People with limited English are significantly more likely to understand the true aim of cancer treatment when given a bilingual consent form, with understanding rising from 35% to 60%, a new study finds.
The study, published in Supportive Care in Cancer, examined how different translation approaches affect understanding of cancer treatments among Bengali- and Sylheti-speaking adults in the UK with limited English proficiency.
Specifically, 60% of participants correctly understood that treatment of myeloma, a type of blood cancer, was not curative when given a bilingual consent form, compared with 34.8% of those given an English-only form.
More than one million people in the UK report limited English proficiency, and patients facing language barriers experience poorer cancer outcomes. Communication difficulties in healthcare can delay diagnosis, increase distress and lead to the misunderstanding of life-changing treatment decisions.
To assess whether translated materials improve patient comprehension, researchers asked almost 100 Bengaliand Sylheti-speaking adults with limited English to imagine supporting a friend or family member with a new diagnosis of myeloma.
Treatments for myeloma can extend lifespan and improve quality of life, but they do not cure the disease. Ensuring patients understand this distinction is central to informed consent.
Participants were first given a Bengali translation of a myeloma information booklet produced by Myeloma UK. After reading the booklet alone, only 15% correctly understood that treatment could prolong life but not cure the cancer.
One to two weeks later, participants attended a simulated consultation with a doctor and professional interpreter and were given either an English-only or bilingual consent form to guide the discussion. Understanding increased substantially in the bilingual group, who were also more confident about responding to questions from family members.
Co-author Professor Federico M. Federici (UCL School of European Languages, Culture and Society) said: "Our findings show that providing bilingual consent forms that patients can read in their own language, combined with a facilitated consultation and access to translated resources, is the most effective way to support people with limited English through complex cancer treatment decisions.
"This is a simple, practical step that can significantly improve understanding, confidence, and equity in cancer care".
Lead author Dr Stephen Hibbs (Queen Mary University of London) said: "Reliable, high-quality translations of cancer consent forms can significantly improve communication with people who do not speak English fluently.
"This is a crucial step, but further research is needed to confirm the impact in real-world clinical settings."
The study also compared a professionally translated myeloma information booklet with a version translated using Google Translate. The machine-translated version contained 11 meaning-changing errors, and overall comprehension remained low when written materials were provided without a bilingual consent form and supported consultation.
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Read Translation approaches to support systemic anti-cancer therapy consent for individuals with limited English proficiency
Sophie Hunter
E: sophie.hunter@ucl.ac.uk
