, country of origin, and gender. In addition, outcomes among migrants with longer lengths of stay and migrant offspring resemble Belgian numbers more than those of first-generation migrants and with shorter lengths of stay. These findings put differential exposures to infectious carcinogens and especially behavioural differences centre stage, and suggest that causes for underlying behavioural differences between groups in the country of origin and Belgium deserve further attention from researchers and policy makers. Prevention and early detection initiatives that consider the social roots of risk, help-seeking, and care-related behaviour could help to minimise cancer risks and maximise chances of survival for the entire population, and decrease inequalities between groups