TY - JOUR
T1 - Emotional distress in cancer survivors from various ethnic backgrounds
T2 - Analysis of the multi-ethnic HELIUS study
AU - Müller, Fabiola
AU - Veen, Linde M.
AU - Galenkamp, Henrike
AU - Jim, Heather S. L.
AU - Lok, Anja
AU - Nieuwkerk, Pythia T.
AU - Suurmond, Jeanine
AU - van Laarhoven, Hanneke W. M.
AU - Knoop, Hans
N1 - Funding Information: The authors are grateful to the participants of the HELIUS study and the management team, research nurses, interviewers, research assistants and other staff who have taken part in gathering the data of this study. The authors also thank the registration team of the Netherlands Comprehensive Cancer Organisation (IKNL) for the collection of data for the NCR. The HELIUS study is conducted by the Amsterdam University Medical Centers, location University of Amsterdam and the Public Health Service of Amsterdam. Both organisations provided core support for HELIUS. The HELIUS study is also funded by the Dutch Heart Foundation, the Netherlands Organization for Health Research and Development (ZonMw), the European Union (FP-7), and the European Fund for the Integration of non-EU immigrants (EIF). This study reported here was supported by additional grants from NKCV Foundation (Dutch: Stichting NKCV) and the Dutch Cancer Society (Dutch: KWF Kankerbestrijding, VU2017-8288). Funding Information: Heather S. L. Jim: consultant for RedHill BioPharma, Janssen Scientific Affairs, and Merck. Grant funding from Kite Pharma. Funding Information: The authors are grateful to the participants of the HELIUS study and the management team, research nurses, interviewers, research assistants and other staff who have taken part in gathering the data of this study. The authors also thank the registration team of the Netherlands Comprehensive Cancer Organisation (IKNL) for the collection of data for the NCR. The HELIUS study is conducted by the Amsterdam University Medical Centers, location University of Amsterdam and the Public Health Service of Amsterdam. Both organisations provided core support for HELIUS. The HELIUS study is also funded by the Dutch Heart Foundation, the Netherlands Organization for Health Research and Development (ZonMw), the European Union (FP‐7), and the European Fund for the Integration of non‐EU immigrants (EIF). This study reported here was supported by additional grants from NKCV Foundation (Dutch: Stichting NKCV) and the Dutch Cancer Society (Dutch: KWF Kankerbestrijding, VU2017‐8288). Publisher Copyright: © 2023 The Authors. Psycho-Oncology published by John Wiley & Sons Ltd.
PY - 2023/9
Y1 - 2023/9
N2 - Purpose: Insight into emotional distress of cancer survivors from ethnic minority groups in Europe is scarce. We aimed to compare distress levels of survivors from ethnic minorities to that of the majority population, determine whether the association between having cancer (yes vs. no) and distress differs among ethnic groups and investigate sociocultural correlates of distress. Methods: Cross-sectional data were derived from HELIUS, a multi-ethnic cohort study conducted in the Netherlands. Of 19,147 participants, 351 were diagnosed with cancer (n = 130 Dutch, n = 75 African Surinamese, n = 53 South-Asian Surinamese, n = 43 Moroccan, n = 28 Turkish, n = 22 Ghanaian). Distress (PHQ-9, MCS-12) and correlates were assessed by self-report. Cancer-related variables were derived from the Netherlands Cancer Registry. Results: Survivors were on average 7 years post-diagnosis. Survivors from South-Asian Surinamese, Moroccan, Turkish and Ghanaian origin reported more distress than survivors from Dutch origin (effect sizerange: 0.44–1.17; adjusted models). The association between having cancer or not with distress differed in direction between Dutch and the non-Dutch ethnic groups: Non-Dutch cancer patients tended to have more distress than their cancer-free peers, whereas Dutch cancer patients tended to have less distress than their cancer-free peers. For Moroccan and Turkish patients, the acculturation style of separation/marginalization, compared to integration/assimilation, was associated with higher depressive symptoms. In analyses pooling data from all ethnic minorities, lower health literacy, lower emotional support satisfaction and younger age at the time of migration were associated with higher depressive symptoms. Lower health literacy, fewer emotional support transactions, and more frequent attendance at religious services were associated with worse mental health. Conclusion: Cancer survivors from ethnic minorities experience more distress than those from the majority population. Culturally sensitive supportive care should be considered.
AB - Purpose: Insight into emotional distress of cancer survivors from ethnic minority groups in Europe is scarce. We aimed to compare distress levels of survivors from ethnic minorities to that of the majority population, determine whether the association between having cancer (yes vs. no) and distress differs among ethnic groups and investigate sociocultural correlates of distress. Methods: Cross-sectional data were derived from HELIUS, a multi-ethnic cohort study conducted in the Netherlands. Of 19,147 participants, 351 were diagnosed with cancer (n = 130 Dutch, n = 75 African Surinamese, n = 53 South-Asian Surinamese, n = 43 Moroccan, n = 28 Turkish, n = 22 Ghanaian). Distress (PHQ-9, MCS-12) and correlates were assessed by self-report. Cancer-related variables were derived from the Netherlands Cancer Registry. Results: Survivors were on average 7 years post-diagnosis. Survivors from South-Asian Surinamese, Moroccan, Turkish and Ghanaian origin reported more distress than survivors from Dutch origin (effect sizerange: 0.44–1.17; adjusted models). The association between having cancer or not with distress differed in direction between Dutch and the non-Dutch ethnic groups: Non-Dutch cancer patients tended to have more distress than their cancer-free peers, whereas Dutch cancer patients tended to have less distress than their cancer-free peers. For Moroccan and Turkish patients, the acculturation style of separation/marginalization, compared to integration/assimilation, was associated with higher depressive symptoms. In analyses pooling data from all ethnic minorities, lower health literacy, lower emotional support satisfaction and younger age at the time of migration were associated with higher depressive symptoms. Lower health literacy, fewer emotional support transactions, and more frequent attendance at religious services were associated with worse mental health. Conclusion: Cancer survivors from ethnic minorities experience more distress than those from the majority population. Culturally sensitive supportive care should be considered.
KW - anxiety
KW - cancer
KW - depression
KW - distress
KW - ethnicity
KW - mental health
KW - oncology
KW - psycho-oncology
KW - supportive care
KW - survivorship
UR - http://www.scopus.com/inward/record.url?scp=85165499370&partnerID=8YFLogxK
U2 - https://doi.org/10.1002/pon.6192
DO - https://doi.org/10.1002/pon.6192
M3 - Article
C2 - 37482911
SN - 1057-9249
VL - 32
SP - 1412
EP - 1423
JO - Psycho-Oncology
JF - Psycho-Oncology
IS - 9
ER -