Addressing disparities in health outcomes for patients with advanced pancreatic cancer and limited English proficiency

Williams, C; Chong, G; Tacey, M; Barnett, F; Mooi, J; Jalali, A; Hodgson, R; Yong, T; Lee, B

Author(s): Williams, C; Chong, G; Tacey, M; Barnett, F; Mooi, J; Jalali, A; Hodgson, R; Yong, T; Lee, B;
Details: Publication Year 2024-08,Volume 20,Issue #4,Page 531-536
Journal Title: Asia Pacific Journal of Clinical Oncology
Abstract: INTRODUCTION: There are significant challenges and a lack of data related to culturally and linguistically diverse (CALD) cancer patients. We compared patient characteristics, treatment patterns, and outcomes of patients with advanced pancreatic cancer that required an interpreter. METHODS: Registry data was extracted for advanced pancreatic cancer patients from a single health institution with a comprehensive Transcultural and Language Service (TALS). Demographic and clinicopathologic characteristics were compared. Kaplan-Meier survival estimates with log-rank testing, and univariate and multivariable regression analysis were performed to compare the group with limited English proficiency (LEP) to the English proficient (EP) group. RESULTS: Of 155 patients, 32.9% (n = 51) required the TALS. The LEP group had a higher mean age (71.2 vs. 76.8 years; p = 0.005) and received less chemotherapy (42.3% vs. 31.4%, p = 0.220). Univariate analysis revealed a shorter median overall survival (OS) in the LEP group (3.6 vs. 5.0 months), with a hazard ratio [HR] of 1.51 (95% confidence interval [CI]: 1.03-2.21, p = 0.033). Upon multivariable analysis, adjusting for Eastern Cooperative Oncology Group (ECOG) performance scale, the number of sites of metastatic disease and chemotherapy use, the strength of association between LEP and OS reduced marginally (HR 1.42, 95% CI: 0.93-2.16), and was no longer statistically significant (p = 0.103). CONCLUSIONS: In patients with advanced pancreatic cancer utilizing a comprehensive TALS, there was a trend to poorer survival with limited English proficiency, although this association was not statistically significant. An ongoing research commitment to the CALD experience is necessary to build a granular understanding of this population and ensure equitable outcomes.
Publisher: Wiley
Keywords: Humans; Female; Male; *Pancreatic Neoplasms/therapy/pathology/drug therapy; Aged; *Limited English Proficiency; *Healthcare Disparities/statistics & numerical data; Middle Aged; Aged, 80 and over; Cald; culturally and linguistically diverse; equity; limited English proficiency; pancreatic cancer
Research Division(s): Personalised Oncology
PubMed ID: 38813793
Publisher's Version: https://doi.org/10.1111/ajco.14076
Terms of Use/Rights Notice: Refer to copyright notice on published article.

Creation Date: 2024-06-24 11:30:02

Last Modified: 2024-07-26 09:30:28