Abstract A59: Providing care for LGBTQ individuals with cancer: A call for education and training
Authors: Tamargo Christina , Sanchez Julian A. , Sutton Steven K. , Kanetsky Peter A. , Simmons Vani N. , Vadaparampil Susan T. , Schabath Matthew B. , Quinn Gwendolyn P. 
Published: May 2016

Background: Lesbian, gay, bisexual, transsexual/transgender, and queer/questioning (LGBTQ) individuals comprise a minority and underserved group with unique and often-unrecognized health needs. The LGBTQ community faces barriers to healthcare such as problems accessing health insurance coverage and stigmatization by some healthcare providers based on sexual orientation or gender identity. Additionally, the LGBTQ community has increased cancer risks due to lower screening rates, less use of regular health care, and an elevated prevalence of cancer risk factors, compared with heterosexual and gender-aligned populations. A recent review by Quinn et al. noted that anal, breast, cervical, colorectal, endometrial, lung, and prostate cancers may disproportionally affect the LGBTQ population. The goal of this project was to identify the attitudes, knowledge, and practice behaviors of healthcare providers specializing in these seven cancer types.

Methods: A 33-item web-based survey was sent by e-mail to oncology healthcare providers at a National Cancer Institute-Designated Comprehensive Cancer Center. The survey included five sections: demographics, attitudes, knowledge, practice behaviors, and open comments. Summary responses were examined only for providers who identified as specialists in breast, gastrointestinal (GI), genitourinary (GU), gynecologic (GYN), and thoracic cancers.

Results: Of the 108 oncology healthcare providers who completed the survey, 36 (33.3%) identified as specialists in breast, GI, GU, GYN, and thoracic cancers. Among this subgroup of clinicians, almost all (91.7%) stated they were comfortable treating LGBTQ patients and agreed the LGBTQ population has unique health risks and needs. However, less than half (49.5%) correctly answered knowledge questions related to health behaviors and cancer risks of LGBTQ individuals. As for practice behaviors, 33.3% actively inquire about a patient's sexual orientation when taking a history, 38.9% agree it is important to know their patients' sexual orientation to provide the best care, and 27.8% believe they are well-informed on the health needs of LGBTQ patients. Nearly 80% believe there should be more education in health professional schools on LGBTQ health needs and 41.7% agree there should be mandatory educational events in the workplace on these needs. Open-ended comments indicated that oncologists in the five highlighted specialties lack awareness of unique LGBTQ health concerns: for example, one thoracic oncology specialist stated that because he treats lung cancer patients, he was “not sure these questions are relevant to my specific area of focus.”

Conclusions: Survey results indicate that oncology providers in specialties where LGBTQ patients may be disproportionately affected are accepting of LGBTQ individuals and acknowledge the existence of unique needs for this population, yet are largely unaware of specific health behaviors and risk factors of, and best practices regarding, this population. This study also highlights the potential need for improved LGBTQ-related content in health professional school curricula, as well as for continuing education and training for providers that addresses the care of LGBTQ patient populations.

Citation Format: Christina Tamargo, Julian A. Sanchez, Steven K. Sutton, Peter A. Kanetsky, Vani N. Simmons, Susan T. Vadaparampil, Matthew B. Schabath, Gwendolyn P. Quinn. Providing care for LGBTQ individuals with cancer: A call for education and training. [abstract]. In: Proceedings of the Eighth AACR Conference on The Science of Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; Nov 13-16, 2015; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2016;25(3 Suppl):Abstract nr A59.