A Matched-pair Analysis on the Effect of Migration Background on Response Rates and Survival of Cancer Patients Treated at a Comprehensive Cancer Center in Germany

Abstract Background: There are several studies that investigate health inequalities in Germany due to its being a destination for immigrants since the 1960s. In this study, we pay specific attention to differences in cancer survival between German patients with and without a migration background being treated at a comprehensive cancer center. This becomes of particular interest since previous studies suggested that immigrant patients have a worse response to treatment and lower survival rates in their new host country.Methods: We considered 8162 cancer patients being treated at the CIO Bonn of the University Hospital of Bonn between April 2002 and December 2015 for our matched-pair analysis. Patients with migrant background were identified using a manual name-based algorithm with high specifity and then matched with patients without migrant background adjusting demographic characteristics, tumor features, defined staging criteria and primary therapy. Finally, 211 patients with a migrant background were matched to 211 patients without a migrant background and then compared with regard to response to treatment and survival rates (i.e. Overall survival, Progression-free survival and Time to progression).Results: Compared to the cohort with migration background, the cohort without migration background is slightly older (57.9 vs. 54.9 years) with equal gender distribution (55.0% vs. 54.5% female) and had a longer follow-up time (42.6 vs. 36.9 months). We did not find significant differences in cancer survival (overall survival; P=0.802) and response rates (ORR; McNemar's test, P=0.3458) between both collectives.Conclusion: In contrast to previous studies, we found no evidence that migration background of cancer patients being significantly affects response rates and survival. A worse outcome in populations of immigrant origin most likely has complex reasons, but highly standardized procedures in a comprehensive cancer center may contribute positively to reducing detrimental effects.