TY  - JOUR
A1  - Dahlhaus, Anne Maren
A1  - Güthlin, Corina
A1  - Schall, Arthur
A1  - Taubenroth, Maja
A1  - Ewijk, Reyn van
A1  - Zeeb, Hajo
A1  - Albay, Zeycan
A1  - Schulz-Rothe, Sylvia
A1  - Beyer, Martin
A1  - Gerlach, Ferdinand M.
A1  - Blettner, Maria
A1  - Siebenhofer-Kroitzsch, Andrea
T1  - Colorectal cancer stage at diagnosis in migrants versus non-migrants (KoMigra) : study protocol of a cross-sectional study in Germany
T2  - BMC cancer
N2  - Background: In Germany, about 20% of the total population have a migration background. Differences exist between migrants and non-migrants in terms of health care access and utilisation. Colorectal cancer is the second most common malignant tumour in Germany, and incidence, staging and survival chances depend, amongst other things, on ethnicity and lifestyle. The current study investigates whether stage at diagnosis differs between migrants and non-migrants with colorectal cancer in an area of high migration and attempts to identify factors that can explain any differences.
Methods/Design: Data on tumour and migration status will be collected for 1,200 consecutive patients that have received a new, histologically verified diagnosis of colorectal cancer in a high migration area in Germany in the previous three months. The recruitment process is expected to take 16 months and will include gastroenterological private practices and certified centres for intestinal diseases. Descriptive and analytical analysis will be performed: the distribution of variables for migrants versus non-migrants and participants versus non-participants will be analysed using appropriate χ2-, t-, F- or Wilcoxon tests. Multivariable, logistic regression models will be performed, with the dependent variable being the dichotomized stage of the tumour (UICC stage I versus more advanced than UICC stage I). Odds ratios and associated 95%-confidence intervals will be calculated. Furthermore, ordered logistic regression models will be estimated, with the exact stage of the tumour at diagnosis as the dependent variable. Predictors used in the ordered logistic regression will be patient characteristics that are specific to migrants as well as patient characteristics that are not. Interaction models will be estimated in order to investigate whether the effects of patient characteristics on stage of tumour at the time of the initial diagnosis is different in migrants, compared to non-migrants.
Discussion: An association of migration status or other socioeconomic variables with stage at diagnosis of colorectal cancer would be an important finding with respect to equal health care access among migrants. It would point to access barriers or different symptom appraisal and, in the long term, could contribute to the development of new health care concepts for migrants.
Trial registration: German Clinical Trials Register DRKS00005056.
KW  - Colorectal cancer
KW  - Cross-sectional
KW  - Observational study
KW  - Ethnicity
KW  - Hard-to-reach population
KW  - Health care access
KW  - Migrants
Y1  - 2014
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/33395
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-333955
SN  - 1471-2407
N1  - © 2014 Dahlhaus et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited.
VL  - 14
IS  - 123
PB  - BioMed Central
CY  - London
ER  -