Supportive Care in Cancer

, Volume 21, Issue 9, pp 2509–2520 | Cite as

Unmet needs in immigrant cancer survivors: a cross-sectional population-based study

  • P. N. ButowEmail author
  • M. L. Bell
  • L. J. Aldridge
  • M. Sze
  • M. Eisenbruch
  • M. Jefford
  • P. Schofield
  • A. Girgis
  • M. King
  • P. S. Duggal
  • J. McGrane
  • D. Goldstein
  • on behalf of the Psycho-Oncology Co-operative Research Group (PoCoG) CALD team
Original Article



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.


Participants were recruited via Australian cancer registries. Eligible cancer survivors had a new diagnosis 1–6 years earlier and were aged between 18 and 80 years at diagnosis. Eligible immigrant participants and 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 was recruited.


Five hundred ninety-six patients (277 immigrants) were recruited to the study (response rate, 26 %). Compared to Anglo-Australians, the adjusted odds ratio 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 ten unmet needs amongst immigrants.


Immigrant 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.


Unmet needs Immigrants Cancer CALD Multi-culturalism Cultural competence 



We are grateful to the organizations which assisted with access to and recruitment of research participants: New South Wales, Victorian and Queensland cancer registries. In particular, we would like to thank Narelle Grayson and Serina Faraji from the NSW Central Cancer Registry, Helen Farrugia and Sue Douglas from the Victorian Cancer Registry, Kerrie Dennison and Carly Scott from the Queensland Cancer Registry, and Shirley Connell from the Queensland University of Technology for their contribution to methods of identifying participants and recruitment. We are most grateful to members of our community advisory boards who provided invaluable advice on community engagement, interpretation of data, and study procedures. Respectively, they are (1) Arabic Advisory Board: Fr Antonios Kaldas, Mona Saleh, Seham Gerges, Katya Nicholl; (2) Chinese Advisory Board: Wendy Wang, Theresa Chow, Daniel Chan, Viola Yeung, Dr. Agnes Li, Hudson Chen, Dr. Ven Tan, Nancy Tam, Soo See Yeo, Prof. Richard Chye; (3) Greek Advisory Board: Nicole Komninou, Fr Sophronios Konidaris, Maria Petrohilos, Bill Gonopoulos, Dr. Peter Calligeros, Elfa Moraitakis. We would also like to thank our bilingual research assistants who assisted with patient recruitment and all our participants. Professor Butow and A/Prof Schofield hold NHMRC fellowships. Professor King is supported by the Australian Government through Cancer Australia.


This study was funded by a grant from the Australian National Health and Medical Research Council (#457432), beyondblue: the national depression initiative, and the Victorian Community Foundation—James & Vera Lawson Trust (managed by ANZ trustees). Professor Butow holds a NHMRC Senior Principal research fellowship, and A/Prof Schofield holds a NHMRC career development fellowship (CDA level 2).

Conflict of interest

The authors have no financial relationships with any of the organizations that sponsored the research. We have full control of all primary data and agree to allow the journal to review the data if requested.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • P. N. Butow
    • 1
    • 2
    Email author
  • M. L. Bell
    • 1
    • 2
  • L. J. Aldridge
    • 1
    • 2
  • M. Sze
    • 1
    • 2
  • M. Eisenbruch
    • 3
  • M. Jefford
    • 4
    • 5
    • 6
  • P. Schofield
    • 4
    • 5
    • 6
  • A. Girgis
    • 7
  • M. King
    • 1
    • 2
  • P. S. Duggal
    • 1
    • 2
  • J. McGrane
    • 8
  • D. Goldstein
    • 9
    • 10
  • on behalf of the Psycho-Oncology Co-operative Research Group (PoCoG) CALD team
  1. 1.Psycho-Oncology Co-operative Research Group (PoCoG)University of SydneySydneyAustralia
  2. 2.School of PsychologyUniversity of SydneySydneyAustralia
  3. 3.School of Psychology and PsychiatryMonash UniversityMelbourneAustralia
  4. 4.Department of Cancer Experiences ResearchPeter MacCallum Cancer CentreMelbourneAustralia
  5. 5.Faculty of Medicine, Dentistry and Health SciencesUniversity of MelbourneMelbourneAustralia
  6. 6.Sir Peter MacCallum Department of OncologyThe University of MelbourneMelbourneAustralia
  7. 7.Ingham Institute for Applied Medical Research, South Western Sydney Clinical SchoolUniversity of New South WalesSydneyAustralia
  8. 8.Pearson Psychometric Laboratory, Faculty of EducationUniversity of Western AustraliaPerthAustralia
  9. 9.Faculty of MedicineUniversity of NSWSydneyAustralia
  10. 10.Dept of Medical OncologyPrince of Wales HospitalSydneyAustralia

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