The need for LGBTQ+ education in cancer care: survey results demonstrating provider knowledge gaps about cancer screenings for sexual and gender minority patients

BACKGROUND: The National Cancer Institute designates the LGBTQ+ community as medically underserved, leading to differential cancer outcomes. It has been established that LGBTQ+ patients have lower cancer screening rates, which is likely multifactorial, involving emotional distress surrounding medical encounters and gaps in health knowledge. This puts the onus on providers to provide a clinical environment that is culturally competent, well-versed in LGBTQ+ care, and informative for patients. OBJECTIVES/METHODS: To assess the attitudes and knowledge of cancer care providers regarding health and screening for LGBTQ+ patients, we distributed a 20-item survey to physicians in primary care and oncology subspecialties (n=355). RESULTS: Providers were more likely to report having formal LGBTQ+-related training if they were female, had less than ten years of practice, or practiced family or internal medicine. These specialists were more likely to agree with the importance of knowing patients’ sexual orientation, despite the fact that every specialty agreed that the LGBTQ+ community experiences different health issues. By specialty, respondents disagreed about which cancer screenings are indicated for certain subpopulations; specialists disagreed whether lesbian women, trans men, and trans women should have mammograms. Responses indicated that some providers were not clear on LGBTQ+ terminology; 36% of providers believed trans women should have pap smears. Seventy-one percent of respondents (and a majority from each demographic) agreed that their clinics would benefit from training about LGBTQ+ health issues. Only 46% of respondents reported confidence in their understanding of health concerns unique to the LGBTQ+ community. CONCLUSIONS/IMPACT: These responses instantiate the need and desire for LGBTQIA+ education for cancer care providers, including details about health considerations for transgender patients and clearer standards of cancer screening for different subpopulations. From there, providers could deliver better healthcare and patient education to improve the disparity in cancer outcomes noted in the LGBTQ+ community.https://jdc.jefferson.edu/sexandgenderhealth/1016/thumbnail.jp