Migrants have a higher burden of cancer compared to Australian-born residents

New joint Cancer Council research shows higher rates of stomach, liver and cervical cancer in specific migrant communities in Australia compared with the general population, highlighting a need for targeted services to reduce disparities in cancer outcomes.

The new study was led by a team from the Daffodil Centre (a joint venture between Cancer Council NSW and The University of Sydney) and Cancer Council Queensland and found that migrants from countries with higher incidence rates of the three infection-related cancers maintained a significantly increased risk in Australia.

The highest rates were for stomach cancer in South American migrants and liver cancer in Vietnamese migrants, with a complex mix of lower and higher rates of cervical cancer compared with the general population in specific countries and regions (see following).

Senior Research Fellow at the Daffodil Centre, Dr Xue Qin Yu said Australia had a growing migrant population with around 30% of the population born overseas. “We have had data for some time showing major inequities in cancer burden affecting migrant communities due to risk factors such as infections,” Dr Yu said.

“Our study provides new and more detailed evidence on stomach, liver and cervical cancer rates in relation to specific migrant communities, which should inform targeted health system responses.”

Anita Dessaix, Chair of Cancer Council’s Public Health Committee, said while cancer outcomes had improved for the general Australian population in recent years, gains were not shared among specific population groups and more needed to be done to reduce disparities.

“We can’t screen average-risk populations for risk of liver and stomach cancer like we can for cervical cancer, however there is important work underway to identify people at increased risk of liver cancer,” Ms Dessaix said. “Liver cancer rates continue to grow, with much of the case load borne by migrant groups identified in the study, who are not protected from hepatitis B like vaccinated Australian-born populations. Efforts to identify at-risk populations need to continue and could assist in targeting earlier interventions.

“Stomach cancer incidence in the general population has fallen by more than 22% over the past two decades. However, this gain has not been shared with groups from South America, North-East Asia and Polynesia, who may have higher rates of the helicobacter pylori infection – which is the leading cause of stomach cancer and can be controlled.

“For cervical cancer, some migrant communities do better than average but Australians originating from places like the Philippines and the Pacific have higher rates. Targeted approaches to encouraging screening, such as self-collection, which becomes universally available to all Australians from 1 July, will be key to reducing inequities.”

Key findings

For stomach cancer, the research showed that of the 13 regions, 10 regions had a higher incidence rate, with the highest rates in migrants from South America, North-East Asia and Polynesia. Migrants from Southern Asia were the only group which had significantly lower incidence.

The data also found, of the 13 regions, migrants from eight regions had higher incidence of liver cancer than the Australian-born population, with the highest rates among migrants from South-East Asia, North Africa and North-East Asia. Only migrants from South Africa had a significantly lower rate than those locally born.

In contrast to stomach and liver cancer, cervical cancer incidence was lower among many migrant women than Australian-born women, including five individual countries and six regions of birth. Women from Southern Asia and North Africa regions had less than half the risk of Australian-born women. The rate of cervical cancer was higher in migrants from New Zealand, the Philippines, and Polynesia.

In light of the findings, researchers are calling for effective targeted cancer control policies and implementation of culturally sensitive prevention measures to help drive this disproportionate cancer rates down. “We urge people born outside of Australia, particularly in these groups to be aware of the symptoms and participate in screening and immunisation as recommended, Dr Yu concludes.