Mapping the Colorectal Cancer Patient Journey From the Oncologist Perspective in Saudi Arabia

Ahmed Alshehri,1 Ahmed Omar Allehebi,2,3 Fahad Almugbel,4 Shereef Elsamany,5 Kanan Alshammari,6 Abdulraheem Ahmed Alshangiti,7 Abdullah Ali Alsharm,8 Ahmed Hashiesh9 1College of Medicine, King Saud Bin Abdulaziz University (KSAU) for Health Sciences, Jeddah, Saudi Arabia; 2Department of Medical Oncology, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia; 3College of Medicine, Al Faisal University, Riyadh, Saudi Arabia; 4Department of Medical Oncology, King Faisal Specialist Hospital, Riyadh, Saudi Arabia; 5Medical Oncology Department, Oncology Center, King Abdullah Medical City, Makkah, Saudi Arabia; 6Department of Medical Oncology, Ministry of National Guard Health Affairs - Central Region (MNGHA - CR), Riyadh, Saudi Arabia; 7Department of Adult Medical Oncology, King Fahad Specialist Hospital, Dammam, Saudi Arabia; 8Department of Oncology, King Fahad Medical City, Riyadh, Saudi Arabia; 9Pfizer Saudi Limited, Riyadh, Saudi ArabiaCorrespondence: Ahmed Alshehri, College of Medicine, King Saud Bin Abdulaziz University (KSAU) for Health Sciences, King Abdul Aziz Medical City, Jeddah, 22384, Saudi Arabia, Tel +966540204640, Email [email protected]: Mapping the colorectal cancer (CRC) patient pathway is needed to identify knowledge gaps and improve patient care. We aimed to understand the medical journey of patients and the role of the multidisciplinary team (MDT) in managing CRC in Saudi Arabia.Methods: A nationwide survey was administered to healthcare professionals (HCPs) in Saudi Arabia during August 1–September 15, 2024, to characterize typical patient profiles and CRC management.Results: Out of 33 responses, 28 were eligible, mostly were medical oncologists (96.4%) in tertiary healthcare settings (> 85%) with 5– 20 years of experience (78.6%). Most HCPs reported that patients had no or limited awareness of CRC (89.3%) and lacked access to support groups (71.4%). The guideline-recommended screening of individuals aged 45– 75 years with no symptoms or a family history of CRC or polyps was only reported by 67.9% of respondents. Common screening methods were colonoscopy (89.3%) and fecal immunochemical test (53.6%). Major barriers to optimal CRC screening were patients’ lack of awareness (92.9%) and challenges in accessing screening programs (75.0%). Gastroenterologists were the primary referrers to specialized centers and were responsible for diagnosing CRC (reported by 92.9% and 85.7%, respectively); 53.6% and 17.9% of respondents reported that surgical oncologists and an MDT also made the definitive diagnosis, respectively. Respondents identified the key MDT members taking care of patients with CRC as surgical (100.0%), medical (100.0%), radiation oncologists (92.9%), and pathologists (92.9%). Some MDTs involved other professionals, including radiologists (85.7%), clinical gastroenterologists (64.3%), dieticians (64.3%) and pharmacists (60.7%). The most common barrier to effective CRC treatment was delays in patient presentation (67.9%).Conclusion: The results give clinicians and public bodies the opportunity to address critical factors for improving the outcomes for CRC patients in Saudi Arabia.Keywords: CRC, survey, oncologist, barrier, management, awareness