Breast Cancer Aftercare Among Women of Turkish Origin in Germany: Tracing the Factors Influencing Uptake

Cansu Erdogan Cengiz, Lara Schürmann, Jürgen Breckenkamp, Alisa Dayangan, Oliver Razum, Christiane Muth, Svetlana Puzhko

Keywords: breast cancer, aftercare, migration background, mixed methods, interviews, focus groups

Background:

Breast cancer is the most common cancer among women in Germany. Follow-up after the acute treatment (aftercare) helps improve life quality, prevent complications, and timely detect relapses. There are no studies evaluating factors influencing the utilization of breast cancer aftercare by women of Turkish origin (the largest group of migrant women) in Germany. It is important to understand whether there are barriers to breast cancer aftercare specific to the migrant population.

Research questions:

How is breast cancer aftercare used and perceived by women of Turkish origin in Germany? What can be done to optimize the role of different healthcare providers, including general practitioners (GP), and interprofessional cooperation?

Method:

This project has three parts. I: Mixed-methods study with an exploratory sequential design to identify factors associated with the aftercare uptake. The qualitative (QUAL) part (interviews (7-10 participants) and focus groups (5-10 participants)) will inform the quantitative (QUAN) part, a cross-sectional survey of women in the German Cancer Registry (n=3500). II: A cross-sectional analysis of the statutory health insurance data on the use of aftercare by women of Turkish vs. non-Turkish origin (n=2000). III: Deliberative consultations with gynecologists, oncologists, and GP (5-10 participants) to develop recommendations to improve aftercare and interprofessional collaboration. Analysis: QUAL data - thematic analysis. QUAN data - bivariate comparison tests and logistic regression. All parts’ findings will be synthesized and translated into recommendations.

Results:

We expect that utilization of aftercare services will be associated with age, socioeconomic status, language barriers, and cultural differences, and will vary among different generations of migrants. Health professionals may report issues related to the certification process and gaps in interprofessional collaboration.

Conclusions:

Study findings will contribute to the improvement of breast cancer aftercare and a better understanding of the barriers to health services for the migrant populations in the German healthcare system.

Points for discussion:

How does the intersection of gender and migration background have an impact on the utilization of health care services and breast cancer aftercare in particular?

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