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Language Proficiency and Survival in Pancreatic Cancer: a Propensity Score-Matched Analysis.

Rodrigo Calvillo-Ortiz¹, J Christopher Polanco-Santana², Manuel Castillo-Angeles³

¹Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue Palmer 6, Boston, MA, 02215, USA.

Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract

|July 14, 2021

Summary

Patients with limited English proficiency (LEP) have worse survival rates for pancreatic ductal adenocarcinoma (PDAC). Further research is needed to address disparities in cancer treatment and outcomes for LEP patients.

Keywords:

Culturally competent care Healthcare disparities Limited English proficiency Pancreatic cancer Pancreatic ductal carcinoma Survival

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Area of Science:

Oncology
Health Services Research
Health Disparities

Background:

Limited English proficiency (LEP) is linked to poorer health outcomes.
Survival rates for pancreatic ductal adenocarcinoma (PDAC) in patients with LEP are not well understood.
This study compares survival between patients with LEP and English proficiency (EP) diagnosed with PDAC.

Purpose of the Study:

To compare survival rates between patients with limited English proficiency (LEP) and English proficiency (EP) diagnosed with pancreatic ductal adenocarcinoma (PDAC).

Main Methods:

Retrospective, propensity-matched cohort study of 739 patients with biopsy-proven PDAC.
Patients classified as LEP or EP based on preferred language.
Survival analysis used to compare outcomes between LEP and EP groups.

Main Results:

LEP was associated with higher odds of death (HR 1.60, 95% CI 1.03-2.47) in matched analyses.
LEP patients had decreased odds of receiving cancer-directed treatment.
LEP patients presented with more advanced stage cancer.

Conclusions:

Limited English proficiency (LEP) predicts worse survival in pancreatic ductal adenocarcinoma (PDAC) patients.
Factors beyond interpreter use, such as health literacy and cultural expectations, may contribute to survival disparities.
Further investigation is warranted to understand and mitigate these disparities.