title: Utilisation of psychosocial and informational services in immigrant and non-immigrant German cancer survivors.
abstract: OBJECTIVE
  We examined psychosocial and informational services used by long-term survivors of breast, colon and prostate cancer in immigrants versus non-immigrants.
  
  
  METHODS
  Patients were sampled from population-based cancer registries in Germany. They completed a questionnaire assessing immigration biography, service use and socio-demographic characteristics.
  
  
  RESULTS
  Data of 6143 cancer survivors were collected of whom 383 (6%) were immigrants. There was no evidence of an association between immigration status and service use. However, immigration biography played a role when patients' and their parents' birthplace were taken into account. When parents were born outside Europe, survivors less frequently used information from the Internet (ORadj 0.4, 95% CI 0.2; 0.8). Web-based information (ORadj 0.7, 95% CI 0.5; 0.9) was less frequently used when the participant was born outside Germany.
  
  
  CONCLUSIONS
  The differences in the use of psychosocial and informational services between immigrants and non-immigrants seem to be generally small. Acculturation may play a role in service uptake. In survey-based health services research, investigators should not stratify by census-defined immigration status, but rather by cultural background.
authors.affiliation: Cancer Registry of Rhineland-Palatinate, Mainz, Germany.
authors.forename: Sylke Ruth
authors.initials: SR
authors.lastname: Zeissig
authors.affiliation: Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Centre, Mainz, Germany.
authors.forename: Susanne
authors.initials: S
authors.lastname: Singer
authors.affiliation: Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany.
authors.forename: Lena
authors.initials: L
authors.lastname: Koch
authors.affiliation: Leibniz Institute of Prevention Research and Epidemiology, Bremen, Germany.|Health Sciences Bremen, University of Bremen, Bremen, Germany.
authors.forename: Hajo
authors.initials: H
authors.lastname: Zeeb
authors.affiliation: Association of Bi-national Families and Relationships, Berlin, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Merbach
authors.affiliation: Cancer Registry North Rhine-Westphalia, Münster, Germany.
authors.forename: Heike
authors.initials: H
authors.lastname: Bertram
authors.affiliation: Bremen Cancer Registry, Bremen, Germany.
authors.forename: Andrea
authors.initials: A
authors.lastname: Eberle
authors.affiliation: Cancer Registry Hamburg, Hamburg, Germany.
authors.forename: Sieglinde
authors.initials: S
authors.lastname: Schmid-Höpfner
authors.affiliation: Saarland Cancer Registry, Saarbrücken, Germany.
authors.forename: Bernd
authors.initials: B
authors.lastname: Holleczek
authors.affiliation: University Medical Center Schleswig-Holstein, Campus Lübeck, Institute of Social Medicine and Epidemiology, Lübeck, Germany.
authors.forename: Annika
authors.initials: A
authors.lastname: Waldmann
authors.affiliation: Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany.
authors.forename: Volker
authors.initials: V
authors.lastname: Arndt
mesh_terms: D000069:Acculturation; D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000523:psychology; D003110:Colonic Neoplasms / Q000523:psychology; D054242:Emigrants and Immigrants / Q000523:psychology*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006300:Health Services Misuse / Q000706:statistics & numerical data; D006801:Humans; D007255:Information Services / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology*; D011471:Prostatic Neoplasms / Q000523:psychology; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology
keywords: cancer; ethnicity; healthcare use; immigration; oncology