Non-English Speaking Patients Utilizing Translators Adhere to Screening Colonoscopy Less Frequently than English Speaking Patients

Abstract

Purpose: Colorectal cancer causes significant morbidity and mortality. Screening recommendations have been established. Adherence to screening recommendations in the U.S. is suboptimal. Multiple factors affect individuals' adherence to recommendations. Language barriers can present unique challenges to doctor-patient communication. Translators are often used in the clinical setting to facilitate quality care and improved health maintenance. However, there are no studies which have evaluated the adherence to colorectal cancer screening by non-English speaking patients utilizing translators. This study compared the rate at which English speaking patients and non-English speaking patients who utilized translators complied with screening colonoscopy recommendations. Methods: The medical records of consecutive non-English speaking patients with documented translator-assistance and English speaking patients referred for screening colonoscopy to an urban university gastroenterology practice in a one-year period were reviewed. Patient age, gender, primary language, utilization of translators and adherence to colonoscopy recommendations were obtained. A database was created using Microsoft Excel. Statistical analysis was performed using Fisher's Exact tests with significance set at p<0.05. The study was approved by the IRB. Results: 42 medical records of non-English speaking patients with documented translator assistance referred for screening colonoscopy were reviewed. There were 36 women and 9 men, with a mean age of 63.7 years. The primary languages of non-English speaking patients were Spanish (63.4%) and Anharic 22%. 35 medical records of English speaking patients referred for screening colonoscopy were reviewed. There were 29 women and 12 men, with a mean age of 56.4 years. 27 (65.9%) non-English speaking patients and 36 (87.8%) English-speaking patients underwent recommended screening colonoscopies. There was a statistically significant difference (p<0.03) in the rate at which non-English speaking patients and English-speaking patients underwent colorectal cancer screening. There was no significant difference based upon patient's age, gender or primary language. Conclusion: Colorectal cancer screening is an important component of preventive health care. Studies have revealed that there is suboptimal screening in the U.S. This study reveals that non-English speaking individuals with translators have less adherence to screening colonoscopy recommendations than English-speaking patients. Increased efforts should be made to ensure that non-English speaking individuals with translators understand the instructions for and importance of colorectal cancer screening to ensure compliance with screening colonoscopy.