Racial and ethnic differences in patient-reported provider communication among patients with cancer.

12102 Background: Patient-provider communication is essential for improving patient experience and understanding. Given significant care coordination in cancer treatment, effective communication is crucial to ensure timely care, optimal patient outcomes, and shared decision making. Improved patient-provider communication also provides opportunities to promote equitable cancer care. We used national survey data to assess racial/ethnic differences in perceptions of provider communication among patients with cancer. Methods: 2011-2021 biannual data from the US Medical Expenditure Panel Survey was used to select cancer survivors aged ≥18. Primary outcomes included how often patients reported their providers (1) treated them with respect, (2) listened carefully, (3) explained things in a way they understood, and (4) spent enough time. Survey-adjusted percentages with chi-square tests characterized differences in patient-reported communication by racial/ethnic group. Multivariable ordinal logistic regression (MVA) models adjusting for survey year, insurance status, income level, geography, sex, and age generated adjusted odds ratios (aORs) with 95% CI to examine associations of race/ethnicity and provider communication. Results: 5,085 patients representing 10,950,670 survivors met inclusion criteria. American Indian (AI) survivors reported the lowest rates of effective provider communication across all four domains (55%: always listened, 42%: always spent enough time, 58%: always showed respect, and 50%: always explained; p<.001), while non-Hispanic Black (NHB) patients reported the highest rates of effective communication in listening (72%), explaining (70%), respect (74%), and spending enough time (63%; p<.001). On MVA, NHB, non-Hispanic Asian (NHA), and Hispanic (HSP) patients were more likely to report feeling listened to (NHB: OR 1.54 95% CI 1.19-1.98; NHA: OR 1.87 95% CI 1.14-3.05; HSP: OR 1.39 95% CI 1.06-1.83) when compared to non-Hispanic White (NHW) patients. NHB and HSP patients reported feeling more respected (NHB: OR 1.40 95% CI 1.109-1.81; HSP: OR 1.39 95% CI 1.04-1.86) when compared to NHW patients. NHB patients were more likely to report that doctors explained well (OR: 1.31 95% CI 1.02-1.67). Conclusions: This national analysis finds that cancer survivors from historically (and presently) marginalized groups – including Black, Asian, and Hispanic patients - were more likely to perceive effective provider communication when compared to non-Hispanic White patients. Considering known disparities in cancer care access and outcomes, these results may reflect differing patient expectations of effective provider communication or the positive results of concerted efforts to improve provider communication to marginalized groups. Univariate analysis also revealed less effective communication for AI patients, suggesting potential unmet needs.