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

作者：Ioannis Liapis, Alfonsus Adrian Harsono, Jaspinder S. Sanghera, Katie West, Rida Ahmad, Michelle Holland, Larry R. Hearld, Smita Bhatia, Krista R. Mehari, Martin J. Heslin, Daniel I. Chu, Annabelle L. Fonseca · 发表于：Annals of Surgical Oncology · 年份：2025 · DOI：10.1245/s10434-025-17113-2 · 被引用次数：8 · 研究领域：Economic and Financial Impacts of Cancer、Global Cancer Incidence and Screening、Healthcare Policy and Management

BACKGROUND: Many patients with foregut cancer do not receive guideline-concordant treatment (GCT). Although social determinants of health (SDOH) have been associated with differences in receipt of GCT, the underlying mechanisms that perpetuate these disparities remain unknown. This mixed-methods study explored barriers to receipt of care among patients with foregut cancer. METHODS: Patients with foregut cancers treated at a safety-net hospital in the Deep South were purposively selected. The patients completed semi-structured interviews, which were recorded, transcribed, and analyzed. Grounded theory methodology was used to generate themes through open coding, develop a thematic coding structure, and create a codebook. Intercoder agreement was above 90%. Patient sociodemographic and treatment-related variables were abstracted from the patients' medical records to produce simple descriptive statistics. RESULTS: The majority of the 30 participating patients were male (n = 23, 77%), black (n = 18, 60%), and with a median age of 63 years (interquartile range, 55-67 years). Using the socioecologic model, barriers were categorized into individual, interpersonal, organizational, and policy levels. Within the individual level, the barriers were access to primary care providers, personal barriers, competing responsibilities, multifaceted financial barriers, and transportation barriers. The interpersonal barriers involved communication challenges, physician mistrust, and absence of soc...