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FACILITATORS TO ONCOLOGICAL CARE IN FOREGUT CANCER. A QUALITATIVE STUDY EXPLORING PATIENT PERSPECTIVES.
Jaspinder S. Sanghera^*1, Michelle Holland¹, Ioannis Liapis¹, Alfonsus Adrian H. Harsono¹, Katie West², Larry Hearld¹, Smita Bhatia¹, Krista Mehari³, Martin Heslin¹, Annabelle L. Fonseca^1
1The University of Alabama at Birmingham, Birmingham, AL; ²University of South Alabama, Mobile, AL; ³Vanderbilt University, Nashville, TN

Introduction
Foregut cancer has a rising global health burden, accounting for over 100,000 deaths in the US alone. The care required is complex and increasingly provided at tertiary, high-volume facilities by a specialized multidisciplinary team. Patient perspectives on facilitators that increase access and adherence to oncological care remain underexplored. This qualitative study investigates patient-reported facilitators at a tertiary institution in the Deep South, with the aim to inform strategies to improve patient-focused oncological care.
Methods
Participants who underwent treatment for foregut cancer at a safety-net and tertiary care facility in the Southeastern U.S. were recruited to participate. A semi-structured interview guide was developed, and interviews were carried out by trained interviewers. Interviews were recorded, transcribed, and analysed using NVivo 14 software. A grounded theory approach was used to generate themes through open coding and then to develop a thematic coding structure and create a codebook. Interrater reliability was >90% for all themes.
Results
A total of 30 patients participated in interviews, including 23 male (77%) and 7 female (23%) patients, with an average age of 63 (range 39-82). The majority of patients were Black (60%). Facilitator themes were clustered in four categories: (1) Individual/Interpersonal; (2) Provider/Care Team; (3) Healthcare systems, and (4) Broader Policy. Themes and representative quotes are summarized in Table 1. Prominent facilitators identified included support from immediate family and friends (83%), patients’ spiritual beliefs (87%), trust in the care team (97%) and effective provider communication (97%).
Conclusion
Understanding patient perspectives is critical for delivering high-quality care in foregut cancer. These facilitators should be actively promoted when developing future interventions. An appreciation of patient beliefs, communication training for the care team, hiring sufficient ancillary staff, use of written handouts, investment in financial aid services and wider healthcare reform are all avenues to explore to improve comprehensive oncological care for patients.


Table 1 summarizes all themes and their representative quotes

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