Primary language and its association with patient-reported treatment adherence and satisfaction in genitourinary oncology.

BACKGROUND: Language-related disparities in cancer care are well documented but remain underexplored in genitourinary (GU) oncology. This study examined the association between primary language and patient-reported satisfaction, communication, and treatment adherence in an outpatient GU oncology cohort. METHODS: We conducted a cross-sectional survey of 138 patients receiving care at a tertiary GU clinic. Participants were grouped according to their self-reported primary language: English (n = 67) or a language other than English (n = 71). English proficiency was measured separately using a four-category scale. The survey assessed patient satisfaction, communication experiences, self-reported treatment adherence, and communication-related treatment delays. 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. A clinically specified multivariable logistic regression model was used to evaluate factors associated with high satisfaction. The model included primary language, age, clarity of treatment explanations, perceived oncologist understanding, and cancer stage. RESULTS: Participants whose primary language was not English 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 the clinically specified multivariable model, English as a primary language (adjusted odds ratio [aOR] 3.90, 95% confidence interval [CI] 1.68-9.04, P = 0.002) and younger age (aOR 0.95 per year, 95% CI 0.91-0.99, P = 0.007) were associated with high satisfaction. No statistically significant difference in self-reported treatment adherence was detected between the primary-language groups (67.2%vs. 63.4%, P = 0.31). Communication-related treatment delays were reported by 19.4% of participants whose primary language was English and 32.4% of those whose primary language was not English (P = 0.08). CONCLUSIONS: Having a primary language other than English was associated with lower patient satisfaction and less favourable communication experiences. No statistically significant difference in self-reported treatment adherence was detected between the primary-language groups. Communication-related treatment delays were numerically more common among participants whose primary language was not English, although the difference was not statistically significant. These findings support further evaluation of language-support approaches that address treatment explanations and written information in addition to interpreter availability.