Disparities Associated with Decision to Undergo Oncologic Surgery: A Prospective Mixed-Methods Analysis

  • 0University of Cincinnati Cancer Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA. vanharrm@ucmail.uc.edu.

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Summary

This summary is machine-generated.

Underrepresented minority patients with surgical cancer face care disparities. Poor patient-physician relationships and minority status were linked to declining recommended surgery, highlighting the need for improved interventions.

Area Of Science

  • Surgical Oncology
  • Health Disparities Research
  • Patient-Physician Relationship Studies

Background

  • Underrepresented minority patients with surgical malignancies experience significant outcome disparities.
  • Provider-based factors like communication, trust, and cultural competency are not fully understood in relation to patient outcomes.
  • This study investigates modifiable provider-based barriers impacting care for patients with surgical malignancies.

Purpose Of The Study

  • To examine provider-based barriers to care for patients with surgical malignancies.
  • To identify factors influencing the decision-making process for cancer surgery among diverse patient populations.
  • To understand the impact of patient-physician relationships on treatment adherence.

Main Methods

  • A prospective, mixed-methods study enrolled patients with lung or gastrointestinal malignancies undergoing surgical consultation.
  • Surveys assessed social needs and patient-physician relationships; semi-structured interviews explored patient experiences.
  • Iterative qualitative analysis identified key themes related to surgical decision-making.

Main Results

  • The cohort (n=24) included 38% Black/African American patients; common cancers were lung (75%) and gastroesophageal (13%).
  • Social needs like food insecurity (21%) and transportation issues (17%) were prevalent. Poor patient-physician relationships (13%), lack of trust (13%), empathy (13%), and cultural competence (13%) were reported.
  • Five patients (21%) declined surgery; they were more likely to be Black, lower income, and report poor patient-physician relationships (all p < 0.05).

Conclusions

  • Underrepresented minority race and poor patient-physician relationships are associated with declining recommended cancer surgery.
  • Addressing modifiable provider-based factors is crucial to improve care access and reduce racial disparities in surgical oncology.
  • Interventions targeting communication, trust, and cultural competency are needed to overcome these barriers.