Non-English speakers face breast cancer treatment delays

Non-English speakers wait 11 more days for treatment

The researchers detected similar health outcomes for English speakers and non-English speakers, particularly in terms of disease-specific survival, disease-free survival and overall survival.

However, those who didn't speak English had to wait 29% longer to receive breast cancer treatment.

Individuals whose preferred language was not English waited a median of 49 days between their initial biopsy, which is part of the screening process, and definitive surgery, which is part of the treatment process.

Comparatively, individuals whose preferred language was English waited a median of 38 days between biopsy and definitive surgery, or 11 days less than those who do not speak English.

Language supports mediate systemic care barriers

The researchers concluded that language preference is not a good predictor of breast cancer survival, at least when a hospital employs adequate supports for individuals who don't speak English.

The academic medical center where the study took place offered comprehensive interpreter services and culturally responsive patient navigation. Patient navigators and interpreters were bilingual in English as well as Mandarin and Cantonese Chinese, which was the most common language spoken by the LEP members of the study population.

"This familiarity with the patients' primary language and cultural norms likely eased communication and may have minimized care discrepancies for this patient population," the researchers said.

This enhanced and supportive care is important as LEP patients face external, systemic barriers to care that are likely the culprit of the care delays, the researchers offered.

LEP study participants were more likely to be insured under Medicaid and live in low-income neighborhoods, which the study's authors pointed out have previously been linked to poorer healthcare access.

"Additionally, the significantly longer delays from diagnosis to surgery in the [LEP] group, particularly among patients from low-income communities, suggest that systemic barriers, such as difficulties in navigating the health care system or securing timely appointments, may still exist," the researchers said.

As noted above, language preference alone is not a great predictor of breast cancer outcomes and survivorship, the researchers stressed. When LEP patients have access to comprehensive language services and patient navigation, their outcomes can be equal to those of their peers.

"Addressing the broader social and structural determinants of health that disproportionately affect patients with [LEP] remains critical," the researchers concluded. "Interventions aimed at reducing treatment delays, improving health literacy, and ensuring culturally sensitive communication could further enhance outcomes for this vulnerable population."

Sara Heath has reported news related to patient engagement and health equity since 2015.