Patient-Reported Barriers to Foregut Cancer Care in the Deep South

Area of Science:

• Oncology
• Health Services Research
• Social Determinants of Health

Background:

• Many patients with foregut cancer do not receive guideline-concordant treatment (GCT).
• Social determinants of health (SDOH) are linked to disparities in GCT receipt, but underlying mechanisms are unclear.
• This study explored barriers to care for patients with foregut cancer.

Purpose of the Study:

• To identify and categorize barriers to receiving guideline-concordant treatment (GCT) for foregut cancer patients.
• To understand the multilevel factors (individual, interpersonal, organizational, policy) contributing to treatment disparities.
• To inform the development of interventions aimed at increasing GCT delivery.

Main Methods:

• Mixed-methods study involving 30 foregut cancer patients at a safety-net hospital.
• Semi-structured interviews analyzed using grounded theory methodology.
• Sociodemographic and treatment data abstracted from medical records.

Main Results:

• Barriers were categorized across individual, interpersonal, organizational, and policy levels.
• Individual barriers included access to primary care, financial constraints, and transportation.
• Interpersonal barriers involved communication issues and mistrust; organizational barriers included health system mistrust and lack of insurance; policy barriers concerned healthcare access and insurance policies.

Conclusions:

• Foregut cancer patients encounter multiple barriers to accessing and adhering to recommended treatments.
• Understanding these multifaceted barriers is essential for designing effective programs to improve GCT delivery.
• Addressing systemic and individual-level barriers can help reduce disparities in cancer care.