Through the lens of oncologists when communicating with non-Western migrants about cancer diagnosis, treatment, and prognosis: Results from a Dutch online survey

Abstract

Objectives

With rising cancer incidence rates and a growing migrant population in Europe, understanding oncologists’ challenges in communication and providing cancer care to patients with a non-Western migration (NWM) background is crucial. This study aimed to explore the perspectives and experiences of oncologists, including those in training, as they interact with such patients about their cancer diagnosis, stage, treatment, and prognosis.

Methods

Between June and September 2023, an online survey was conducted among medical oncologists and trainees (MO) and pulmonologists and trainees (PO) from university medical centers or regional hospitals in the Netherlands. The survey, hosted on LimeSurvey, included descriptive statistics, Chi-Square tests to compare the responses of MO and PO, and thematic qualitative analysis of responses to open questions.

Results

The survey included 112 oncologists, including trainees. The majority directly disclosed a cancer diagnosis to patients, often using family members as interpreters because of language barriers. When families opposed direct disclosure, most oncologists explored the patients’ preferences. More than half of MO and PO were satisfied with their communication, with PO reporting higher levels of helplessness and discontent. Challenges included managing family expectations and addressing cultural differences. Qualitative analysis of open responses revealed six themes in decreasing frequency: person-centered care, cultural competence and ethics, education and research, third parties, communication, and palliative care. Nearly 80 percent of oncologists want more research to develop practical tools to optimize communication.

Conclusion

Oncologists (in training) adhere to Western care practices when communicating with patients with an NWM background, which can lead to challenges because of different expectations and cultural beliefs. Oncologists express a need for tools to optimize communication with patients with an NWM background.

Practice implications

The implementation of education and training programs can support oncologists in their daily work and promote culturally sensitive healthcare delivery in oncology.