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Epidemiology

Arsenic exposure and cancer risk among migrant populations: bridging gaps in European public health policies and oncological screening

British Journal of Cancer (2026)Cite this article

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A less commonly addressed aspect, especially in Western countries, is that this public health concern extends beyond the population residing solely within Bangladesh’s geographic boundaries. Indeed, Bangladesh ranks as the 6th largest migrant-sending country globally [7]. In 2020, the Bangladeshi diaspora accounted for 7.40 million individuals, predominantly young men with potential medical histories of arsenic exposure, residing abroad. A significant portion of these migrants currently resides within the European Union (EU), with approximately 456,516 reported in 2021 according to the International Organisation for Migration (IOM) (Fig. 1c), and the influx of newcomers is rapidly increasing, particularly in Mediterranean regions [7].

The EU’s cancer policy promotes screening programs for oncological prevention in the resident population, tailored to the specific incidence and mortality rates in the European region. The EU Council’s December 2022 recommendations on cancer screening represent a paradigm shift in Europe’s approach to early cancer detection. These updated recommendations provide member states with significantly revised guidance on implementing screening programs for breast, cervical, and colorectal cancers. Furthermore, they introduce, for the first time, recommendations for screening lung, prostate, and gastric cancers, marking a significant expansion in the scope of cancer screening initiatives across the EU [8]. However, the prevention strategies adopted for the resident population do not fully align with the specific oncological risks faced by Bangladeshi migrants and asylum seekers previously exposed to arsenic contamination (Fig. 1d). In Europe, medical awareness of the epidemiology of arsenicosis in developing countries is low, and specific cancer screening programs for migrants exposed to arsenic are not available, thus increasing the risk of misdiagnosis or late diagnosis. Lastly, given the reduced risk perception associated with arsenicosis among migrants, it remains challenging to engage the exposed population in targeted oncological prevention programs. At the EU policy level, current recommendations do not include population-based screening for liver or bladder cancer, and eligibility for lung cancer screening remains anchored to age and cumulative smoking history rather than environmental exposures—thereby overlooking arsenic-exposed groups such as Bangladeshi migrants [8]. To bridge this gap, EU member states could pilot risk-adapted, exposure-informed screening pathways that incorporate documented (or likely) arsenic exposure into eligibility criteria. Such strategies should focus on identifying high-risk subcohorts, prioritising those with long-term exposure histories or additional clinical or demographic risk factors. This approach maximises cost-effectiveness, reduces unnecessary diagnostic work-ups, and mitigates the risk of overdiagnosis, while remaining consistent with exposure-adapted oncological prevention frameworks. To better classify prior exposure in migrant populations, cumulative exposure metrics such as the Lifetime Average Daily Dose (LADD) may also be applied. LADD integrates arsenic concentration, ingestion rate, and duration of exposure, and has been used to identify individuals with true long-term, carcinogenic-level exposure, thereby improving eligibility assessment and risk stratification within arsenic-adapted screening pathways.

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Fig. 1: Arsenic exposure and risk in migrant populations.

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Authors and Affiliations

  1. Department of Public Health and Infectious Diseases, University of Rome Sapienza, Rome, Italy

    Giancarlo Ceccarelli & Gabriella d’Ettorre

  2. Azienda Ospedaliero Universitaria Umberto I, Rome, Italy

    Giancarlo Ceccarelli

  3. Migrant and Global Health Research Organization—Mi-Hero, Rome, Italy

    Giancarlo Ceccarelli & Massimo Ciccozzi

  4. Unit of Medical Statistics and Molecular Epidemiology, Università Campus Bio-Medico di Roma, Rome, Italy

    Francesco Branda & Massimo Ciccozzi

  5. Climate Amplified Diseases and Epidemics (CLIMADE), Minas Gerais, Brazil

    Marta Giovanetti

  6. Instituto Rene Rachou, Fundação Oswaldo Cruz, Minas Gerais, Brazil

    Marta Giovanetti

  7. Sciences and Technologies for Sustainable Development and One Health, Università Campus Bio-Medico di Roma, Rome, Italy

    Marta Giovanetti

  8. Department of Biomedical Sciences, University of Sassari, Sassari, Italy

    Fabio Scarpa

  9. Department of Occupational Medicine. Vito Fazzi Hospital, Lecce, Italy

    Gabriele d’Ettorre

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  1. Giancarlo Ceccarelli
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GC wrote the first draft. MC supervised and validated the study. All authors were involved in the study conception and design, interpreted the results, reviewed the literature, and revised the manuscript and agree to be accountable for all aspects of the work.

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Correspondence to Francesco Branda.

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Ceccarelli, G., Branda, F., d’Ettorre, G. et al. Arsenic exposure and cancer risk among migrant populations: bridging gaps in European public health policies and oncological screening. Br J Cancer (2026). https://doi.org/10.1038/s41416-026-03424-y

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