Is Language a Barrier for Timely Oral Pathology Treatment?

Abstract

ObjectiveNearly 20% of the U.S. population speaks a language other than English at home, and 8% of the population considers themselves to have limited English proficiency. According to previous studies, language proficiency may have a greater impact on healthcare access than race, ethnicity, or socioeconomic status. In cancer care specifically, access to timely and definitive care is paramount. Investigations into whether English proficiency delays treatment time in oral surgery has for the most part not been studied. Hence, the purpose of this study is to evaluate the effect of limited English proficiency on treatment duration of oral pathology patients treated with curative surgery. Subjects and methodsThis is a retrospective analysis consisting of 257 patients who presented for initial evaluation and treatment of head and neck pathology at an academic medical center from 2015 to 2019. Both benign and malignant pathology were included. The primary endpoint was time from initial consultation to time of definitive surgery. Statistical analysis included descriptive and bivariate analysis. ResultsAmong the 257 patients in this study, 36 self-reported having limited English proficiency (LEP) (14.0%). LEP patients, compared to non-LEP patients, had a higher mean time from consultation to surgery (73.8 versus 49.3 days, P = .027). LEP patients were less likely to present to the consultation visit with a biopsy result (36.1% versus 67.4%, P < .001). There were no significant differences between LEP and non-LEP patients in regards to time from referral to consultation visit, nor was there a significant difference in the percentage of malignant diagnoses.When the patient sample was further divided by malignant and benign pathology, LEP patients with malignant pathology, when compared to non-LEP patients, showed no significant difference in time from consultation visit to surgery (50.3 versus 40.3 days, P = .130). However, LEP patients with benign pathology had an increased time from consultation visit to surgery (84.6 versus 59.6 days, P = .027). ConclusionProlonged treatment time was observed in LEP patients with benign pathology. However, it was not observed in LEP patients with malignant pathology. Potential health disparities as a result of limited English proficiency require further investigation. Practice implicationsLanguage-specific patient education and patient navigation services should be considered in head and neck pathology patients receiving complex, often multidisciplinary care.