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Background: This study aimed to determine the robustness of the impact of immigration on risk for alcohol use disorder (AUD) using different measures, designs, and immigrant regional cohorts. Methods: The analytic sample included all individuals born between 1950 and 1990 and registered in Sweden from 1973 to 2017. Using Cox regression models, we examined the risk for AUD from Swedish nationwide registries in immigrants to Sweden from seven geographical regions: Africa, Asia and Oceania, Eastern Europe, Finland, Latin America and the Caribbean, Middle East/North Africa, and Western countries. We assessed greater exposure to Swedish culture, which we interpreted as increasing acculturation, by (i) comparing first‐generation immigrants and their children with no and one native Swedish parent and (ii) examining age at immigration. The baseline comparison group was the native Swedish population. We also examined AUD risk in first‐generation sibling pairs discordant for their age at immigration. Results: In nearly all immigrant cohorts in Sweden, increasing degrees of acculturation, as assessed by both our variables, were associated with rates of AUD that approached those of the Swedish population. These findings occurred in both men and women and both regional cohorts whose first‐generation immigrants had lower and higher levels of AUD than native‐born Swedes. For most cohorts, the rates of change with acculturation were greater in women than in men. In sibling pairs from most regions, the sibling who was younger at immigration had a higher rate of AUD. Conclusions: An examination of both sexes and two different proxies for acculturation provides consistent support for socio‐cultural influences on AUD risk. Our co‐sibling analyses suggest that a meaningful proportion of this effect is likely to be causal in nature. [ABSTRACT FROM AUTHOR]

Background: There is a lack of studies of Parkinson's disease (PD) in immigrants. Objective: To study the association between country of birth and incident PD in immigrants in Sweden versus Swedish-born individuals. Methods: Study population included all adults aged 50 years and older in Sweden (n = 2775736). PD was defined as having at least one registered diagnosis of PD in the National Patient Register. The incidence of PD in different first-generation immigrant groups versus Swedish-born individuals was assessed by Cox regression, expressed as hazard ratios (HRs) and 95% confidence intervals (CI). The models were stratified by sex and adjusted for age, geographical residence in Sweden, educational level, marital status, neighbourhood socioeconomic status and co-morbidity. Results: Totally 35833 individuals had an incident diagnosis of PD (20401 men and 15432 women). Incidence rates per 100,000 person-years were for all Swedish-born 95.9 and for all foreign-born 60.1; for all men 112.3 and for all women 73.4, with a male to female ratio of 1.53, with the highest incidence rates for the group 80–84 years of age. After adjusting for potential confounders, the overall relative risk of PD was lower in immigrant men (HR 0.78; 95% CI 0.74–0.82) and women (HR 0.92; 95% CI 0.87–0.98). Among immigrant subgroups, a higher risk of PD was found among women from Finland (HR 1.13; 95% CI 1.05–1.23). Conclusion: In general, the risk of PD was lower in first-generation immigrant men and women compared to Swedish-born. The only group with a higher risk of PD was women from Finland. [ABSTRACT FROM AUTHOR]

Despite recent successes in the identification of genetic susceptibility loci, no familial risk has been demonstrated for childhood acute lymphoblastic leukaemia ( ALL). We identified 3994 childhood ALL cases from two cancer registries; family members were obtained from population registers. The standardized incidence ratio for familial risk in singleton siblings and twins was 3·2 (95% confidence interval 1·5-5·9) and 162·6 (70·2-320·4), respectively. The present data constitute the first demonstration of familial risk for singleton siblings; the high risk for twins is believed to result from shared prenatal blood circulation. The data suggest that currently unidentified genetic loci underlie these observed familial effects. [ABSTRACT FROM AUTHOR]

