No evidence to support the impact of migration background on treatment response rates and cancer survival: a retrospective matched-pair analysis in Germany
Roman Rüdiger,
Franziska Geiser,
Manuel Ritter,
Peter Brossart,
Mignon-Denise Keyver-Paik,
Andree Faridi,
Hartmut Vatter,
Friedrich Bootz,
Jennifer Landsberg,
Jörg C. Kalff,
Ulrich Herrlinger,
Glen Kristiansen,
Torsten Pietsch,
Stefan Aretz,
Daniel Thomas,
Lukas Radbruch,
Franz-Josef Kramer,
Christian P. Strassburg,
Maria Gonzalez-Carmona,
Dirk Skowasch,
Markus Essler,
Matthias Schmid,
Jennifer Nadal,
Nicole Ernstmann,
Amit Sharma,
Benjamin Funke,
Ingo G. H. Schmidt-Wolf
Affiliations
Roman Rüdiger
Department of Integrated Oncology, CIO Bonn, Center for Integrated Oncology ABCD, University Hospital Bonn
Franziska Geiser
Institute of Psychosomatic Medicine and Psychotherapy, University Hospital Bonn
Manuel Ritter
Department of Urology, University Hospital Bonn
Peter Brossart
Department of Internal Medicine III, University Hospital Bonn
Mignon-Denise Keyver-Paik
Department of Senology and certified Breast Center, University Hospital Bonn
Andree Faridi
Department of Senology and certified Breast Center, University Hospital Bonn
Hartmut Vatter
Department of Neurosurgery, University Hospital Bonn
Friedrich Bootz
Department of Otorhinolaryngology, University Hospital Bonn
Jennifer Landsberg
Department of Dermatology and Allergy, University Hospital Bonn
Jörg C. Kalff
Department of Surgery, University Hospital Bonn
Ulrich Herrlinger
Department of Neurology, University Hospital Bonn
Glen Kristiansen
Institute of Pathology, University Hospital Bonn
Torsten Pietsch
Department of Neuropathology, University Hospital Bonn
Stefan Aretz
Institute of Human Genetics, University Hospital Bonn
Daniel Thomas
Department of Radiology, University Hospital Bonn
Lukas Radbruch
Department of Palliative Medicine, University Hospital Bonn
Franz-Josef Kramer
Department of Oral and Maxillofacial Plastic Surgery, University Hospital Bonn
Christian P. Strassburg
Department of Internal Medicine I, University Hospital Bonn
Maria Gonzalez-Carmona
Department of Internal Medicine I, University Hospital Bonn
Dirk Skowasch
Department of Internal Medicine II, University Hospital Bonn
Markus Essler
Department of Nuclear Medicine, University Hospital Bonn
Matthias Schmid
Institute for Medical Biometry, Computer Science and Epidemiology, University Hospital Bonn
Jennifer Nadal
Institute for Medical Biometry, Computer Science and Epidemiology, University Hospital Bonn
Nicole Ernstmann
Center for Health Communication and Health Services Research, Department of Psychosomatic Medicine and Psychotherapy, University Hospital Bonn
Amit Sharma
Department of Integrated Oncology, CIO Bonn, Center for Integrated Oncology ABCD, University Hospital Bonn
Benjamin Funke
Department of Integrated Oncology, CIO Bonn, Center for Integrated Oncology ABCD, University Hospital Bonn
Ingo G. H. Schmidt-Wolf
Department of Integrated Oncology, CIO Bonn, Center for Integrated Oncology ABCD, University Hospital Bonn
Abstract Background Immigration has taken the central stage in world politics, especially in the developed countries like Germany, where the continuous flow of immigrants has been well documented since 1960s. Strikingly, emerging data suggest that migrant patients have a poorer response to the treatment and lower survival rates in their new host country, raising concerns about health disparities. Herein, we present our investigation on the treatment response rate and cancer survival in German patients with and without an immigrant background that were treated at our comprehensive cancer center in Germany. Methods Initially, we considered 8162 cancer patients treated at the Center for Integrated Oncology (CIO), University Hospital Bonn, Germany (April 2002–December 2015) for matched-pair analysis. Subsequently, the German patients with a migration background and those from the native German population were manually identified and catalogued using a highly specific name-based algorithm. The clinical parameters such as demographic characteristics, tumor characteristics, defined staging criteria, and primary therapy were further adjusted. Using these stringent criteria, a total of 422 patients (n = 211, Germans with migration background; n = 211, native German population) were screened to compare for the treatment response and survival rates (i.e., 5-year overall survival, progression-free survival, and time to progression). Results Compared to the cohort with migration background, the cohort without migration background was slightly older (54.9 vs. 57.9 years) while having the same sex distribution (54.5% vs. 55.0% female) and longer follow-up time (36.9 vs. 42.6 months). We did not find significant differences in cancer survival (5-year overall survival, P = 0.771) and the response rates (Overall Remission Rate; McNemar’s test, P = 0.346) between both collectives. Conclusion Contrary to prior reports, we found no significant differences in cancer survival between German patients with immigrant background and native German patients. Nevertheless, the advanced treatment protocols implemented at our comprehensive cancer center may possibly account for the low variance in outcome. To conduct similar studies with a broader perspective, we propose that certain risk factors (country-of-origin-specific infections, dietary habits, epigenetics for chronic diseases etc.) should be considered, specially in the future studies that will recruit new arrivals from the 2015 German refugee crisis.
