Cancer care providers show varying attitudes, knowledge of LGBTQ patients
Health care providers reported limited overall knowledge about the health needs of lesbian, gay, bisexual, transgender and queer/questioning patients with cancer, according to survey results.
The results, presented at the virtual American Association for Cancer Research Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved, also showed differences in attitudes related to treatment setting, having LGBTQ friends or family, and political affiliation, although most providers expressed an interest in receiving more education regarding this patient population.
“Our group conducted a prior study among oncologists at NCI-designated cancer centers regarding knowledge, attitudes and institutional practices about LGBTQ patients with cancer. In this prior work, we found oncologists reported limited knowledge about LGBTQ health and cancer needs, but high interest in receiving education regarding this community,” Matthew B. Schabath, PhD, associate member in the departments of cancer epidemiology and thoracic oncology at Moffitt Cancer Center, told Healio. “As a follow-up to this prior study, we conducted the current study in the ECOG-ACRIN Cancer Research Group, which is not exclusive to NCI-designated cancer centers, but includes academic and nonacademic medical centers, as well as both oncologists and other health care providers.”
In 2019, Schabath and colleagues administered a web-based survey that assessed the attitudes and knowledge of LGBTQ health and institutional practices among members of the ECOG-ACRIN Cancer Research Group. Researchers used descriptive and stratified analyses to quantify their results.
Of the 490 heath care providers (mean age, 46 years; 77% white; 75% women; 81% heterosexual) who completed the survey, nearly half (47%) were medical oncologists, 39% practiced in academic medical centers and 49% practiced in the Midwest or Northeast.
Overall, 77% of respondents reported high interest in receiving education on the unique health care needs of LGBTQ patients.
However, the survey results revealed limited overall knowledge about LGBTQ health and cancer needs. Moreover, from the time of the survey assessment to the post-survey assessment, respondents reported a significant decrease in confidence of their knowledge about the unique health care needs of LGBTQ patients with cancer.
Investigators observed high agreement among survey respondents (71%) regarding the importance of knowing gender identity, whereas there was low agreement (48%) regarding the importance of knowing sexual orientation.
Researchers observed significant differences in certain attitude and knowledge items based on characteristics of the health care provider and their treatment setting.
For instance, MDs and DOs were significantly more likely to be listed as a LGBTQ-friendly provider (81% vs. 50%) and more reported being knowledgeable about LGBTQ health needs (69% vs. 53%) than registered nurses, nurse practitioners and physician assistants.
In addition, compared with providers at nonacademic medical centers, providers at academic medical centers were significantly more likely to be listed as a LGBTQ-friendly provider (71% vs. 53%) and more believed there should be mandatory education regarding care of LGBTQ patients (72% vs. 60%).
Having family members and friends who are LGBTQ and political affiliation were both strong effect modifiers resulting in significant differences for many attitude and knowledge items, Schabath noted.
“Importantly, we found higher rates of collection of sexual orientation and gender identity at the institutional level than in our prior work. Although the overall rates are still too low, the results are heading in a promising direction,” Schabath added. “As more and more institutions are collecting sexual orientation and gender identity, research is still needed to document and then address health disparities among LGBTQ populations across the cancer care continuum, from prevention, early detection, diagnosis, treatment and quality of life to end of life.”
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Schabath MB, et al. Abstract PO-068. Presented at: American Association for Cancer Research Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved (virtual); Oct. 2-4, 2020.
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