Differences in Cancer Patient Experience by Race, Ethnicity, and Preferred Language: A Systematic Review

Patient experience ratings are tied to high quality patient-centered care and value-based health system metrics. Existing research has identified disparities in cancer care access and clinical outcomes. This systematic review summarizes findings on how the cancer patient experience differs by race, ethnicity, and preferred language.

Using PRISMA guidelines, we searched PubMed, EMBASE, PsycINFO, CINAHL, and Cochrane CENTRAL through August 2023. Studies were included if the population consisted of White and racial and/or ethnic underrepresented patients who were receiving or had received cancer care; a comparison was made across racial, ethnic, and/or preferred language groups; and outcomes included patient experience ratings or related measures. Studies were excluded if they lacked cancer-specific populations, relative comparisons, or outcomes related to patient experience. Study quality was assessed using Joanna Briggs Institute critical appraisal tools, and data were independently extracted by two authors.

Thirty-six studies (n = 292,345 cancer patients) met inclusion criteria. Twenty-three studies demonstrated worse experiential outcomes among racial and ethnic minority groups compared to non-Hispanic White patients. Among studies including language in their analysis, nine studies indicated cancer patients with a non-English language preference tended to report worse experiences compared to those who prefer to communicate in English.

Cancer patients belonging to racial, ethnic, or preferred language minority groups are more likely to report worse care experiences than non-Hispanic White patients. Significant variation exists in how patient experience is defined and measured. These disparities must be addressed to optimize clinical outcomes and ensure equity in health system value-based metrics.

PROSPERO: CRD42018102189.