Global burden of cancer among refugees: A systematic review and meta-analysis

Background

Refugees are a distinct group of migrants with a variety of cancer risks through cumulative exposures from their country of origin, migration process, and host countries. We conducted a comprehensive systematic synthesis of the epidemiological burden (incidence, prevalence, and mortality) of overall and site specific cancers among refugee populations globally.

Method

We systematically searched in OVID (Medline, Embase), CINAHL, and Scopus for studies reporting cancer prevalence, incidence, or mortality data among refugees globally from database inception to December 15, 2023. We screened for eligible studies using Covidence®. We applied a random-effects model to estimate the pooled proportions of site-specific cancer proportions using R software.

Result

Twenty-nine studies from 12 host countries comprising 561,850 refugees, mainly from Syria and Iraq were included. The pooled proportions for commonly reported site-specific cancer among refugee cancer patients were breast cancer (25.4% (95% CI: 20.3%, 30.4%)), lung cancer (4.8% (95% CI: 3.9%, 5.6%)), leukaemia (16.9% (95% CI: 8.2%, 25.6%)), and central nervous system (CNS) cancer (7.0% (95% CI: 5.3%, 8.7%)) respectively. Studies also reported a higher cervical cancer incidence among female refuges and higher liver cancer mortality among male refugees than non-refugee populations.

Conclusion

Although the existing evidence is limited, this review highlights a notable cancer burden among refugees, with higher incidence and mortality for certain cancers such as cervical and liver cancer among refugees than non-refugees. Targeted practical initiatives in ensuring optimal cancer continuum of care for refugees with cross-disciplinary collaboration are needed.