EP796 - Understanding Delays In Definitive Treatment For Rectal Cancer

Purpose/Background: Standard of care for definitive treatment of rectal cancer is within 60 days of diagnosis, which has been shown to improve outcomes. Delays in care occur because of multiple reasons, from systemic issues to social determinants of health. In a retrospective review of rectal cancer patients at a tertiary center, female sex (OR 1.74 [95 % CI 1.05-2.91], p = 0.03) and distance greater than 60 miles (OR 2.49 [95 % CI 1.09-5.85], p = 0.03) were associated with significant delays in care. This study seeks to further understand contributory factors to delays in treatment and care coordination of rectal cancer patients that experienced these delays.

Methods/Interventions: Semi-structured interviews were conducted with adult patients with a prior or current diagnosis of rectal cancer at a tertiary cancer institution starting in August 2025. Interviews were conducted via telephone call, audio-recorded and digitally transcribed. Transcriptions were coded and thematic analysis was conducted to understand delays in rectal cancer care.

Results/Outcomes: 24 participants were interviewed. An equal number of females and males living greater or less than 60 miles from a National Cancer Institute-designated center were interviewed. Most patients were aged 50-70 years old. Through qualitative analysis, four main themes emerged: (1) patient perception of disease, (2) provider communication, (3) social determinants of health, and (4) fragmentation of care. Many patients highlighted a lack of literacy regarding rectal cancer and its signs and symptoms, leading to delays in seeking initial diagnosis. Additionally, participants expressed satisfaction with the timeliness of their management and outcome, even if they were identified as having delays to definitive treatment. Participants recognized coordination of care, including transitioning care to a facility more convenient in location, as essential to facilitating care and patient satisfaction.

Conclusion/Discussion: Increased level of awareness and literacy for rectal cancer and its presentation in the general population is vital to early diagnosis and treatment. Comfort and connection with providers enhance patient willingness to actively participate in care. Transitioning care to a more convenient method, such as tele-health or facilities closer to patient homes, encourages decreased fragmentation and delays in care.