Abstract A004: Lived experiences and systemic barriers in lung cancer surgery: Perspectives from caregivers, clinicians, and administrators on social determinants of health

Abstract Background: Social Determinants of Health (SDoH) significantly influence outcomes across the cancer care continuum. However, systematic identification and integration of social risk factors into care remain limited. Understanding the perspectives of key stakeholders is essential to inform effective SDoH integration in lung cancer surgery. Methods: This qualitative study was embedded within a larger investigation of family caregivers (FCGs) and patients undergoing lung cancer surgery at a National Cancer Institute-designated center in Southern California. Semi-structured interviews were conducted with FCGs, healthcare providers, and system/healthcare administrators to explore their views on SDoH and its role in cancer care. Data were analyzed using conventional content analysis. Themes were developed through a collaborative coding and review process, supported by existing literature and expert input to ensure accurate interpretation. Any differences in coding were resolved through discussion, and descriptive statistics were used to summarize caregiver demographics. Results: FCG participants (n=13) were primarily non-Hispanic White females, aged 60–68 years. We identified six major themes, and 19 sub-themes related to SDoH and caregiving burden. Four providers and two administrators (including thoracic surgeons, a nurse practitioner, a public health administrator, and a nurse scientist) emphasized the need for electronic health record (EHR)-based SDoH documentation, interdisciplinary collaboration, and recognition of FCGs as integral to care delivery. Integrating SDoH into lung cancer surgery intake and follow-up care was viewed as particularly challenging due to the clinical emphasis on survival. Discussion/conclusions: Given the focus on patient survival, the healthcare system should broaden its approach by integrating SDoH into lung cancer care. This shift toward coordinated, interdisciplinary care is essential for supporting long-term survival. Stakeholder insights highlight the need for systematic documentation, EHR integration, and comprehensive approaches to address social needs and improve outcomes. Citation Format: Dede K. Teteh-Brooks, Madeleine Love, Aldenise P. Ewing, Betty Ferrell, Oluwatimilehin Okunowo, Audrey Shin, Loretta Erhunmwunsee, Dan Raz, Rick Kittles, Jae Y. Kim, Virginia Sun. Lived experiences and systemic barriers in lung cancer surgery: Perspectives from caregivers, clinicians, and administrators on social determinants of health [abstract]. In: Proceedings of the 18th AACR Conference on the Science of Cancer Health Disparities; 2025 Sep 18-21; Baltimore, MD. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2025;34(9 Suppl):Abstract nr A004.