Potential risk factors for cholangiocarcinoma were investigated in a case-control study among inhabitants of north-east Thailand, which included 103 cases from 3 hospitals, with age- and sex-matched controls. A clear association with past or present infection with Opisthorchis viverrini, as indicated by raised serum antibodies, was found (o.r. 5.0), and at least two-thirds of cases can be attributed to this cause. The results suggest that males may be at higher risk than females. There was no association with hepatitis B infection, with aflatoxin intake as estimated from albumin adducts in serum or with any particular dietary patterns. Alcohol consumption was very low in the population, and the risk associated with regular drinking was non-significant. Regular users of betel nut-predominantly female-had a high risk (o.r. 6.4), a possible mechanism being through their increased exposure to nitrosamines.
Cigarette-smoking males (6,364), aged 40-64, were randomized into an intervention group which received 6-monthly screening by chest X-ray and sputum cytology, and a control group which received no asymptomatic investigation. After 3 years, both groups entered a follow-up period during which they received annual chest X-rays. Lung cancer cases detected by screening were identified at an earlier stage, more often resectable, and had a significantly better survival than "interval" cases diagnosed mainly because of symptoms. Comparison of the 2 groups showed a higher incidence of lung cancer in the intervention group, despite the follow-up period when both groups received annual examinations. There was no significant difference in mortality between the 2 groups.
This paper investigates age variations in foreign-born vs. native-born mortality ratios in an international comparative perspective, with the purpose of gaining insight into the mechanisms underlying the so-called migrant mortality advantage. We examine the four main explanations that have been proposed in the literature for the migrant mortality advantage (i.e., in-migration selection effects, out-migration selection effects, cultural effects, and data artifacts), and formulate expectations as to whether they should generate an increase, a decrease, or no change in relative mortality over the life course. Using data from France, the US and the UK for periods around 2010, we then examine typical age patterns of foreign-born vs. native-born mortality ratios in light of this theoretical framework. We find that these mortality ratios vary greatly by age, with important similarities across migrant groups and host countries. The most systematic age pattern we find is a U-shape pattern: at the aggregate level, migrants often experience excess mortality at young ages, then exhibit a large advantage at adult ages (with the largest advantage around age 45), and finally experience mortality convergence with natives at older ages. The explanation most consistent with this pattern is the “in-migration selection effects” explanation. By contrast, the “out-migration selection effects” explanation is poorly supported by the observed patterns. Our age disaggregation also shows that migrants at mid-adult ages experience mortality advantages that are often far greater than typically documented in this literature. Overall, these results reinforce the notion that migrants are a highly-selected population exhibiting mortality patterns that poorly reflect their living conditions in host countries.
Objective: To review studies on the morbidity, mortality and nutrition of migrant populations in France. Design: A systematic search of the bibliographic database Medline, and direct contact with associations and institutions concerned with migrants' health.
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