Oral Presentation FCIC Survivorship Conference 2013

Unmet needs in CALD (Chinese, Greek and Arabic speaking) first generation immigrant cancer survivors. (#22)

Phyllis Butow 1 , Melanie Bell 2 , Lynley Aldridge 2 , Ming Sze 2 , Michael Jefford 3 , Penelope Schofield 3 , Maurice Eisenbruch 4 , Afaf Girgis 5 , Madeleine King 2 , Joshua McGrane 2 , David Goldstein 6
  1. CeMPED/ PoCoG, The University of Sydney, NSW, Australia
  2. PoCoG, Sydney, NSW, Australia
  3. Peter McCallum Cancer Centre, Department of Nursing and Supportive Care Research, Melbourne, VIC, Australia
  4. Monash University, School of Psychology and Psychiatry, Melbourne, VIC, Australia
  5. Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, University of NSW, Sydney, NSW, Australia
  6. Dept of Medical Oncology, Prince of Wales Hospital, Sydney, NSW, Australia

Background: Social suffering, language difficulties and cultural factors may all make the cancer experience more difficult for immigrants. This study aimed to document unmet needs, and variables associated with these, in a population-based sample of first generation immigrants and Anglo-Australians who had survived cancer. 

Methods: Participants were recruited via Cancer Registries in New South Wales, Queensland, and Victoria, Australia. Eligible cancer survivors had a new diagnosis of one of 12 most incident cancers (all stages) 1–6 years earlier, were aged between 18 and 80 years at the time of diagnosis and had a treating doctor assigned to their registry record who approved approach. Eligible immigrant participants and both parents were born in a country where Arabic, Chinese (Mandarin, Cantonese, and other dialects),  or Greek is spoken and they spoke one of these languages. A random sample of English-speaking Anglo-Australian-born controls, frequency matched for cancer diagnosis, was recruited. 

Results: 596 patients of whom 277 were immigrants were recruited to the study (response rate of 26%). Due to 20% missing data on cancer stage and small numbers with known metastatic disease, stage was excluded from analyses, but estimates for impact of immigration status were unaffected when stage was included in sensitivity analyses. In multiple logistic regression models which adjusted for age, sex, education, socio-economic status, time since diagnosis and type of cancer, Arabic immigrants were 3.9 and 2.7 times more likely and Chinese immigrants were 5.1 and 2.2 times more likely than Anglo-Australians to have at least one unmet information and physical need, respectively. Greek patients did not appear to have more unmet needs than Anglo-Australians. Written information and having a specialist, support services and other health professionals who spoke their language were in the top 10 unmet needs amongst immigrants. 

Discussion: Immigrants who are survivors of cancer, several years after initial diagnosis, are significantly more likely to have an unmet need for information or for help with a physical problem than Anglo-Australian controls. They strongly desire information and support in their own language.