Inferior health-related quality of life and psychological well-being in immigrant cancer survivors: A population-based study |
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| Authors: | Phyllis N. Butow Lynley Aldridge Melanie L. Bell Ming Sze Maurice Eisenbruch Michael Jefford Penelope Schofield Afaf Girgis Madeleine King Priya Duggal-Beri Joshua McGrane David Goldstein |
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| Affiliation: | 1. Psycho-oncology Co-operative Research Group (PoCoG), and School of Psychology, University of Sydney, Sydney, NSW, Australia;2. School of Psychology and Psychiatry, Monash University, Victoria, Australia;3. Department of Nursing and Supportive Care Research, Peter MacCallum Cancer Centre, Victoria, Australia;4. Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Victoria, Australia;5. Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, University of New South Wales, NSW, Australia;6. Pearson Psychometric Laboratory, Faculty of Education, University of Western Australia, Australia;7. Faculty of Medicine, University of NSW, Department of Medical Oncology, Prince of Wales Hospital, NSW, Australia |
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| 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. |
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