All-cause mortality differentials by migratory background among cancer cases in 2018 in Veneto, Italy

Abstract Background The number of international migrants is increasing in Italy. Evidence suggests they face reduced access to healthcare, which may lead to lower quality of care and worse outcomes. This study aims to analyse whether there are differentials in all-cause mortality (ACM) by migratory background (MB) in a cohort of prevalent cancer cases from the EPICOST 2 study. This analysis was conducted within the JA Prevent NCD, which includes cancer as cross-cutting theme. Methods Observational study based on 56,569 prevalent cancer cases among 30-79-year-olds for the 10 most frequent cancer types recorded in the Veneto Cancer Registry, as of 01/01/2018, with a 1-year follow-up for vital status. We described the clinically relevant phases of care (initial, continuing, end of life-EOL) according to birthplace (non-Italian vs native) as a proxy for MB. We calculated person-time and estimated crude and age-adjusted ACM rate ratios (RR) and 95%CI for individuals with MB vs natives. Results Preliminary results show that out of 56,569 prevalent cancer cases, 1,950 (3.5%) had a MB and 3,977 (7.0%) died. The distribution by phase shows a higher proportion of cases among individuals with a MB compared to native in the initial (37.0% vs 21.0%, respectively) and in the EOL phase (5.7% vs 4.2%, respectively), and vice versa for the continuing phase (57.3% vs 74.9%). Both crude (1.2;95%CIs:1.01-1.40) and age-adjusted ACM RR (1.7;95%CIs:1.44-2.00) were higher among individuals with a MB compared to natives. Conclusions These results suggest differences in the patterns of care and ACM disparities among cancer cases by MB. A culturally sensitive care approach, considering the changing demographics, may increase the participation of migrants in cancer screening, thus improving survival and reducing costs. Further analyses are necessary to investigate the role of MB on access to healthcare services and related costs. Key messages • Monitoring the impact of demographic changes on healthcare needs is crucial to optimize healthcare policies and resource allocation, both for prevention and sustainability of healthcare Systems. • This monitoring approach may be extended to other European Countries in the framework of the JA Prevent NCD, provided that population-based Cancer Registry and healthcare data are available.