Cancer incidence in first-generation migrants and host populations in seven European registries, including Ukrainian-born migrants in Poland: a population-based study
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Background
Where people are born shapes their cancer risk, yet European cancer surveillance rarely records migration background. We estimated cancer incidence in first-generation migrants and assessed whether birth-country incidence stratifies their cancer risk.
Methods
We harmonised data from six population-based cancer registries in Belgium, the Netherlands, Spain (Murcia, Tarragona), Italy (Turin), and Switzerland (Ticino) for 2003–17, examining breast, colorectal, cervical, stomach, liver, and lung cancer in first-generation migrants and host populations. Countries-of-birth were grouped into quartiles of GLOBOCAN age-standardised incidence by cancer site and sex ( birth-country incidence categories ). We estimated cumulative risks (CR) and migrant-to-host cumulative risk ratios (CRR). Ukrainian-born migrants in Poland were analysed separately for 2022–23.
Findings
Migrants’ cancer risk increased with birth-country incidence for cervical, stomach, and liver cancer. For cervical cancer, CRR rose from close to 1 in migrants from low-incidence countries to 4·9 (95% CI 3·5–6·9) in those from high-incidence countries in Turin. Breast and colorectal cancer diagnosis risk was lower than in host populations in every category. Across the six cancers combined, migrants had lower risk in 9 of 11 registry–sex strata, as lower breast, colorectal, and lung cancer risk outweighed higher cervical, stomach, and liver cancer risk. Ukrainian-born migrants in Poland (n=4450) had higher CR at most anatomical sites than the host population.
Interpretation
Migrants’ cancer risk relative to host populations depends on country of birth and cancer site. Birth-country incidence is a useful way of grouping migrants by risk. National averages can mask residual risk in subgroups, e.g. migrants born in high-incidence countries had up to five times the cervical cancer risk of host populations with rates near or below the WHO elimination threshold. Routine recording of country of birth can support risk-tailored prevention and cancer service planning for displaced populations.
Funding
ZonMw-09150162210124; IARC-WHO; and participating cancer registries.
RESEARCH IN CONTEXT
Evidence before this study
We searched PubMed, Embase, and Web of Science from inception to Oct 15, 2026, without language restrictions, for population-based studies reporting cancer incidence among first-generation migrants in Europe compared with host populations. We used terms for migration (eg, “migrant”, “immigrant”, “country of birth”), cancer, and incidence. Existing studies specific on migrants in Europe remain sparse and fragmented, with most studies limited to individual countries, migrant groups, or cancer types. They differed in how migrants were grouped, in their reference populations, and in their methods, and often had small numbers per country of birth. A 2010 review reported higher incidence of infection-related cancers among migrants grouped as “non-western”, and similar or lower incidence of breast and colorectal cancer, but heterogeneity prevented quantitative analyses. These differences have been attributed mainly to factors acquired before migration, notably infections, possibly compounded by differences in access to healthcare and preventive services, including lower participation in screening. Comparable estimates across European populations have been lacking. So has evidence on whether birth-country incidence can stratify migrants by cancer risk, and on what registries can capture after recent large-scale displacement.
Added value of this study
To our knowledge, this is the first harmonised multi-country analysis to group first-generation migrants by cancer incidence in their country of birth, using data from population-based cancer registries. For cervical, stomach, and liver cancer, cumulative risk among migrants followed the incidence ranking of their countries of birth. For breast and colorectal cancer, it was consistently lower than in host populations, independent of the country of birth. In most settings, the combined burden of the six cancers was lower among migrants. Grouping countries of birth by publicly available national incidence estimates gives a first population-level picture of the cancer profile of migrant populations. A case study of Ukrainian-born migrants in Poland shows what registry data can and cannot analyse and describe after large-scale displacement.
Implications of all the available evidence
Routine recording of country of birth in cancer registries can generate evidence for equitable cancer control, supporting planning of prevention, screening and care services for settled and newly arrived migrants, particularly for infection-related cancers. The harmonised protocol and openly available analytic tools developed for this study can be applied by other registries for further research and routine surveillance. Harmonising migration-related data collection across European registries would strengthen surveillance and cancer service planning for displaced populations, and support equity-oriented cancer control policies.
