Abstract C070: Equity and barriers to care in head and neck cancer treatment: A qualitative study

Abstract

Identify and describe patient experiences related to equity, discrimination, and structural vulnerability during cancer care. In this qualitative study, semi-structured interviews were recorded in-person between November 2024 and March 2025 using a 9-question guide. Recordings were then transcribed verbatim by Ubiquis, LLC, verified by study staff, and de-identified. Four independent coders trained in qualitative methods coded the transcripts using Dedoose. Thematic analysis was conducted. A retrospective chart review was performed for descriptive quantitative data. A total of 16 Black HNC survivors were recruited from one HNC clinic and participated in this study. Four main themes emerged as influential in participants’ experience of HNC care and included Interpersonal Equity in Oncology Care, Institutional Context and Experience of Respectful Care, Structural Vulnerability Shaping Pathways to Diagnosis and Care, and Collective Agency and Social Support as Protective Mechanisms. Majority of responses described equitable and patient-centered experiences during cancer treatment. Participants emphasized strong trust in clinicians, clear communication, and appreciation for relational continuity with their clinicians. Institutional features, including multidisciplinary care teams, structured care pathways, and continuity across treatment phases, were perceived to support consistent and respectful care. Participants also emphasized the importance of familial support and faith-based coping, with social support serving as a key mechanism for navigating barriers to care. Barriers to timely diagnosis and access to care prior to entering tertiary care were commonly reported, with participants describing delays related to misdiagnosis, referral-dependent specialty access, geographic distance from care, and insurance-related challenges. Patients with HNC perceived high levels of interpersonal equity within a tertiary academic medical center despite experiencing structural barriers to care access. These findings suggest that improving equity in HNC outcomes requires interventions that extend beyond the individual level of the clinical encounter to address upstream social determinants that pose barriers to access to care. Micaela L. Shields, Brooke C. Fowler, Anne C. Kane, Hudson D. Tate, Abigail Gamble, Rolanda J. Buck. Equity and barriers to care in head and neck cancer treatment: A qualitative study [abstract]. In: Proceedings of the 19th AACR Conference on the Science of Cancer Health Disparities; 2026 Oct 18-21; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2026;35(10 Suppl):Abstract nr C070.