Cancer causes & control : CCC · 2025
The effect of cultural and linguistic diversity on the timeliness of prostate cancer treatment: a registry-based retrospective cohort study.
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Tamirat Koku Sisay, Leach Michael James, Papa Nathan, Millar Jeremy, Ristevski Eli
Аннотация
PURPOSE: To examine associations between culturally and linguistically diverse (CALD) status and definitive treatment delay among individuals diagnosed with intermediate- or high-risk prostate cancer (PCa) in Victoria, Australia.
METHODS: Data were sourced from the Victorian Prostate Cancer Outcomes Registry (PCOR-Vic). Individuals with index diagnoses of intermediate- or high-risk PCa (February 2009-August 2022) who were receiving PCa-directed definitive treatment (radical prostatectomy or radiotherapy) were included. CALD status was defined as being born in non-English-speaking countries versus mainly English-speaking countries (MESC) or Australia. Additionally, using preferred spoken language, CALD individuals were categorized into English-speaking CALD and non-English-speaking CALD individuals. Binary logistic regression was used to examine associations between CALD status and definitive treatment delay (> 90 days from diagnosis to treatment). Mediation analysis was undertaken using generalized structural equation modeling.
RESULTS: Of 13,625 participants, 2,455 were from CALD backgrounds (18%). Nine per cent of 2,455 CALD individuals preferred speaking languages other than English. Median days to definitive treatment were longer for non-English-speaking CALD (92) compared to Australian-born (64) individuals. Non-English-speaking CALD individuals experienced significantly (adjusted odds ratio = 2.54, 95% confidence interval = 1.92-3.38) greater treatment delay than Australian-born individuals, adjusted for sociodemographic and clinical factors. The association between CALD status and definitive treatment delay was fully mediated by non-English-speaking CALD individuals being diagnosed mostly at public institutions.
CONCLUSION: Non-English-speaking-CALD individuals experienced greater delays in the definitive treatment of intermediate- and high-risk PCa than Australian-born individuals, which is largely explained by the type of diagnosing health institution. More timely treatment for non-English-speaking-CALD will require less delay in public hospitals.
METHODS: Data were sourced from the Victorian Prostate Cancer Outcomes Registry (PCOR-Vic). Individuals with index diagnoses of intermediate- or high-risk PCa (February 2009-August 2022) who were receiving PCa-directed definitive treatment (radical prostatectomy or radiotherapy) were included. CALD status was defined as being born in non-English-speaking countries versus mainly English-speaking countries (MESC) or Australia. Additionally, using preferred spoken language, CALD individuals were categorized into English-speaking CALD and non-English-speaking CALD individuals. Binary logistic regression was used to examine associations between CALD status and definitive treatment delay (> 90 days from diagnosis to treatment). Mediation analysis was undertaken using generalized structural equation modeling.
RESULTS: Of 13,625 participants, 2,455 were from CALD backgrounds (18%). Nine per cent of 2,455 CALD individuals preferred speaking languages other than English. Median days to definitive treatment were longer for non-English-speaking CALD (92) compared to Australian-born (64) individuals. Non-English-speaking CALD individuals experienced significantly (adjusted odds ratio = 2.54, 95% confidence interval = 1.92-3.38) greater treatment delay than Australian-born individuals, adjusted for sociodemographic and clinical factors. The association between CALD status and definitive treatment delay was fully mediated by non-English-speaking CALD individuals being diagnosed mostly at public institutions.
CONCLUSION: Non-English-speaking-CALD individuals experienced greater delays in the definitive treatment of intermediate- and high-risk PCa than Australian-born individuals, which is largely explained by the type of diagnosing health institution. More timely treatment for non-English-speaking-CALD will require less delay in public hospitals.