Adam Harvey-Sullivan, Sana Ali, Parveen Dhesi, Joseph Hart, Helena Painter, Fiona M Walter, Garth Funston, Dominik Zenner
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引用次数: 0
Abstract
Background: Migrants face barriers accessing healthcare, risking delays in cancer diagnosis. Diagnostic delays result in later stage diagnosis which is associated with poorer cancer survival. This review aims to compare the differences in cancer stage at diagnosis between migrants and non-migrants.
Methods: We conducted a systematic review and meta-analysis of three databases from 2000 to 2023 for studies conducted in OECD countries that compared stage at diagnosis between migrants and non-migrants. Meta-analysis compared odds ratios (OR) for early (stage I and II) stage at diagnosis. The Risk of Bias in Non-randomised Studies of Exposure tool was used to assess study quality.
Results: 41 of the 11,549 studies identified were included; 34 studies had suitable data for meta-analysis. Overall, migrants were significantly less likely to be diagnosed with early stage cancer compared with non-migrants (OR 0.84; 95% CI 0.78-0.91). This difference was maintained across cancer types, although only statistically significant for breast (OR 0.78; 95% CI 0.70-0.87) and prostate cancer (OR 0.92; 95% CI 0.85-0.99).
Discussion: Published studies indicate that migrants are less likely to be diagnosed with early stage cancer. Variation by cancer type, study location and region of origin highlights the need for further research to understand these differences.
背景:移民在获得医疗保健方面面临障碍,有可能延误癌症诊断。诊断延误导致晚期诊断,而晚期诊断与较差的癌症生存率有关。本综述旨在比较移民和非移民在癌症诊断阶段的差异:我们对 2000 年至 2023 年在经合组织国家进行的比较移民和非移民癌症诊断阶段的研究进行了系统回顾和荟萃分析。荟萃分析比较了早期(I期和II期)诊断时的几率比(OR)。采用 "非随机暴露研究中的偏倚风险"(Risk of Bias in Non-randomised Studies of Exposure)工具评估研究质量:在已确定的 11,549 项研究中,有 41 项被纳入;34 项研究的数据适合进行荟萃分析。总体而言,与非移民相比,移民被诊断为早期癌症的可能性明显较低(OR 0.84; 95% CI 0.78-0.91)。这一差异在不同癌症类型中都得以保持,但只有乳腺癌(OR 0.78;95% CI 0.70-0.87)和前列腺癌(OR 0.92;95% CI 0.85-0.99)的差异具有统计学意义:讨论:已发表的研究表明,移民被诊断为早期癌症的可能性较低。癌症类型、研究地点和原籍地区的差异凸显了进一步研究了解这些差异的必要性。
期刊介绍:
The British Journal of Cancer is one of the most-cited general cancer journals, publishing significant advances in translational and clinical cancer research.It also publishes high-quality reviews and thought-provoking comment on all aspects of cancer prevention,diagnosis and treatment.