Language, Culture, and Cancer: Qualitative Insights Into Communication Disparities Among Spanish-Speaking Caregivers of Children With Cancer.

BACKGROUND

Latino children are projected to make up nearly one-third of United States (US) children by 2060, and many of their caregivers speak Spanish. Prior survey research has documented communication difficulties for Spanish-speaking caregivers of children with cancer, but contemporary qualitative data are limited. We sought to understand the communication experiences of Spanish-speaking caregivers during a new childhood cancer diagnosis and elicit recommendations for improving family-centered diagnostic communication.

METHODS

We conducted semi-structured qualitative interviews in Spanish with adult Spanish-speaking caregivers present during the initial oncology diagnosis conversation for a child diagnosed within the prior 10 years. Participants were recruited from two US pediatric centers using purposeful sampling. Bilingual interviewers conducted interviews from July 2024 to May 2025. Transcripts were analyzed using inductive qualitative content analysis by two independent bilingual coders, with iterative codebook development and constant comparison until thematic saturation.

RESULTS

Eleven mothers participated, all born outside the US; most children had hematologic malignancies. Five themes were identified as follows: (1) interpreter access and quality impacted understanding; (2) strong emotional responses to diagnosis, sometimes framed by cultural beliefs; (3) difficulty voicing concerns due to language differences; (4) experiencing connection when clinicians took time to communicate the diagnosis; and (5) recommendations, including more bilingual clinicians, in-person professional interpreters, plain-language explanations, and cultural humility training.

CONCLUSIONS

Meaningful communication with Spanish-speaking families at diagnosis requires systems-level investment in qualified interpreters and bilingual clinicians, clinician behaviors that invite questions and validate emotion, and culturally responsive care.