Ukrainian refugee women have double the odds of having advanced-stage breast cancer compared with Polish citizens, according to research published April 22 in JAMA Network Open.
A team led by Lukasz Rabalski, PhD, from the University of Gdansk in Poland found that compared with the general Polish population, war refugee status was tied to a higher prevalence of aggressive tumor grades and more advanced stage disease at diagnosis. And refugee women tended to be younger.
“Our findings may inform health care policy decisions and resource allocation for cancer care in humanitarian crises,” the Rabalski team wrote.
Since 2022, when Russia invaded Ukraine, millions of Ukrainians have been displaced by war. Refugees have sought shelter in European Union (EU) countries, including Poland. The researchers noted that this influx of refugees has its share of unique challenges in distributing cancer care resources.
Rabalski and colleagues studied associations between Ukrainian refugee status and clinical presentation of breast cancer compared with Ukrainian permanent residents in Poland and the general Polish population.
The retrospective, single-center study included data collected between 2021 and 2024 from 3,259 women. It included adult women with a diagnosis of stage 0 to IV breast cancer, regardless of treatment intent.
Of the total women, 44 were in the war refugee group, 72 were in the Ukrainian permanent resident group, and 3,143 were in the general Polish population group. The permanent resident group had the youngest average age at 49.9 years, followed by the refugee group (52.9 years) and the Polish resident group (59.5 years).
The refugee group had the highest prevalence of stage III to IV disease and grade III tumors.
| Breast cancer trends among Ukrainian refugees, permanent residents, and general Polish population | |||
|---|---|---|---|
| Diagnosis | General Polish population | Ukrainian permanent residents | Refugee group |
| Stage III to IV disease | 27% | 18% | 43.2% |
| Grade 3 tumors | 21.5% | 12.5% | 34.1% |
Adjusted analysis showed that refugees had a twofold increase for odds of having stage III to IV disease (p = 0.03) and a 2.42-fold increase for odds of developing grade III tumors (p = 0.006).
And on weighted logistic regression analyses, the refugee group had significantly lower odds of presenting with stage 0 or I disease compared to the general Polish population group (odds ratio [OR], 0.43). Finally, Ukrainian permanent residents showed no significant differences from the general Polish population in stage distribution but had lower odds of high-grade tumors (OR for grade 3, 0.67; p = 0.26).
The study authors highlighted that the combination of younger age at presentation with more advanced disease suggests that current age-based screening recommendations may need to be adjusted for refugee populations. They suggested that healthcare practitioners consider breast cancer in younger refugee women and prioritize access to diagnostic services regardless of age.
“These findings highlight the need for targeted health care interventions for refugee populations, including enhanced screening programs and expedited diagnostic pathways,” the authors wrote.
The full study can be accessed here.