Background: We aimed to estimate lifetime cumulative risk of melanoma (CRM) in relatives of patients with melanoma by histology and age at diagnosis in patients and relatives., Methods: A population-based cohort of 238724 first-degree relatives of 46091 melanoma patients diagnosed in 1955-2010 in Nordic countries was followed for cancer incidence., Findings: The CRM (0-79 years) in first-degree relatives of a patient with superficial spreading (SSM), nodular (NM), or lentigo maligna melanoma was quite similar, ranging from 2.5% to about 3%, which represents about 2-fold increase over the general population risk. When one melanoma patient in the family was diagnosed before age 30, the CRM was about 3%. When there were > or =2 melanoma patients diagnosed before age 30 in a family, CRM for relatives was about 14%, 6% for diagnoses at age 30-59, and 5% for diagnoses at age 60 or older. Depending on age at diagnosis of same-sex twins (not known whether monozygotic/dizygotic), their CRM was about 7-21%. Although no familial case of concordant histological types of acral lentiginous/desmoplastic/compound nevus/spindle cell melanomas or malignant blue nevus was found, familial risks of discordant histological types of melanoma were interchangeably high for most of the types, e.g. higher risk of SSM when a first-degree relative had NM [standardized incidence ratios (SIR)=2.6, 95% confidence interval (CI)=2.1-3.3, n=72] or acral lentiginous (4.0, 95% CI=1.5-8.8, n=6) and vice versa. There was a tendency toward concordant age at diagnosis of melanoma among relatives of melanoma patients., Interpretation: Findings of this study may help clinicians to find subjects at high melanoma risk for the genetic counseling. The risk was highest when melanoma occurred in a same-sex twin, one first-degree relative diagnosed at young age (<30), or > or =2 first-degree relatives. Histological type of melanoma does not seem to play an important role in familial melanoma., Funding: This work was supported by the Nordic Cancer Union, Swedish Council for Working Life and Social Research, and German Cancer Aid., (Copyright © 2014 Elsevier Ltd. All rights reserved.)

Background & Aims: Small intestinal cancer (SIC) is rare, and its etiology is poorly understood. We compared clusters of families with SICs of different histologic subtypes., Methods: By using the nationwide family cancer data sets of Sweden and Finland, we identified a cohort of 9964 first-degree relatives of 1799 patients with SIC, diagnosed from 1961 through 2009. Data were collected from time periods as long as 47 years (mean, 35.4 y), and cancer incidence was determined. Standardized incidence ratios (SIRs) were calculated and stratified by sex, age, time period, and cancer type, using the incidence rates for the entire national population as the reference., Results: Among the 1799 SIC cases, 1.1% had a sibling with SIC, so the SIR was 11.8 (95% confidence interval [CI], 7.2-18.2); 1.1% had a parent or child with SIC (SIR, 3.5; 95% CI, 2.0-5.6). The SIR of concordant carcinoid histology of SIC among siblings was 28.4 (95% CI, 14.7-49.6; n = 12) and in parent-child pairs was 9.9 (95% CI, 5.4-16.6; n = 14). The familial risk of concordant histologic subtypes increased for siblings diagnosed with adenocarcinoma, but only 2 familial cases were identified. In family members of patients with SIC of the adenocarcinoma subtype, risks of colorectal and bladder cancer were modestly but significantly increased compared with the general population. Family members of patients with SIC of the carcinoid subtype had an increased risk for kidney cancer and polycythemia vera., Conclusions: Based on data from our population-based study, first-degree relatives of patients with small intestinal carcinoid tumors have developed these tumors with high incidence. Because of the rareness of this tumor, the absolute risk remains moderate even within families. Gastroenterologists could inform patients with small intestinal carcinoids about the familial risk and encourage counseling for their first-degree relatives. Studies are needed to identify genetic factors that affect susceptibility to SIC., (Copyright © 2013 AGA Institute. Published by Elsevier Inc. All rights reserved.)

Time trends in incidence, causes of death, and prognosis of cancer of unknown primary (CUP) could provide important clues for occult primary sites and thus result in effective organ-specific treatment, although such studies are seldom reported. We aimed at examining time trends in percentage and incidence rates, causes of death, and survival of CUP. A total of 50 545 patients with CUP were identified in the Swedish Cancer Registry from 1960 to 2008. We used direct standardization to standardize age-adjusted incidence rate to the Segi world population. Consistent increase before the late 1990s and dramatic decrease afterward was observed for both percentage and incidence of CUP in Swedes regardless of sex. Comparable time trends were noted in Norwegian and Finnish populations, but with several years earlier peaking times. For most anatomic sites, CUP and lung cancer were the two most common causes of death for patients with CUP irrespective of nodal involvement. Survival probability at 12 months after CUP was approximately 20% and then leveled off at approximately 10%. Adenocarcinoma accounted for most of this incidence variation and experienced the worst prognosis. High incidence rates and comparable time trends for CUP were observed in Sweden, Norway, and Finland. The increasing time trends may partially reflect the change of autopsy rates in these countries. The decreased incidence in the last decade could be due to an increasing identification of unknown primary caused by improving diagnostic methods. Histological types were significantly associated with survival in patients with CUP.

