Abstract A20: LGBTQ self-disclosure in healthcare: The need for providers to discuss LGBTQ-specific cancer education
Authors: Wilson Lauren E. , Sehovic Ivana , 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: The lesbian, gay, bisexual, transgender, queer/questioning (LGBTQ) community represents a growing and medically underserved population in the US. The LGBTQ population faces significant documented clinical health disparities and barriers to healthcare, including access to LGBTQ-specific cancer risk education and preventative cancer screenings. The goal of this project was twofold: to identify LGBTQ community perceptions of cancer risk education, screening and prevention, and their experiences with healthcare providers, knowledge, attitudes, and cultural competency towards LGBTQ patients.

Methods: A 41-item survey was administered to attendees at two community events: the Tampa PRIDE Parade and the Moffitt Cancer Center Men's Health Forum via a hard copy and web-based format, respectively. The survey contained 5 domains: demographics, including sexual orientation and gender identity, cancer screening and prevention use, general healthcare experiences, perceptions of physician knowledge, attitudes, and competency, and an open comments sections. Summary responses are reported for respondents who self-identified as belonging to the LGBTQ population. Content analysis was used to analyze the qualitative comments.

Results: Of the 174 participants who completed the survey, 120 (69%) self-identified as belonging to the LGBTQ population. Among this population: 86% believed LGBTQ patients have different health concerns and cancer risks compared to straight patients and 86% of those who reported disclosing sexual orientation to a healthcare provider perceived the provider did not offer education in terms of LGBTQ-specific health risks, cancer risks, and screenings. 82% had a usual place to receive routine healthcare; 88% believed disclosing sexual orientation to a provider is an important aspect of healthcare; additionally, 64% reported having rarely or never been asked by their healthcare provider about sexual orientation. Thirty-five percent reported a negative reaction from office staff or a healthcare provider pertaining to their LGBTQ status and 52% feared a negative reaction if they came out as LGBTQ. Open-ended responses suggested a need for LGBTQ cultural competence training to improve healthcare providers' knowledge about and attitudes toward their LGBTQ patients.

Conclusions: Results indicate the cancer risk education and screening and prevention needs of the LGBTQ community are not being met. Experiences and perceptions of LGBTQ individuals revealed knowledge gaps, lack of awareness, and irresolute attitude among healthcare providers regarding the LGBTQ population. These perceptions indicate a need for additional training and education regarding the LGBTQ population including increased interpersonal interactions and communication. Results from the members of the LGBTQ population highlight the need for examination of medical school curriculum, hospital policies, and improved cultural competency for health care professional and those working in a healthcare setting.

Citation Format: Lauren E. Wilson, Ivana Sehovic, Julian A. Sanchez, Steven K. Sutton, Peter A. Kanetsky, Vani N. Simmons, Susan T. Vadaparampil, Matthew B. Schabath, Gwendolyn P. Quinn. LGBTQ self-disclosure in healthcare: The need for providers to discuss LGBTQ-specific cancer education. [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 A20.