The influence of limited English proficiency on outcome in patients treated with radiotherapy for head and neck cancer

Qureshi, Muhammad M.; Romesser, Paul B.; Jalisi, Scharukh; Zaner, Ken S.; Cooley, Timothy P.; Grillone, Gregory A.; Kachnic, Lisa A.; Truong, Minh Tam

doi:10.1016/j.pec.2014.07.031

Cited by 44 publications

(37 citation statements)

References 27 publications

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“…The first examined the influence of limited English proficiency on outcome in 131 patients with head and neck cancer who were treated with RT. 33 In this study, the authors found that Hispanic-Americans and Asian-Americans (grouped together in analysis because of sample size limitations) were less likely to receive RT (60.9% vs. 84.7%; P = .038) than Caucasian patients. More importantly, patients with limited English proficiency were less likely to undergo chemoradiation (60% vs. 83.8%; P = .028) and had significantly lower 3-year actuarial locoregional control (58.3% vs. 82.2%; P = .038) than patients who were proficient in English, regardless of race or ethnicity.…”

Section: Resultsmentioning

confidence: 69%

“…More importantly, patients with limited English proficiency were less likely to undergo chemoradiation (60% vs. 83.8%; P = .028) and had significantly lower 3-year actuarial locoregional control (58.3% vs. 82.2%; P = .038) than patients who were proficient in English, regardless of race or ethnicity. 33 This finding is of marked significance for Hispanic-Americans because they may have a higher percentage of limited-proficiency English speakers than Caucasians or other underrepresented minorities, particularly if they recently emigrated to the United States.…”

Section: Resultsmentioning

confidence: 99%

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The pervasive crisis of diminishing radiation therapy access for vulnerable populations in the United States—part 3: Hispanic-American patients

McClelland

Perez

2018

Advances in Radiation Oncology

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PurposeHealth disparities have profoundly affected underrepresented minorities throughout the United States, particularly with regard to access to evidence-based interventions such as surgery or medication. The degree of disparity in access to radiation therapy (RT) for Hispanic-American patients with cancer has not been previously examined in an extensive manner.Methods and materialsAn extensive literature search was performed using the PubMed database to examine studies investigating disparities in RT access for Hispanic-Americans.ResultsA total of 34 studies were found, spanning 10 organ systems. Disparities in access to RT for Hispanic-Americans were most prominently studied in cancers of the breast (15 studies), prostate (4 studies), head and neck (4 studies), and gynecologic system (3 studies). Disparities in RT access for Hispanic-Americans were prevalent regardless of the organ system studied and were compounded by limited English proficiency and/or birth outside of the United States. A total of 26 of 34 studies (77%) involved analysis of a population-based database, such as Surveillance, Epidemiology and End Result (15 studies); Surveillance, Epidemiology and End Result-Medicare (4 studies); National Cancer Database (3 studies); or a state tumor registry (4 studies).ConclusionsHispanic-Americans in the United States have diminished RT access compared with Caucasian patients but are less likely to experience concomitant disparities in mortality than other underrepresented minorities that experience similar disparities (ie, African-Americans). Hispanic-Americans who are born outside of the United States and/or have limited English proficiency may be more likely to experience substandard RT access. These results underscore the importance of finding nationwide solutions to address such inequalities that hinder Hispanic-Americans and other underrepresented minorities throughout the United States.

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Section: Resultsmentioning

confidence: 69%

Section: Resultsmentioning

confidence: 99%

The pervasive crisis of diminishing radiation therapy access for vulnerable populations in the United States—part 3: Hispanic-American patients

McClelland

Perez

2018

Advances in Radiation Oncology

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“…Because patients with cancer and limited English proficiency report inferior treatment outcomes, their ineligibility may have affected results. 47 Any potential underestimated illness severity allows for 2 possible effects. First, our identified symptom severity and frequency admission rate, hospital length of stay, and other variables related to severity potentially represent the lower bound of severity.…”

Section: Discussionmentioning

confidence: 99%

Analysis of Diagnoses, Symptoms, Medications, and Admissions Among Patients With Cancer Presenting to Emergency Departments

et al. 2019

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Key Points Question What are the characteristics of patients with active cancer presenting to US emergency departments? Findings In this multicenter cohort study of 1075 adult patients with active cancer in the Comprehensive Oncologic Emergencies Research Network (CONCERN), patients commonly presented with symptoms such as pain (62.1%) and nausea (31.3%), were frequently treated for potential infection (26.5%), and were admitted (57.2%; 25.0% for <2 days) or placed in observation (7.6%). Meaning Opportunities for improving emergency department care for patients with cancer include establishing protocols and processes for prompt and appropriate symptom control, creating improved risk stratification tools, and improving outpatient management to prevent ED visits.

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“…A single study was found that retrospectively examined 131 patients from a single institution with biopsy-proven head and neck cancer (nonmetastatic, nonrecurrent) who completed curative-intent RT. 66 There were no statistically significant differences by race with regard to treatment intent, time from diagnosis to start of treatment, or treatment duration. 66 …”

Section: Resultsmentioning

confidence: 83%

“… 66 There were no statistically significant differences by race with regard to treatment intent, time from diagnosis to start of treatment, or treatment duration. 66 …”

Section: Resultsmentioning

confidence: 83%

The pervasive crisis of diminishing radiation therapy access for vulnerable populations in the United States, part 1: African-American patients

McClelland

Page

Jaboin

et al. 2017

Advances in Radiation Oncology

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IntroductionAfrican Americans experience the highest burden of cancer incidence and mortality in the United States and have been persistently less likely to receive interventional care, even when such care has been proven superior to conservative management by randomized controlled trials. The presence of disparities in access to radiation therapy (RT) for African American cancer patients has rarely been examined in an expansive fashion.Methods and materialsAn extensive literature search was performed using the PubMed database to examine studies investigating disparities in RT access for African Americans.ResultsA total of 55 studies were found, spanning 11 organ systems. Disparities in access to RT for African Americans were most prominently study in cancers of the breast (23 studies), prostate (7 studies), gynecologic system (5 studies), and hematologic system (5 studies). Disparities in RT access for African Americans were prevalent regardless of organ system studied and often occurred independently of socioeconomic status. Fifty of 55 studies (91%) involved analysis of a population-based database such as Surveillance, Epidemiology and End Result (SEER; 26 studies), SEER-Medicare (5 studies), National Cancer Database (3 studies), or a state tumor registry (13 studies).ConclusionsAfrican Americans in the United States have diminished access to RT compared with Caucasian patients, independent of but often in concert with low socioeconomic status. These findings underscore the importance of finding systemic and systematic solutions to address these inequalities to reduce the barriers that patient race provides in receipt of optimal cancer care.

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The influence of limited English proficiency on outcome in patients treated with radiotherapy for head and neck cancer

Cited by 44 publications

References 27 publications

The pervasive crisis of diminishing radiation therapy access for vulnerable populations in the United States—part 3: Hispanic-American patients

The pervasive crisis of diminishing radiation therapy access for vulnerable populations in the United States—part 3: Hispanic-American patients

Analysis of Diagnoses, Symptoms, Medications, and Admissions Among Patients With Cancer Presenting to Emergency Departments

The pervasive crisis of diminishing radiation therapy access for vulnerable populations in the United States, part 1: African-American patients

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