Objective: The incidence of type 1 diabetes shows a large variation worldwide, but whether the causes are environmental or genetic has not been settled. We examine here the incidence of type 1 diabetes among second-generation immigrants and adoptees from abroad to disentangle genetic/ethnic vs. environmental influence, assuming adoptees from abroad have similar environmental exposures compared with the native Swedes, with the only difference in their genetic background., Methods: Second-generation immigrants and adoptees from abroad were retrieved from the MIGMED2 database, and they were followed up until the diagnosis of type 1 diabetes, death, or the end of study. Standardized incidence ratios (SIRs) were calculated for type 1 diabetes among these immigrants compared with native Swedes., Results: A total of 1,050,569 children were defined as second-generation immigrants and the overall SIR of type 1 diabetes was significantly decreased. A decreased risk was observed for all countries of origin, with an exception for children with parents from Finland. A total of 51,557 children born in foreign countries were adopted by Swedes. Adoptees from Eastern Europe, Soviet countries, India, Pakistan, Afghanistan, East and Southeast Asia, Chile, and other Central and South American countries had a significantly decreased SIR., Conclusions: The decreased incidence of type 1 diabetes observed in some second-generation immigrants and adoptees from abroad strongly suggests that ethnic genetic heterogeneity could play an important role on type 1 diabetes.

Aims: There is a lack of studies comparing health among immigrant groups with health among the population in their country of origin. This study compared the prevalence of self-rated poor health between Finns living in Sweden and Finns living in Finland., Methods: Data were obtained from the Swedish Annual Level of Living Survey between 1996 and 2003 and the Finnish national survey "Health 2000''. Odds ratios (OR) of self-rated poor health were estimated adjusting for age, marital status, education, employment and smoking. The participants were 21,991 Swedes and 836 Finns living in Sweden, and 5,096 Finns living in Finland., Results: For Finnish women living in Sweden the odds of self-rated poor health was significantly higher (OR=1.25, 95% CI=1.02-1.54) than for Finnish women living in Finland. An opposite pattern appeared among men; Finnish men living in Finland tended to have higher odds of self-rated poor health than Finnish men living in Sweden, although not to a statistically significant extent. In addition, Finns in Finland and in Sweden rated their health poorer than Swedes., Conclusions: Migration may have a different effect on Finnish men's and women's self-rated health. Further studies are needed to investigate the complex pathways between country of residence and self-rated health among immigrants.

The aim of this study was to examine whether the hypothesized association between country of birth and suicide rates remains after adjustment for age, marital status, socioeconomic status, and hospitalization due to psychiatric disorders or substance abuse. A Swedish cohort of 4.4 million individuals aged 25-64 years was followed from January 1, 1994, to December 31, 1999 for suicide. Suicide rates varied according to country of birth. Among men the highest risk of suicide was found among men from Finland. Among women the highest risk of suicide was found among women from Finland, Poland, and Eastern Europe. Key factors to prevent suicide include early detection and treatment of psychiatric disorders and/or substance abuse, especially among certain population groups.

The main aims of this study were to investigate whether the increased risk of psychotic disorders among certain immigrant groups is present in the next generation and whether having one parent born in Sweden has a protective effect on the risk of psychotic disorders among second-generation immigrants. In total, 2,243,546 individuals were followed from January 1, 1992, until December 31, 1999, for first hospital admission for schizophrenia or other psychoses. Cox regression was used to estimate hazard ratios. The highest risks of psychotic disorders were found among first-generation and second-generation Finns, after adjustment for socioeconomic status. Having one parent born in Sweden had no protective effect on the risk of being hospitalized for psychotic disorders among second-generation immigrants. The disabling symptoms of psychotic disorders call for increased awareness among clinicians and public health planners involved in the treatment and prevention of psychotic disorders, especially among certain immigrant groups.