Overall and Site-Specific Cancer Mortality Among Older Migrants and Nonmigrants in Finland: A Population Register Study on All Deaths, 2002–2020

Abstract

Objective: This study examined all-cause and cause-specific cancer mortality among older migrants and non-migrants in Finland and the role of socioeconomic status in mortality differences. Methods: We used the Finnish Causes of Death Register on all deaths (2002–2020) among individuals aged ≥ 70 (N = 718,717) and the corresponding population-at-risk data (N = 13,241,620 person years). Poisson regression was used with two sequential models adjusting for age at death, calendar year, and region of residence in Finland (M1), and personal annual disposable income (M2). Results: We found an overall cancer mortality advantage for both migrant men (IRR in the full model 0.83, 95% CI: 0.78–0.89) and migrant women (IRR: 0.89, 95% CI: 0.83–0.95) and lung cancer mortality advantage for migrant men (IRR: 0.77, 95% CI: 0.67–0.89) and women (IRR: 0.67, 95% CI: 0.53–0.85). For migrant men, advantage was found in pancreatic cancer (IRR: 0.76, 95% CI: 0.58–0.99), prostate cancer (IRR: 0.78, 95% CI: 0.66–0.93), and leukaemia and lymphoma (IRR: 0.73, 95% CI: 0.58–0.93), and for women in genital cancers (IRR: 0.69, 95% CI: 0.55–0.86). Notable variations were observed by region of origin and in certain cases, migrants' lower income obscured the full extent of their cancer mortality advantage. A mortality disadvantage was observed in stomach cancer among men (IRR: 2.76, 95% CI: 2.08–3.65) and women (IRR: 2.32, 95% CI: 1.79–3.00) born in the former USSR. Liver cancer mortality disadvantage was found for men from the Global South and East (IRR: 2.00, 95% CI: 1.10–3.61), and this association was attenuated after adjustment for personal disposable income. In cancers of the urinary tract, men born in Sweden had elevated mortality (IRR: 2.09, 95% CI: 1.14–3.81). Conclusion: Finings underscore the need for targeted cancer prevention and screening programmes that account for the diverse backgrounds, sex, socioeconomic status, and health risks of migrant populations, particularly those from higher-risk regions.