Division of Medical Oncology and Hematology, Department of Medicine, Princess Margaret Hospital/University Health Network and University of Toronto, Toronto, ON, Canada.
Department of Biostatistics, Princess Margaret Cancer Centre/University Health Network and University of Toronto, Toronto, ON, Canada.
Cancer Med. 2019 May;8(5):2623-2635. doi: 10.1002/cam4.2079. Epub 2019 Mar 21.
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.
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.
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 = 0.46, aOR = 0.47, P = 0.02), drink alcohol (aOR = 0.22, aOR = 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).
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.
健康行为，包括戒烟、身体活动（PA）和适度饮酒，是癌症生存者的关键方面。移民可能有独特的生存需求。我们评估了移民癌症幸存者的健康行为和认知是否与本土出生的癌症幸存者不同。
从玛格丽特公主癌症中心的成年癌症患者中调查了他们的吸烟、PA 和饮酒习惯以及对这些行为对生活质量（QoL）、5 年生存率和疲劳影响的认知。多变量模型评估了移民身份和原籍地区对行为和认知的影响。
在 784 名患者中，39%自我认定为移民。调查的中位时间是组织学诊断后 24 个月。在基线时，移民者有不符合加拿大 PA 指南或有饮酒史的趋势；来自非西方国家的患者不太可能吸烟（OR = 0.46，OR = 0.47，P = 0.02）、饮酒（OR = 0.22，OR = 0.52，P < 0.001）或符合 PA 指南（OR = 0.44，P = 0.006）。在移民中，远程移民（移民时间≥40 年前）在诊断时更有可能饮酒（OR = 5.70，P < 0.001）与近期移民相比。与非移民相比，移民者认为吸烟对 QoL 的危害较小（OR = 0.58，P = 0.008）和生存（OR = 0.56，P = 0.002），并认为 PA 改善疲劳的可能性较小（OR = 0.62，P = 0.04）和生存（OR = 0.64，P = 0.08）。
移民的健康行为模式与非移民不同。移民者不太可能认为继续吸烟有害，也不太可能意识到 PA 的好处。对于诊断时吸烟或久坐不动的移民，可能需要进行文化上量身定制的咨询。
