Cancer survivorship outcomes in immigrants.

Abstract

6111 Background: Immigration is increasing world-wide. Cancer survivorship is now recognised as a period of difficult adjustment for all patients, and possibly more so for immigrants. We explored disparities in quality of life outcomes for immigrant (IM) versus Anglo-Australian (AA) cancer survivors. Methods: In a cross-sectional design, cancer survivors were recruited through the New South Wales, Queensland and Victorian Cancer Registries in Australia. IM participants, their parents and grandparents were born in a country where Chinese, Greek, or Arabic is spoken and spoke one of those languages. AAs were born in Australia and spoke English. All were diagnosed with cancer 1-3 years previously. Questionnaires (completed in preferred language) included the Hospital Anxiety and Depression Scale (anxiety/ depression), FACT-G (quality of life) and Supportive Care Needs Survey (unmet needs). Outcomes were compared between AA and IM groups in adjusted regression models that included age, gender, socio-economic status, education, marital status, religion, time since diagnosis and cancer type (prostate, colorectal, breast and other). Results: There were 599 participants (response rate 41%). Consent was unrelated to demographic and disease variables. AA and IM groups were similar except that immigrants had higher proportions in the low and highly educated groups (p < 0.0001), and higher socioeconomic status (p = 0.0003). In adjusted analyses (see table), IMs had clinically significant higher depression (possible range 0-21), greater unmet information and physical needs, and lower quality of life than AAs. The possible range for the latter three is 0-100. Conclusions: Immigrants experience poorer outcomes in cancer survivorship, even after adjusting for socio-economic, demographic and disease differences. Interventions are required to improve their adjustment after cancer. Results highlight areas of unmet need that might be better addressed by the health system (particularly with regard to provision of information and support. [Table: see text]