Abstract PO-013: Qualitative results to a survey of ECOG-ACRIN members regarding experience with sexual and gender minority patients with cancer
Authors: Tamargo Christina L. , Mitchell Edith P. , Wagner Lynne I. , Simon Melissa A. , Carlos Ruth C. , Giantonio Bruce J. , Quinn Gwendolyn P. , Schabath Matthew B. 
Published: December 2020

Abstract
Background: While societal acceptance for sexual and gender minority (SGM/LGBTQ) individuals is increasing, this population continues to face health care barriers. In addition to encountering stigmatization, SGM/LGBTQ patients are an understudied population, particularly within oncology. Little is known about clinicians’ knowledge and practice behaviors regarding SGM in the oncology setting. To address this lack of knowledge, a mixed method survey was administered to members of the ECOG- ACRIN Cancer Research Group in late 2019. Methods: In this analysis, we report on results of the qualitative portion of the survey. Four open-ended questions asked healthcare providers (i.e., oncology physicians, researchers, physician assistants, and nurses) to describe experiences with SGM patients, reservations in caring for SGM patients, suggestions for improvement in SGM cancer care, and any additional comments. Responses were organized in spreadsheet and content analysis was used to group a priori and emergent themes. Results: 490 people responded to the quantitative survey and 365 provided responses to the open-ended questions. In the personal experience question, the majority noted they had no or little familiarity with SGM patients. A minority of respondents noted experience with gay and lesbian patients with cancer, but not transgender patients; many who reported experience with transgender patients noted difficulty navigating the correct use of pronouns. In the reservations question, the majority stated they had no reservations treating SGM patients but lacked training. Suggestions for improvement included providing training in the care of SGM patients with cancer, ensuring training occurred throughout the institution and not only among clinicians, need to attend to unique end-of-life care issues among SGM patients, and need to build trust. A minority of respondents described SGM patients with cancer as difficult to treat and non- compliant. Many respondents endorsed a fear of offending patients due to general lack of knowledge or saying the wrong thing. Additional comments offered related to lack of knowledge about potential interactions between cancer treatment and gender-affirming hormones, and lesbian women’s frustrations with requirements of pregnancy testing. Conclusions: Clinicians have minimal experiences and/or exposure to SGM patients with cancer but desire training. Training the entire workforce may improve trust with, outreach efforts to, and cancer care delivery to the SGM community.
Citation Format: Christina L. Tamargo, Edith P. Mitchell, Lynne I. Wagner, Melissa A. Simon, Ruth C. Carlos, Bruce J. Giantonio, Gwendolyn P. Quinn, Matthew B. Schabath. Qualitative results to a survey of ECOG-ACRIN members regarding experience with sexual and gender minority patients with cancer [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-013.