title: Inferior health-related quality of life and psychological well-being in immigrant cancer survivors: a population-based study.
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) 1-6years 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.
authors: Psycho-oncology Co-operative Research Group (PoCoG), and School of Psychology, University of Sydney, Sydney, NSW, Australia. phyllis.butow@sydney.edu.au
authors: Phyllis N
authors: PN
authors: Butow
authors: Lynley
authors: L
authors: Aldridge
authors: Melanie L
authors: ML
authors: Bell
authors: Ming
authors: M
authors: Sze
authors: Maurice
authors: M
authors: Eisenbruch
authors: Michael
authors: M
authors: Jefford
authors: Penelope
authors: P
authors: Schofield
authors: Afaf
authors: A
authors: Girgis
authors: Madeleine
authors: M
authors: King
authors: Priya
authors: P
authors: Duggal-Beri
authors: Joshua
authors: J
authors: McGrane
authors: David
authors: D
authors: Goldstein
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D018912:Arabs / Q000208:ethnology; D044466:Asian People / Q000208:ethnology; D015897:Comorbidity; D054242:Emigrants and Immigrants / Q000523:psychology* / Q000706:statistics & numerical data; D005260:Female; D006115:Greece / Q000208:ethnology; D006306:Health Surveys / Q000379:methods / Q000706:statistics & numerical data; D006801:Humans; D016014:Linear Models; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology / Q000523:psychology*; D008875:Middle Aged; D015999:Multivariate Analysis; D009369:Neoplasms / Q000453:epidemiology / Q000523:psychology*; D009517:New South Wales / Q000453:epidemiology; D011788:Quality of Life; D011793:Queensland / Q000453:epidemiology; D012042:Registries / Q000706:statistics & numerical data; D017741:Survivors / Q000523:psychology* / Q000706:statistics & numerical data; D006113:United Kingdom / Q000208:ethnology; D014739:Victoria / Q000453:epidemiology; D055815:Young Adult