Link between alcohol consumption and myocardial infarction, stroke, and all-cause mortality among Swedish male automotive workers over 30 years.

Gastrointestinal (GI) cancers comprise over 25% of total cancer incidence and have an overall related mortality of 35%. Colorectal, esophageal, and pancreatic are among the five most frequent GI cancers []. Surgery is often the cornerstone of treatment for these cancers, and high‐quality education has been shown to lead to better surgical outcomes, especially within enhanced recovery programs (ERP) []. These evidence‐based programs consist of pre‐operative to post‐operative processes for which patients' understanding and compliance are essential, and that could not be implemented adequately without high‐quality patient education. Such education goes beyond knowledge delivery—it must be tailored to patient needs, considering baseline knowledge and comprehension levels, and designed to instill major behavioral change []. Additionally, structured preoperative education has been linked to more reasonable patient expectations, increased engagement, and improved satisfaction [, , ]. During the preoperative phase, education is particularly crucial as it helps patients anticipate and manage their surgical experience by providing access to health information, postoperative psychosocial support, and anxiety reduction strategies []. After surgery, education can also markedly improve patients' quality of life by increasing patients' awareness of disease and late complications, providing guidance on lifestyle and diet, improving patients' self‐care skills, and creating supportive familial and social environments []. Engaged and well‐informed patients are more likely to experience fewer postoperative complications and shorter hospital stays, leading to reduced healthcare costs and improved overall recovery outcomes []. Despite its critical role in improving patient outcomes, patient education throughout the surgical journey remains inconsistent, inadequate, and often ineffective [, , , , ]. While studies have reported that preoperative patient education is technically delivered, it remains insufficient as many patients continue to experience high levels of anxiety and confusion about their procedures [], and frequently struggle to fully understand the information provided []. Persisting key gaps include unclear or inadequate instructions regarding the surgical process and inconsistencies in how staff members provide preoperative information []. Moreover, the factors that hinder or facilitate the delivery of high‐quality patient education are also still unclear. Such facilitators and barriers may differ for patients with different health literacy levels. Low health literacy created barriers in the preoperative (difficulty understanding diagnosis), perioperative (refusing aspects of care), and postoperative surgery phase (difficulty understanding postoperative complications) [] specific health literacy‐sensitive education strategies that can effectively target patients across all literacy levels. To address these knowledge gaps, this study aimed to explore GI cancer patients' perspectives on facilitators and barriers to high‐quality pre to postoperative patient education across different levels of health literacy. Findings are important to inform future education improvement efforts across all surgical phases. This is an analysis of data from semi‐structured interviews with GI cancer patients recruited from Alabama and Mississippi as part of the Advancing Surgical Cancer Care and Equity in the Deep South (ASCENDS) study [, ]. The ASCENDS study investigated barriers to access to surgical care for three GI cancers (esophageal, pancreatic, and colorectal [CRC]) using a mixed‐methods approach, including quantitative surveys and qualitative interviews. The study was approved by the University of Alabama at Birmingham (UAB) Institutional Review Board (IRB‐300005475). Participants provided informed consent for the interviews and received a monetary incentive for their participation.