Open AccessImpact of immigration status on health behaviors and perceptions in cancer survivors
Author(s) -
Liu Sophia Y.,
Lu Lin,
Pringle Dan,
Mahler Mary,
Niu Chongya,
Charow Rebecca,
Tiessen Kyoko,
Lam Christine,
Halytskyy Oleksandr,
Naik Hiten,
Hon Henrique,
Irwin Margaret,
Pat Vivien,
Gonos Christina,
Chan Catherine W. T.,
Villeneuve Jodie,
Shani Ravi M.,
Chaudhry Maha,
Brown M. Catherine,
Selby Peter,
Howell Doris,
Xu Wei,
Alibhai Shabbir M. H.,
Jones Jennifer M.,
Liu Geoffrey,
Eng Lawson
Publication year - 2019
Publication title -
cancer medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.403
H-Index - 53
ISSN - 2045-7634
DOI - 10.1002/cam4.2079
Subject(s) - immigration , medicine , survivorship curve , cancer survivorship , moderation , demography , cancer , smoking cessation , gerontology , quality of life (healthcare) , environmental health , psychology , pathology , social psychology , sociology , history , nursing , archaeology
Background Health behaviors including smoking cessation, physical activity (PA), and alcohol moderation are key aspects of cancer survivorship. Immigrants may have unique survivorship needs. We evaluated whether immigrant cancer survivors had health behaviors and perceptions that were distinct from native‐born cancer survivors. Methods Adult cancer patients from Princess Margaret Cancer Centre were surveyed on their smoking, PA, and alcohol habits and perceptions of the effects of these behaviors on quality of life (QoL), 5‐year survival, and fatigue. Multivariable models evaluated the association of immigration status and region‐of‐origin on behaviors and perceptions. Results Of the 784 patients, 39% self‐identified as immigrants. Median time of survey was 24 months after histological diagnosis. At baseline, immigrants had trends toward not meeting Canadian PA guidelines or being ever‐drinkers; patients from non‐Western countries were less likely to smoke (aOR current = 0.46, aOR ex‐smoker = 0.47, P = 0.02), drink alcohol (aOR current = 0.22, aOR ex‐drinker = 0.52, P < 0.001), or meet PA guidelines (aOR = 0.44, P = 0.006). Among immigrants, remote immigrants (migrated ≥40 years ago) were more likely to be consuming alcohol at diagnosis (aOR = 5.70, P < 0.001) compared to recent immigrants. Compared to nonimmigrants, immigrants were less likely to perceive smoking as harmful on QoL (aOR = 0.58, P = 0.008) and survival (aOR = 0.56, P = 0.002), and less likely to perceive that PA improved fatigue (aOR = 0.62, P = 0.04) and survival (aOR = 0.64, P = 0.08). Conclusions Immigrants had different patterns of health behaviors than nonimmigrants. Immigrants were less likely to perceive continued smoking as harmful and were less likely to be aware of PA benefits. Culturally tailored counselling may be required for immigrants who smoke or are physically sedentary at diagnosis.