Evidence map›Paper›PMID 41619346›Full record

ArticleAmerican journal of surgery2026

Examining health system stakeholder-reported barriers and solutions to foregut cancer care.

Jaspinder Sanghera, Ioannis Liapis, Nritya Nair, Michelle Holland, Manish Tripathi, Larry Hearld, Krista Mehari, Smita Bhatia, Annabelle L Fonseca

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in American journal of surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Jaspinder SangheraUniversity of Alabama at Birmingham, Department of Surgery, 1808 7th Avenue South, Boshell Diabetes Building, Birmingham, AL, 35233, USA; University of Alabama at Birmingham, Institute for Cancer Outcomes and Survivorship, Lowder Bldg., Suite 500, 1600 7th Avenue South, Birmingham, AL, 35233, USA.
Ioannis LiapisUniversity of Alabama at Birmingham, Department of Surgery, 1808 7th Avenue South, Boshell Diabetes Building, Birmingham, AL, 35233, USA; University of Alabama at Birmingham, Institute for Cancer Outcomes and Survivorship, Lowder Bldg., Suite 500, 1600 7th Avenue South, Birmingham, AL, 35233, USA.
Nritya NairUniversity of Alabama at Birmingham, Department of Surgery, 1808 7th Avenue South, Boshell Diabetes Building, Birmingham, AL, 35233, USA; University of Alabama at Birmingham, Institute for Cancer Outcomes and Survivorship, Lowder Bldg., Suite 500, 1600 7th Avenue South, Birmingham, AL, 35233, USA.
Michelle HollandUniversity of Alabama at Birmingham, Department of Surgery, 1808 7th Avenue South, Boshell Diabetes Building, Birmingham, AL, 35233, USA; University of Alabama at Birmingham, Institute for Cancer Outcomes and Survivorship, Lowder Bldg., Suite 500, 1600 7th Avenue South, Birmingham, AL, 35233, USA.
Manish TripathiUniversity of Alabama at Birmingham, Institute for Cancer Outcomes and Survivorship, Lowder Bldg., Suite 500, 1600 7th Avenue South, Birmingham, AL, 35233, USA; University of Alabama at Birmingham, Collat School of Business, 710 13th St. South, Birmingham, AL, 35233, USA.
Larry HearldUniversity of Alabama at Birmingham, School of Health Professions, 1716 9th Ave S, Birmingham, AL, 35233, USA.
Krista MehariVanderbilt University, Department of Psychology, 230 Appleton Pl, Nashville, TN, 37203, USA.
Smita BhatiaUniversity of Alabama at Birmingham, Institute for Cancer Outcomes and Survivorship, Lowder Bldg., Suite 500, 1600 7th Avenue South, Birmingham, AL, 35233, USA.
Annabelle L FonsecaUniversity of Alabama at Birmingham, Department of Surgery, 1808 7th Avenue South, Boshell Diabetes Building, Birmingham, AL, 35233, USA; University of Alabama at Birmingham, Institute for Cancer Outcomes and Survivorship, Lowder Bldg., Suite 500, 1600 7th Avenue South, Birmingham, AL, 35233, USA. Electronic address: afonseca@uabmc.edu.

Funding

Using Modifiable Factors to Predict Risk of non-Guideline Concordant Treatment in Foregut Cancers: A Novel Implementation Science-based approachK23MD018383 · NIMHD · UNIVERSITY OF SOUTH ALABAMA · PI Annabelle L Fonseca · 2023 to 2026
$647k
NIMHD NIH HHS K23 MD018383
6 · The paper itself

Abstract

purposeMany patients with foregut cancers fail to receive guideline-concordant treatment. The perspectives of health system stakeholders who care for these patients, and their insights into feasible solutions, remain underexplored.

methodsUsing grounded theory methodology, 12 semi-structured interviews were conducted to identify multilevel barriers, and health system stakeholders proposed solutions to overcome these barriers.

resultsParticipants described barriers across four levels. Individual-level barriers included financial toxicity, transportation challenges, and psychosocial distress. Provider-level barriers included inadequate physician-patient communication and insufficient inter-provider communication. Institutional barriers included delays in accessing specialty care, scheduling inefficiencies, and institutional resource limitations. Policy-level barriers included care fragmentation, inadequate sub-specialty care in rural areas, and inadequate reimbursement. Proposed solutions included strengthening institutional psychiatric support programs, increasing inter-provider engagement, streamlining referral pathways, targeted rural physician recruitment, and reimbursement reform.

conclusionHealth system stakeholders proposed interventions emphasizing communication, navigation, and system-level integration that may improve the delivery of foregut cancer care in resource-constrained environments.

Indexed as

Delivery of Health CareGastrointestinal NeoplasmsHealth Services AccessibilityFemaleGrounded TheoryHumansInterviews as TopicPhysician-Patient Relations

Identifiers

PMID41619346
PMCPMC12882813

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.