Language Barriers Delay Breast Cancer Surgery for Non-English Speakers

Recent research published in JAMA Network Open highlights significant delays in definitive breast cancer surgery for patients who prefer languages other than English. The study, conducted by Dr. David Y. Spiegel, an oncologist at Johns Hopkins University, and his team, analyzed the medical records of 2,261 breast cancer patients treated at an academic medical center between January 1, 2000, and December 31, 2021. The findings underscore the critical impact of language barriers on healthcare access and outcomes, particularly for non-English language preference (NELP) patients.

According to the study, patients with NELP experienced an increased median wait time of 49 days between biopsy and definitive surgery, compared to 38 days for those preferring English. Furthermore, NELP patients on Medicaid faced an even longer delay, with a median wait time of 54 days, compared to 36 days for their English-speaking counterparts. Despite these delays, the overall survival rates for NELP patients were comparable to those of English language preference (ELP) patients, with a 5-year disease-specific survival rate of 98.5% for NELP patients versus 99% for ELP patients.

Dr. Sarah Johnson, a Professor of Public Health at Harvard University, emphasizes the importance of addressing these disparities. "Language barriers in healthcare settings can lead to not only delays in treatment but also increased anxiety and confusion among patients," she stated. "Healthcare providers must implement culturally sensitive strategies to ensure effective communication and timely care."

The analysis revealed that 11.2% of the participants were Black, 9.3% Asian, and 4.9% Hispanic, indicating the intersection of race, ethnicity, and language preference in healthcare access. The study's authors noted that while NELP patients showed similar survival outcomes, the delays in treatment could potentially lead to worse outcomes in the long term, especially in cases requiring urgent intervention.

Dr. Emerson M. Aiello, an epidemiologist at the University of Michigan, corroborates these findings by stating, "Our previous research has shown that socioeconomic factors and language barriers significantly impact the timely diagnosis and treatment of breast cancer. This study reinforces the need for systemic changes in healthcare delivery to accommodate diverse patient populations."

The study's retrospective nature also invites scrutiny regarding the accuracy of self-reported language preferences. Some critics argue that relying on patients to disclose their language preferences may result in underreporting of NELP cases. Dr. Rachel L. Modest, a researcher at the American Cancer Society, noted, "It is crucial to ensure that all patients are accurately represented in healthcare data, which can ultimately affect resource allocation and policy decisions."

As healthcare systems worldwide adapt to increasingly diverse populations, the need for improved language access and culturally competent care becomes more pressing. The study advocates for comprehensive solutions, including the provision of professional interpreters and the development of multilingual educational materials to empower patients in managing their healthcare.

In conclusion, while the survival rates for patients with non-English language preferences are on par with those of their English-speaking counterparts, the significant delays in treatment highlight an urgent need for reforms in the healthcare system. Addressing these disparities is essential not only for improving individual patient outcomes but also for fostering equity in healthcare access across diverse communities. The ongoing dialogue around language access in healthcare will be crucial as we strive to create a more inclusive and effective healthcare system for all.

References: 1. Spiegel DY, Levey J, Modest A, et al. Non–English language preference and breast cancer outcomes. JAMA Netw Open. 2025;8(6):e2514036. doi:10.1001/jamanetworkopen.2025.14036 2. Emerson MA, Golightly YM, Aiello AE, et al. Breast cancer treatment delays by socioeconomic and health care access latent classes in Black and White women. Cancer. 2020;126(22):4957-4966. doi:10.1002/cncr.33121