Language barriers may hinder access to cancer care before patients even encounter a physician, according to a study published in the Journal of the National Comprehensive Cancer Network.

The study showed that Spanish speakers and Mandarin speakers who called US hospitals seeking cancer care were far less likely than English speakers to be informed about how to access care.

For this study, researchers conducted an audit of 144 hospitals, including 56 teaching hospitals and 88 non-teaching hospitals, located across 12 states.

Continue Reading

Using a script, trained researchers were assigned to the roles of English-, Mandarin-, or Spanish-speaking patients. They called hospitals’ general information lines seeking access to care for lung, colon, or thyroid cancer. The 1296 calls made were evenly distributed across languages, regions, and cancer types.

About half (52.9%) of the calls resulted in the callers being given the next steps to access cancer care. Next steps were provided to 93.5% of English-speaking callers, 37.7% of Spanish-speaking callers, and 27.5% of Mandarin-speaking callers (P <.001).

English-speaking callers were told “no” or hung up on 1.6% of the time, compared to 29.6% for Spanish-speaking callers and 41.4% for Mandarin-speaking callers.

In a multivariable analysis, English-speaking callers were more likely to receive information about accessing care than Spanish-speaking callers (odds ratio [OR], 0.04; 95% CI, 0.02-0.06) or Mandarin-speaking callers (OR, 0.02; 95% CI, 0.01-0.04).  

“Our study findings identified significant systems-level barriers that non–English-speaking patients may encounter when attempting to access cancer care, well before they see a physician for treatment of their cancer,” the researchers concluded. “It is essential that we take a critical look at our healthcare system and engage in efforts to mitigate these communication barriers that disproportionately impact the health of vulnerable patient populations with cancer.”


Chen DW, Banerjee M, He X, et al. Hidden disparities: How language influences patients’ access to cancer care. J Natl Compre Canc Netw. Published online September 6, 2023. doi:10.6004/jnccn.2023.7037