Inferior health-related quality of life and psychological well-being in immigrant cancer survivors: A population-based study

• Published in: European journal of cancer (1990) 2013-05, Vol.49 (8), p.1948-1956
• Main Authors: Butow, Phyllis N, Aldridge, Lynley, Bell, Melanie L, Sze, Ming, Eisenbruch, Maurice, Jefford, Michael, Schofield, Penelope, Girgis, Afaf, King, Madeleine, Duggal-Beri, Priya, McGrane, Joshua, Goldstein, David
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Anxiety; Arabs - ethnology; Asian Continental Ancestry Group - ethnology; Biological and medical sciences; CALD; Cancer; Comorbidity; Cultural competence; Depression; Emigrants and Immigrants - psychology; Emigrants and Immigrants - statistics & numerical data; Female; Greece - ethnology; Health disparities; Health Surveys - methods; Health Surveys - statistics & numerical data; Hematology, Oncology and Palliative Medicine; Humans; Immigrants; Linear Models; Male; Medical sciences; Mental Disorders - epidemiology; Mental Disorders - psychology; Middle Aged; Multi-culturalism; Multiple tumors. Solid tumors. Tumors in childhood (general aspects); Multivariate Analysis; Neoplasms - epidemiology; Neoplasms - psychology; NESB; New South Wales - epidemiology; Oncology survivorship; Pharmacology. Drug treatments; Quality of Life; Queensland - epidemiology; Registries - statistics & numerical data; Survivors - psychology; Survivors - statistics & numerical data; Tumors; United Kingdom - ethnology; Victoria - epidemiology; Young Adult
• ISSN: 0959-8049; 1879-0852
• DOI: 10.1016/j.ejca.2013.01.011

Abstract This study compared health-related quality of life (QOL) and psychological morbidity in a population-based sample of first generation immigrant and Anglo-Australian cancer survivors. Eligible participants, recruited via three State Cancer Registries, included those: with a new diagnosis of one of 12 most incident cancers (all stages) 1–6 years earlier; aged 18–80 at diagnosis; born in a Chinese, Arabic, or Greek speaking country and able to speak one of these languages. A random sample of English-speaking Anglo-Australian-born controls frequency matched for cancer diagnosis was recruited. 596 patients (277 of whom were immigrants) participated (a 26% response rate). In multiple linear regression models adjusted for age, sex, education, marital status, socio-economic status, time since diagnosis and type of cancer, immigrants had clinically significantly worse QOL (5.4–8.5 points on Functional Assessment of Cancer Therapy – General (FACT-G), P < 0·0001), higher depression ( P < 0·0001) and higher incidence of clinical depression ( P < 0·01) than Anglo-Australians. Understanding the health system partially mediated this relationship for depression ( P = 0·0004) and QOL ( P = 0·001). Immigrant survivors of cancer have worse psychological and QOL outcomes than Anglo-Australians. Potential targets for intervention include assistance in navigating the health system, translated information and cultural competency training for health professionals.