Abstract PO-259: The need for LGBTQ+ education in oncology: Provider survey results demonstrate lack of consensus regarding cancer screenings for sexual and gender minorities
Authors: Nelson Nicolas G. , Smith Alexandra P. , Ko Kevin , Lombardo Joseph F. , Ruggiero Marissa , Murphy Rita , Richard Scott D. , Leader Amy E. , Shimada Ayako , Simone Nicole L. 
Published: December 2020

Abstract
BACKGROUND: The LGBTQ+ community is noted to experiences worse cancer outcomes, and the NCI has therefore designated this population as medically underserved. The reasons for this disparity are likely multifactorial, due in part to lower screening rates from emotional distress surrounding medical encounters and gaps in health knowledge. Therefore, ensuring inclusive clinical environments is crucial to narrowing this disparity. We sought to understand the medical perceptions of providers regarding cancer screening for LGBTQ+ patients. METHODS: Between 8/2017 and 8/2018, an IRB-approved 20-item REDCap survey was distributed to physicians in primary care via ACOG and oncology subspecialists via ASTRO, AUA, ACOSOG, and RSNA. Differences were assessed using chi-square or Fisher’s exact tests with a significance level set to 0.05. Participants were not compensated for completing the survey. RESULTS: The survey was completed by 361 individuals with a complete data set from 355. Female- and male-identifying providers completed the survey almost evenly (54% female, 45% male), and the majority of respondents had over ten years of experience in their practice (59%). The most common specialty of respondents was radiology (43%), followed by internal medicine (15%) and medical oncology (14%). The majority of respondents practiced in an urban setting (56%).
Summaries of their approximate number of LGBTQ+ patients seen, confidence in caring for this population, and willingness to be listed as “LGBTQ+-friendly” did not vary significantly by region of practice. Significant findings included: 1) Providers were more likely to report having formal LGBTQ+-related training if they were female (34%; 22% for male), had under ten years of practice (40% did not disagree; 54% for longer), or practiced family or internal medicine (39%; 28% for medical/radiation oncology, 21% for radiology). 2) These specialists were also more likely to agree with the importance of knowing patients’ sexual orientation (94%; 62% for medical/radiation oncology). 3) By specialty, respondents disagreed about which cancer screenings are indicated for various LGBTQ+ subpopulations, e.g., specialists disagreed whether lesbian women have concerns with mammograms (85% for family/internal medicine, 72% for medical/radiation oncology, 62% for radiology). Regarding LGBTQ+ terminology, 36% of respondents believed trans women should have pap smears. Only 46% of providers reported confidence in their understanding of health concerns unique to the LGBTQ+ community, and 71% of all respondents agreed that their clinics would benefit from training about LGBTQ+ health issues. CONCLUSIONS: Our study demonstrated a lack of consensus regarding cancer screenings for gay, lesbian, and transgender patients. These responses indicate the need for clear cancer screening standards for LGBTQ+ subpopulations and educational programs for cancer care providers to reduce disparities and improve healthcare delivery for our LGBTQ+ community.
Citation Format: Nicolas G. Nelson, Alexandra P. Smith, Kevin Ko, Joseph F. Lombardo, Marissa Ruggiero, Rita Murphy, Scott D. Richard, Amy E. Leader, Ayako Shimada, Nicole L. Simone. The need for LGBTQ+ education in oncology: Provider survey results demonstrate lack of consensus regarding cancer screenings for sexual and gender minorities [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-259.