Limited English proficiency and head and neck cancer outcomes

• Published in: American journal of otolaryngology Vol. 43; no. 3; p. 103470
• Main Authors: Duraiswamy, Swetha, Rubin, Samuel J., Kim, Yeahan, Mur, Taha, Edwards, Heather A.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.05.2022; Elsevier Limited
• Subjects: Adult; Alcohol use; Cancer; cancer outcomes; Cancer therapies; Demographic variables; Demographics; Demography; Drug use; Head & neck cancer; Head and neck cancer; Head and neck carcinoma; Head and Neck Neoplasms - diagnosis; Head and Neck Neoplasms - therapy; Health care access; Health care policy; Health insurance; Health services; Hispanic people; Hospitals; Humans; Language; Larynx; Limited English Proficiency; Medical prognosis; Multivariate analysis; Patients; Retrospective Studies; Squamous cell carcinoma; Statistical analysis; Surgery; Survival; Survival analysis; Tumors; United States > US; Limited English proficiency; cancer outcomes; Head and neck cancer
• DOI: 10.1016/j.amjoto.2022.103470
• ISSN: 0196-0709

Limited English proficiency (LEP) is common among hospitalized patients and may impact clinical care and outcomes. This study aimed to examine the relationship between LEP and clinical oncological outcomes for patients with head and neck cancer (HNC). A single center retrospective review was conducted including adult patients with squamous cell carcinoma of the head and neck who received treatment with curative intent between January 1, 2014 and July 1, 2019. Clinical data collected included patient demographics and clinical variables. Univariate and multivariate analysis was performed to determine whether there was an association between LEP and demographic and clinical factors. There were 477 patients included in the study; 426 (81%) were English proficient (EP) while 51 (10.7%) were LEP. The LEP patients were diagnosed with cancer at a later overall stage (p = 0.03) and less frequently treated with surgery alone compared to English speaking patients (p < 0.001). After adjusting for overall stage and primary site, LEP patients were significantly more likely to receive primary surgical management compared to primary non-surgical management [OR = 2.29 95% CI (0.93, 5.58), p = 0.008]. There was also a significant association between LEP and primary site of tumor (p < 0.01). Kaplan-Meyer curves for overall survival and disease specific survival showed no significant differences between the two cohorts (p = 0.8063 and p = 0.4986, respectively). LEP may impact access to care resulting in more advanced overall tumor stage at presentation and treatment with primary surgery compared to non-surgical management after adjusting for tumor stage and primary site. Interventions to provide better access to care, awareness of HNC in the LEP populations, and earlier detection may improve outcomes for LEP patients.