Cancer survival and its social determinants among children with a migrant background: systematic review protocol

INTRODUCTION: Childhood cancer survival rates are not equal for all, with disparities existing both between and within low- and middle-income countries and high-income countries, particularly among ethnic minorities and children with migrant backgrounds. Factors such as cultural misunderstandings, language barriers and limited support networks can lead to delays in diagnosis and treatment challenges, which can result in poor health outcomes. Social determinants of health (SDoH), such as housing insecurity and poverty, may worsen these disparities. This protocol outlines a systematic review to examine childhood cancer survival in children with migrant backgrounds compared with non-migrants and to explore the SDoH associated with these survival outcomes. METHODS AND ANALYSIS: We will search MEDLINE (PubMed), Scopus, Web of Science, and Embase for relevant studies, with secondary searches of grey literature. Two reviewers will screen for observational studies, including longitudinal cohort, case-control, cross-sectional and registry-based studies, that report childhood cancer survival outcomes (eg, survival rates, HRs) for both migrant and non-migrant populations. A narrative synthesis will explore SDoH and their association with survival outcomes. If data allow, we will perform random-effects meta-analyses to estimate pooled survival outcomes. Subgroup analyses will examine factors such as geographic region, migration status and type of cancer. DISCUSSION: Understanding factors contributing to childhood cancer survival disparities in migrant populations is critical for informing the development of targeted strategies to address them, ensuring all children, regardless of their migration status, have an equitable opportunity for effective care and improved outcomes. ETHICS AND DISSEMINATION: Ethical approval is not required for this study as it is based on previously published data and does not involve primary data collection. We will publish the results in peer-reviewed journals and present at academic conferences. PROSPERO REGISTRATION NUMBER: CRD42024547239.