Colorectal cancer stage at diagnosis in migrants and non-migrants: a cross-sectional analysis of the KoMigra Study in Germany

Abstract

Background Colorectal cancer is one leading cause of cancer-related morbidity and mortality. Its prognosis depends largely on tumour stage at diagnosis. Migration status was associated with late stage at diagnosis in some studies, yet results are inconsistent.

Methods The cross-sectional study “The Diagnostics of Colorectal Carcinoma in Migrants and Non-Migrants in Germany” (KoMigra) investigated the association between migration background and tumour stage of colorectal cancer at diagnosis in a large German urban area. Patient variables were collected via a survey translated into nine languages. Data on tumour stage were extracted from medical records.

Results 437 patients could be recruited for analysis. Explorative logistic regression yielded no significant difference for tumour stage “I” versus “II-IV” according to the tumour classification “Union Internationale Contre le Cancer” (UICC) between migrants and non-migrants. Although the odds of a higher tumour stage were consistently higher in migrants than non-migrants, the effect estimates had wide confidence intervals. In descriptive analyses, migrants reported symptoms more often and for longer time than non-migrants. This was especially true for patients with poor proficiency of German.

Conclusions Migration background was not significantly associated with advanced tumour stage at diagnosis. However, the effect of poor language proficiency should be explored further.

Zusammenfassung

Hintergrund Das kolorektale Karzinom ist eine der führenden Ursachen krebsspezifischer Morbidität und Mortalität. Die Prognose hängt vom Stadium bei Diagnosestellung ab. Es wurde berichtet, dass das Vorliegen eines Migrationshintergrunds mit einem späteren Stadium bei Diagnose assoziiert sei; die Studienlage ist diesbezüglich jedoch nicht konsistent.

Methodik Die querschnittliche Studie „Diagnostik des Kolorektalen Karzinoms bei Migranten und Nicht-Migranten in Deutschland“ (KoMigra) untersuchte den Zusammenhang zwischen dem Vorliegen eines Migrationshintergrunds und dem Tumorstadium des kolorektalen Karzinoms bei Diagnosestellung in einer deutschen Großstadtregion. Patienteneigenschaften wurden über einen in neun Sprachen übersetzten Fragebogen und Tumordaten aus medizinischen Dokumenten erfasst.

Ergebnisse 437 Patienten konnten in die Analyse eingeschlossen werden. In der logistischen Regression zeigte sich kein Unterschied für Migranten versus Nicht-Migranten hinsichtlich des Tumorstadiums „I“ versus „II – IV“ nach der UICC-Tumorklassifikation („Union Internationale Contre le Cancer“). Obgleich die Odds für ein höheres Tumorstadium bei Migranten durchgehend höher lagen als bei Nicht-Migranten, wurde dies durch ein weites Konfidenzintervall relativiert. In der deskriptiven Analyse berichteten Migranten häufiger und über bereits seit Längerem bestehende Symptome als Nicht-Migranten. Dies traf besonders für Patienten mit eingeschränkten Deutschkenntnissen zu.

Schlussfolgerungen Das Vorliegen eines Migrationshintergrunds war nicht signifikant mit einem höheren Tumorstadium bei Diagnosestellung assoziiert. Dennoch sollten die Auswirkungen eingeschränkter Deutschkenntnisse weitergehend untersucht werden.

Key words

Colorectal cancer - cross-sectional analysis - migrants - UICC tumor stage

Schlüsselwörter

Kolorektales Karzinom - Querschnittsstudie - Migranten - UICC-Tumorstadium

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