Language use and its relationship to patient experience and treatment compliance in genitourinary oncology.

Abstract

e23254 Background: Disparities associated to language in cancer care are well-documented however inadequately defined in genitourinary oncology. This study investigates the impact of language proficiency on patient satisfaction and treatment adherence within a heterogeneous outpatient genitourinary (GU) oncology cohort. Methods: We conducted a cross-sectional survey of 138 patients receiving care at a tertiary GU oncology clinic. Participants were categorized as primary English speakers (n=67) or non-English speakers (n=71). The survey assessed outcomes including patient satisfaction and treatment compliance, defined as consistent adherence to treatment without reported delays due to communication or understanding. Categorical variables were compared using chi-square or Fisher’s exact tests, and continuous variables using Student’s t-test or Wilcoxon rank-sum test. To identify factors independently associated with high satisfaction and treatment compliance, we performed multivariable logistic regression. Predictor variables were selected through forward stepwise modeling if they had a univariable P-value <0.25 and clinical relevance. The Akaike information criterion (AIC) and likelihood ratio tests were used to evaluate the model's performance. Results: Non-English speakers reported lower satisfaction (43.7% vs. 70.1%, P=0.003) and less clarity in treatment discussions (36.6% vs. 70.1%, P<0.001). Perceived oncologist understanding was also lower (42.3% vs. 73.1%, P<0.001). In multivariable analysis, high satisfaction was independently associated with English as a primary language (aOR 3.02, 95% CI 1.48–6.17, P=0.002) and younger age (aOR 0.97 per year, 95% CI 0.94–0.99, P=0.04). Among non-English speakers, high clarity in explanations (aOR 3.33, P=0.025) and earlier cancer stage (aOR 0.24, P=0.049) predicted greater satisfaction. Treatment compliance was reported similarly across groups (67.2% English vs. 63.4% non-English, P=0.31), but 40% of adherent non-English speakers still reported delays due to communication challenges. English proficiency (aOR 3.66, 95% CI 1.67–8.01, P=0.001) and earlier cancer stage (aOR 0.59, P=0.043) were associated with higher compliance. Conclusions: Limited English proficiency is independently associated with lower satisfaction and reduced treatment compliance in GU oncology care. Despite institutional language services, non-English speakers report communication gaps that impact care. These findings support incorporating linguistically tailored strategies to enhance equity in cancer communication and adherence.