Australia is one of the most multicultural nations in the world. Social suffering, language difficulties and cultural factors may all make the cancer experience more difficult for immigrants. PoCoG, in collaboration with researchers around Australia, has recently completed a series of studies exploring outcomes in immigrant cancer survivors.
Method
We recruited adult immigrants via the NSW, Victorian and Queensland Cancer Registries. Eligible immigrant participants were born in a country where Arabic, Chinese (Mandarin, Cantonese, and other dialects), or Greek is spoken, they spoke one of these languages and their parents were also born in that country and spoke that language. A random sample of English-speaking Anglo-Australian-born controls, matched for cancer site, was also recruited. Participants were sent a questionnaire in their language.
Results
596 patients (277 immigrants) were recruited to the study (response rate 26%). Compared to Anglo-Australians, the adjusted odds ratios of Chinese immigrants for at least one unmet information/support need was 5.1 (95%CI: 3.1,8.3) and for any unmet physical need was 3.1 (95%CI: 1.9, 5.1). For Greek these were 2.0 (95%CI: 1.1, 4.0) and 2.7 (95% CI: 1.4, 5.2). Arabic patients had elevated, but not statistically significant, odds ratios compared to 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.
Conclusion
Immigrants cancer survivors, several years after initial diagnosis, are more likely to have an unmet need for information or for help with a physical problem than Anglo-Australians. They strongly desire information and support in their own language. Interventions are required to better support immigrants with cancer in Australia. Several studies are underway or planned to explore potential interventions, evaluating: a) providing immigrants with a question prompt list in their language and an audiotape of their oncology consultation, with written information about their cancer; b) consultation skills training for oncologists in culturally appropriate care, including working with an interpreter; c) a centralized telephone support service delivered by trained nurses who can speak the patient’s language for the first 6 months after diagnosis. These and other strategies will be discussed.