Persistent Barriers in Gastric Cancer Care: GI Cancers Alliance Study
In 2024, approximately 26 890 individuals in the US will be diagnosed with gastric cancer, according to the National Cancer Institute. Of these, an estimated 10 880 will die from the disease. With a 5-year relative survival rate of just 36%, understanding the lived experiences of patients is crucial for improving outcomes. In response to this need, the GI Cancers Alliance conducted a year-long patient-reported outcomes (PRO) initiative aimed at amplifying the voices of gastric cancer patients, particularly those from underserved communities.
From September 2023 to August 2024, the Alliance engaged 651 patients with gastric cancer and survivors through online surveys, focus groups, and personalized interviews. Notably, 89% of participants requested follow-up conversations, demonstrating a high level of engagement and a strong desire to share their stories.
The study focused intentionally on populations that often experience systemic barriers to quality care, including rural and urban underserved communities, diverse ethnic groups, and patients receiving treatment in federally funded and charity care centers. This diverse sampling provided critical insights into the intersection of clinical care, education, and socioeconomic challenges.
A central takeaway for oncology professionals is the striking lack of biomarker education and access. Nearly 70% of participants reported that their clinicians did not suggest biomarker testing or explain its significance in treatment planning. This omission can limit access to precision therapies and leave patients without critical tools to make informed decisions.
Additionally, 68% of patients voiced concern about insufficient knowledge to navigate treatment options effectively. These findings point to an urgent need for standardized patient education protocols, particularly in community-based settings where specialist resources may be limited.
The research also brought to light significant psychosocial burdens. Approximately 64% of respondents reported mental health concerns, including severe depression, anxiety, and feelings of hopelessness. Financial toxicity was another prevailing issue; 63% struggled to afford nutritious food compatible with post-surgical dietary restrictions—an often overlooked but vital component of recovery and long-term care.
Demographic insights underscored the persistent racial and ethnic disparities in care. Participants self-identified as 24% Black, 22% Hispanic, 21% Multiracial, 19% Non-Hispanic White, 7% Asian/Pacific Islander, and 2% Native American. These figures, coupled with the reported care gaps, reflect systemic inequities that demand targeted intervention.
For oncologists and clinical pathway stakeholders, this report is a call to prioritize culturally responsive communication, equitable biomarker testing access, and mental health integration across care models. Oncology payers should consider supporting expanded coverage for patient navigation, biomarker testing, and psychosocial support services.
The GI Cancers Alliance plans to continue collaborating with over 100 advocacy partner organizations to act on these findings.
Reference
Raymond M, Simonetta M. Gastric cancer patient insights: patient-reported outcomes and real-world perspectives from the gastric cancer patient community. Presented at: 2025 ASCO Gastrointestinal Cancers Symposium; January 23-24, 2024; San Francisco, CA, and virtual; Abstract 362.
