Cancer Care Differs by Race, Language, and Health Status

Asians, Pacific Islanders, those in worse health less likely to rate care experiences highly
By Beth Gilbert
HealthDay Reporter

WEDNESDAY, Aug. 18 (HealthDay News) -- Patients' ratings and reports of care for lung or colorectal cancers differ significantly by language, health status, and race, with Asian and Pacific Islander patients and those in worse health reporting worse care experiences, according to research published online Aug. 16 in the Journal of Clinical Oncology.

At four to seven months after cancer diagnosis, John Z. Ayanian, M.D., of Harvard Medical School in Boston, and colleagues conducted a telephone survey of 4,093 patients with lung cancer and 3,685 patients with colorectal cancer (or their surrogates) in English, Spanish, or Chinese. Their objective was to assess patients' experiences with three domains of interpersonal care: physician communication, nursing care, and coordination and responsiveness of care.

The investigators found that white, black, and Hispanic patients had similar experiences with interpersonal care but that English-speaking Asian/Pacific Islanders, Chinese-speaking patients, and those in worse health reported significantly worse adjusted experiences with all three domains. However, 44.4 percent of patients with lung cancer and 53.0 percent of patients with colorectal cancer rated the overall quality of cancer care as excellent, with these ratings most strongly correlated with positive experiences with coordination and responsiveness of care. After multivariate adjustment, excellent ratings were less common among patients reporting worse health status, black patients, English-speaking Asian/Pacific Islanders, and Chinese-speaking patients.

"Efforts to improve patients' experiences with cancer care should focus on problems affecting Asian and Pacific Islander patients and those in worse health," the authors write.

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