Emotional distress in cancer survivors from various ethnic backgrounds: Analysis of the multi-ethnic HELIUS study.

Journal: Psycho-oncology

Volume: 32

Issue: 9

Year of Publication: 2023

Affiliated Institutions:  Medical Psychology, Amsterdam UMC Location University of Amsterdam, Amsterdam, the Netherlands. Cancer Center Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, the Netherlands. Department of Public and Occupational Health, Amsterdam UMC Location University of Amsterdam, Amsterdam, the Netherlands. Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida, USA. Amsterdam Public Health, Mental Health, Amsterdam, the Netherlands.

Abstract summary 

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.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.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 size : 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.Cancer survivors from ethnic minorities experience more distress than those from the majority population. Culturally sensitive supportive care should be considered.

Authors & Co-authors:  Müller Fabiola F Veen Linde M LM Galenkamp Henrike H Jim Heather S L HSL Lok Anja A Nieuwkerk Pythia T PT Suurmond Jeanine J van Laarhoven Hanneke W M HWM Knoop Hans H

Study Outcome 

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Statistics
Citations :  Mehnert A, Hartung TJ, Friedrich M, et al. One in two cancer patients is significantly distressed: prevalence and indicators of distress. Psycho Oncol. 2018;27(1):75-82. https://doi.org/10.1002/pon.4464
Authors :  9
Identifiers
Doi : 10.1002/pon.6192
SSN : 1099-1611
Study Population
Male,Female
Mesh Terms
Humans
Other Terms
anxiety;cancer;depression;distress;ethnicity;mental health;oncology;psycho-oncology;supportive care;survivorship
Study Design
Cohort Study,,Cross Sectional Study
Study Approach
Country of Study
Ghana
Publication Country
England