Table 3.
Rate Ratios (RR) and 95% Confidence Intervals: Internal comparison among FSU-migrants in Israel and Germany aged 15+ by length of residence
| Person-Years | Rate Ratios* (95% Confidence Intervals) | ||||||||
| Viral Hepatitis | Stomach Cancer | Liver Cancer | Rheum. fever/rheum. heart disease | ||||||
| Years of residence | Germany | Israel | Germany | Israel | Germany | Israel | Germany | Israel | Israel |
| 0–2 | 123046 | 1657868 | 0.75 (0.14 – 3.88) |
0.67 (0.41 – 1.10) |
1.25 (0.63 – 2.48) |
1.88 (1.53 – 2.33) |
0.79 (0.29 – 2.17) |
0.86 (0.63 – 1.19) |
1.74 (0.97 – 3.11) |
| 3–5 | 99301 | 1375751 | 1.06 (0.23 – 4.93) |
1.29 (0.83 – 2.02) |
0.92 (0.44 – 1.92) |
1.58 (1.28 – 1.96) |
0.73 (0.26 – 2.07) |
0.74 (0.54 – 1.03) |
1.47 (0.81 – 2.64) |
| 6–8 | 64964 | 1024203 | 1.77 (0.41 – 7.53) |
1.28 (0.81 – 2.01) |
1.15 (0.55 – 2.39) |
1.40 (1.12 – 1.75) |
0.96 (0.34 – 2.67) |
0.93 (0.68 – 1.28) |
2.09 (1.19 – 3.67) |
| 9+ | 57145 | 735267 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 |
For all malignant neoplasms, both sexes of migrants to Germany combined and female migrants specifically, had statistically significantly lower mortality than Germans. Both sexes of FSU-migrants in Israel show a statistically significant excess mortality risk for all malignant neoplasms compared to the population in their destination country.
Although a difference in all cancer mortality was observed between the migrant cohorts, both had statistically significant increased risks for two of the cancer sites examined which are associated with infectious agents. Among the migrants in Germany the risk of dying of stomach cancer was almost one and a half times that of male and female Germans, respectively. And among migrants in Israel the risk of dying of this cause was almost double that of other Israelis, for each sex. In both countries these differences were statistically significant. Similarly, the mortality risk of liver cancer relative to Germans was higher for both sexes with a joint SMR of 1.64 (95% CI: 1.15–2.35) relative to German rates. For the migrants in Israel the SMR was 1.32 (95% CI: 1.22–1.42) compared to other Israelis. No significant differences in cervical cancer mortality were found between migrants and the host population in Israel and Germany, respectively. For both sexes combined the mortality risk for acute rheumatic fever and chronic rheumatic heart disease for migrants in Israel was lower than for other Israelis and statistically significant. For German migrants no meaningful statement can be made due to the small number of deaths from this cause.
Table 3 shows results from the multivariate analysis which was carried out to assess mortality differences by length of residence in the host country. No clear pattern was observed for viral hepatitis and liver cancer. For cervical cancer, numbers were too small for this analysis. However, stomach cancer mortality in FSU-migrants was affected by length of residence, indicating mortality risks were reduced after lengths of residence of nine years in Israel. Migrants in their first two years of residence had almost twice the risk of dying from stomach cancer as those who lived in Israel for more than nine years. This result was not influenced by arrival cohort as no differences were found between migrants who arrived in the early or the late 1990s (result not shown). For rheumatic fever it also appears that the risk was reduced after 9 years in Israel, but here the pattern is weaker and only the category of 6–8 years in Israel was statistically significant.
* Adjusted for sex, age, immigration period