STANFORD, CA — While it is well known that veteran populations have higher lung cancer incidence and worse overall survival compared with non-veteran populations, it is not clear how VA lung cancer patients perceive their care.
“Although recent clinical advancements have reduced lung cancer death rates, these advances are not routinely received among veteran populations because of multilevel factors, including veterans’ complex comorbidities, limited health literacy and other economic and social disadvantages,” wrote researchers from Stanford University School of Medicine in Stanford, CA, and the VA Palo Alto, CA, Health Care System.
Their study, published in JCO Oncology Practice, sought to assess veterans’ perspectives regarding their lung cancer care. The researchers zeroed in on identifying modifiable barriers to evidence-based care delivery.1
To do that, the study team conducted 1:1 semi-structured interviews with 24 veterans diagnosed with lung cancer at the VA Palo Alto Health Care System. All interviews were recorded, transcribed and analyzed using the constant comparative method of qualitative analysis.
The authors pointed out that four themes emerged, including:
- Social and economic disadvantages can prevent routine delivery of evidence-based cancer care;
- Fragmented care contributes to worsening patient mental and emotional well-being;
- Lack of health system interventions to address limited health literacy inhibits patient engagement in shared decision-making regarding diagnosis, genomic and molecular testing, targeted and other treatments, and end-of-life care; and
- Deep appreciation for care and VA trustworthiness facilitates adherence to cancer care recommendations.
“This study revealed critical gaps in lung cancer care delivery and the role of institution-engendered trust in overcoming barriers in the VA system,” the researchers wrote. “Targeted solutions should address the identified barriers to routine, evidence-based lung cancer care delivery among veterans.”
- Lopez C, Murillo A, Das M, Patel MI. Understanding Barriers and Facilitators to High-Quality Cancer Care Among Veterans With Lung Cancer: A Qualitative Study. JCO Oncol Pract. 2023 Dec;19(12):1153-1159. doi: 10.1200/OP.23.00228. Epub 2023 Sep 29. PMID: 37774255.
