Introduction: Clinical trial accrual and enrollment are essential to break disparities seen in minority populations affected by cancer. Despite Hispanics (HI) being 18.9% of the US population and the fastest-growing minority in the US, they only represent 4% of the patients enrolled in clinical trials. These disparities are often explained by different social determinants of health, but could also be due to decreased perceived interest by oncologists in their participation simply due to lack of English proficiency. Effective doctor-patient communication is vital in establishing a healthy doctor-patient relationship, and is vital in delivering high-quality health care. In this study, we explore whether physician-patient language concordance affects clinical trial enrollment. Methods: We evaluated 233 patients diagnosed with breast cancer who consented to experimental clinical trials in a private Oncology practice in Houston, Texas, from 2008-2022. All trials had approved consent in English and Spanish. We used logistic regression to model the probability of treatment, while adjusting for the effects of cancer type, gender, race, ethnicity, and language concordance. Results: Of the 233 patients with breast cancer, 191(82%) were enrolled in a clinical trial, and 96% of these patients spoke the same language as their providers. 42 patients were not enrolled, with 95% of patients speaking the same language as their provider. There were 209 (90%) patients who spoke English, 22 (9%) were Spanish speakers and 2 (1%) were Arabic speakers. Of the Spanish speakers, 18 were enrolled, with 13 (72%) having language concordance with their provider. The ethnicity was evaluated, resulting in 72 (31%) patients being Hispanics, 55 (24%) African American, 94 (40%) Caucasian, 7 (3%) Asian, 4 (2%) Middle Eastern and 1 (0.4%) American Indian. It also evaluated the rate of consent withdrawal, showing only 6 (3%) patients. After evaluating the results, it was noted that there was no statistically significant association of physician-patient language concordance with enrollment rate (p=0.776). There was also no significant difference in consent withdrawal (p=0.626), and no change associated with gender (p=0.344) or ethnicity when evaluated (p=0.13). Conclusion: In conclusion, our analysis confirms no significant difference in breast cancer patients’ enrollment in clinical trials if there is language concordance between physician and patient. The efforts of the medical workforce to use translators and translated versions of informed consents, surveys or outcome assessments, when available, seem enough for our patients to agree to continue enrollment. Citation Format: Daniela Urueta Portillo, Ana M. Mendoza Sanchez, Nitzia E. Quilantan, Lisa Maria Mendoza Sanchez, Marcela Mazo Canola, Jonathan Gelfond, Julio A. Peguero. Does physician-patient language concordance increase clinical trial enrollment in breast cancer patients?: A real-life study in a majority-minority population. [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 5522.
Is physician-patient language concordance better for clinical trial enrollment in breast cancer patients. IJCCD.
e18539 Background: Clinical trials are essential for enhancing cancer care. Participation is concerning in racial and ethnic minority groups historically under-represented in research. So, it is crucial to note that, despite Hispanics and African-Americans being 18.9% and 13.6% of the US population, each only represents 4% of the patients enrolled in clinical trials. We address effective doctor-patient communication as a fundamental clinical function in establishing an effective doctor-patient relationship, and is vital in delivering high-quality care. In this study, we question whether physician-patient language concordance affects clinical trial enrollment. Methods: The study evaluated 982 patients diagnosed with cancer who consented to experimental clinical trials in a private practice in Houston, Texas, from 2008-2022. All trials had approved language translations for English and Spanish. We used logistic regression to model the probability of treatment, while adjusting for the effects of cancer type, gender, race, ethnicity, and language (same or different as provider). Results: 982 patients with multiple cancer types (hematological, breast, thoracic/respiratory, genitourinary, gastrointestinal, head and neck and CNS) were included in the study. The most represented tumor types were GI (32%), Breast (24%) and Thoracic (23%). 66% of patients were successfully enrolled in an experimental clinical trial and started treatment, and 95% spoke the same language as their providers. 14% of patients spoke a different language than English, Spanish being the most commonly spoken language other than English spoken by the patient and provider. The study has adequate minority representation (Caucasian 45%, Hispanic 30%, African-American 18% and Asian 5%), and equal gender distribution (52% were female). After evaluating the results, it was found that there was no statistically significant association between physician-patient language and enrollment rates (p = 0.3). It was also found that there was no impact when the assessment was divided by tumor type, gender (p = 0.8) or ethnicity. It also evaluated the rate of consent withdrawal, with only 4% of patients withdrawing consent, showing no statistically significant association with language concordance. Conclusions: In conclusion, our study confirms no significant difference in cancer patients’ enrollment rate in clinical trials if there is language concordance between physician and patient. The efforts of the medical workforce to use translators and translated versions of informed consents, surveys or outcome assessments, when available, seem enough for our patients to collect all the information required to agree to continue enrollment. It is required to further evaluate more variables that impact enrollment in minorities to stop this disparity in cancer care.
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