How do health concerns present in cancer survivors who require interpreters? Database analysis of a structured survivorship clinic for early-stage cancer.

Abstract

1632 Background: Cancer survivors (CS) of Culturally and Linguistically Diverse (CALD) backgrounds face disparities in care. We aimed to compare demographics and health concerns of CALD CS with non-CALD CS following completion of primary treatment. Methods: The Sydney Cancer Survivorship Centre (SCSC) database was analyzed to compare baseline differences in demographics and health concerns between early-stage CS of solid tumor or hematologic cancers requiring interpreters (CALD CS) during initial consultations to those who did not (non-CALD CS). Descriptive statistics were used to illustrate distribution by age, gender and tumour type. Survivors completed questionnaires on symptoms, quality of life (QoL), distress, exercise time and were assessed by a psychologist for fear of cancer recurrence (FCR). Univariate analyses were used to determine differences at presentation to the survivorship clinic between CALD and non-CALD groups. Results: From September 2013 to April 2024, 939 initial consultations (median 10.9 months from diagnosis) with consenting CS were conducted at SCSC. 15% (n = 137) required interpreters in 21 different languages (Mandarin (n = 48, 35%), Korean (n = 26, 19%) and Cantonese (n = 19, 14%)): 83 (61%) used professional interpreters, 25 (18%) family/friends. CALD CS were more likely to be female (58%), aged 40-64 (51%) and have colorectal cancer (55%). Common symptoms in CALD CS of at least moderate severity included fatigue (39%), numbness (32%), and pain (31%), not significantly different to non-CALD CS. Significantly lower proportions of CALD CS reported trouble concentrating (19 vs 29%, p = 0.023), hot flashes (14 vs 23%, p = 0.017) and problems with sexual function (12 vs 20%, p = 0.032). CALD CS were significantly more likely than non-CALD CS to report less minutes/week doing vigorous (13.2 vs 32.8; p < 0.001), moderate (32.3 vs 73.0; p < 0.001) and resistance exercise (4.6 vs 18.7; p < 0.001), but more light exercise (219.6 vs 115.5; p = 0.041). Mean global FACT-G QoL score for CALD CS was 77.4 (SD 20), with physical (mean 21.4, SD 6) and emotional (mean 17.6, SD 5) domains most impacted; these were not significantly different from non-CALD CS scores. There were no significant differences between groups in mean distress thermometer scores (3.09 vs 3.39/10; p = 0.288), rates of moderate-to-severe distress (36 vs 41%; p = 0.952) or rates of psychologist-assessed moderate-to-severe FCR (19 vs 28%; p = 0.228). Conclusions: CALD CS experience similar physical and psychosocial health concerns to non-CALD CS at initial survivorship clinic consultations but are less likely to report issues with sexual function, concentration and hot flashes, and are more likely to exercise less. Future work should focus on longitudinal effects and comparisons over time, with particular focus on addressing cultural sensitivities and increasing exercise intensity.