Syrian Refugee and Turkish Women with Breast Cancer: A Comparison on Clinicopathological Features and Survival

Abstract

Background: Cancer is a significant health problem for refugees and host countries. Breast cancer is the most common cancer among refugees. The subject of our study is to examine the clinical and pathological features of Syrian refugees with breast cancer and compare them with Turkish patients with breast cancer. Methods: Data of patients with breast cancer between January 2018 and December 2020 were retrospectively reviewed. The clinical and histological features, treatment modalities and overall survival were collected and analyzed. Results: A total number of 338 women with breast cancer were included in this study. Ninety-nine of the 338 (29.3%) patients were Syrian refugees and 239 patients (70.7%) were Turkish. The median follow-up time was significantly lower in Syrian patients (P<0.001). Median OS was 146 months in Turkish and 116 months in Syrian group (P=0.022). Independent risk factors associated with long survival were receiving adjuvant chemotherapy (HR 0.465; 95% CI 0.234–0.926; P=0.029), adjuvant radiotherapy (HR 0.372 95% CI 0.182–0.758; P=0.007), and adjuvant hormonotherapy (HR 0.367; 95% CI 0.201–0.669; P=0.001). The rates of receiving adjuvant chemotherapy, adjuvant radiotherapy, and adjuvant hormonal therapy were significantly lower in the Syrian group (P=0.023, P=0.005, P=0.002, respectively). Conclusion: Syrian refugees with breast cancer are more likely to receive suboptimal treatments. They have inferior survival compared to local patients. Our findings highlight the need for the provision of cancer therapy in such vulnerable populations. We suggest that more attention should be paid to breast cancer, as it is the most common cancer among refugees.