Background: In 2023, over five million people immigrated to countries in the European Union (EU). These newly arrived migrants have been identified by the ECDC as a priority population for entry health assessments, which represent a key opportunity to prevent infection-related cancers. However, implementation is inconsistent in practice. Information on cancer risk among migrants remains fragmented but indicates that migrants generally have a higher risk of infection-related cancers than their host populations. Infection-related cancers are well suited to prevention through screening and vaccination, and 90% worldwide are caused by four pathogens: hepatitis B, hepatitis C, human papillomavirus, and H. pylori.
Objectives: To estimate the long-term burden of infection-related cancers among migrants entering to countries in the EU in 2023 and to quantify the proportion of hepatocellular, cervical, and gastric cancers preventable through current and expanded ECDC-recommended screening and vaccination strategies.
Methods: Using data on migration flows, cancer incidence, the proportion of cancer attributable to each infectious agent, and the effectiveness of preventive interventions, we estimated the burden of hepatocellular carcinoma (HCC), cervical cancer (CvC), and gastric cancer (GC) over the next 60 years among migrants who arrived in the EU in 2023. We then estimated the proportion of cases preventable through vaccination and screening, first as defined in ECDC recommendations (focusing on viral hepatitis) and then including expanded services for CvC and GC prevention.
Results: An estimated 5.8 million people immigrated to EU countries in 2023, 45% of whom came from other European countries. With respect to cancer risk, 46% of migrants originated from countries with age-standardised CvC incidence rates above the global median, compared with 66% for GC and 18% for HCC. Among all migrants, we project 140,000 cancer cases over the next 60 years (33,000 HCC, 34,000 CvC, and 73,000 GC). Over half (52%) of these cases are expected to occur among men, driven by the high projected burden of GC in this group (49,000 cases).
Hepatitis screening and vaccination as currently recommended by the ECDC could prevent 16% of HCC cases among migrants. Adding CvC and GC prevention could prevent 56% and 49% of cases, respectively. Expanding ECDC-defined eligibility for HCC prevention to include all migrants from countries with above-global-median HCC incidence would prevent 29% of HCC cases, compared with 16% under current criteria.
Conclusion: A large proportion of infection-related cancer burden among migrants entering to countries in the EU could be prevented through effective screening and vaccination soon after arrival. These findings support including CvC and GC prevention alongside expanded HCC prevention in regional and country-specific migrant health guidance. Providing these interventions at entry could overcome healthcare access barriers by delivering simple and effective care. Ensuring continuity of care as migrants integrate into host-country health systems remains essential and could further increase impact.