Genomics and Computational Biology, Barts Cancer Institute, London, UK; Gender Identity Clinic, Tavistock and Portman NHS Foundation Trust, London, UK.
UCL Cancer Institute, London, London, UK; Royal College of Physicians, London, London, UK.
ESMO Open. 2020 Nov;5(6):e000906. doi: 10.1136/esmoopen-2020-000906.
Over one million people in the UK identify as LGBTQ+ (lesbian, gay, bisexual, transgender, queer or questioning). Research has shown that this population experience differing cancer risk factors compared with non-LGBTQ+ patients and persistent inequalities in cancer care. Literature concerning the knowledge of oncologists of this group's healthcare needs is limited; our study aimed to evaluate knowledge, attitudes and behaviours of UK oncologists about LGBTQ+ patients.
A 53-question survey was delivered via a secure online platform. Questions covered respondent demographics, knowledge, attitudes and behaviours with the majority of responses on a Likert scale. Oncologists were recruited via email from professional bodies and social media promotion. Informed consent was sought and responses fully anonymised. Multifactorial ordinal logistic regression and Fisher's exact test were used to assess for interactions between demographics and responses with Holm-Bonferroni multiple testing correction.
258 fully completed responses were received. Respondents had a median age of 43 years (range 28-69); 65% consultants and 35% registrars; 42% medical, and 54% clinical, oncologists. 84% felt comfortable treating LGBTQ+ patients but only 8% agreed that they were confident in their knowledge of specific LGBTQ+ patient healthcare needs. There were low rates of routine enquiry about sexual orientation (5%), gender identity (3%) and preferred pronouns (2%). 68% of oncologists felt LGBTQ+ healthcare needs should be a mandatory component of postgraduate training.
This survey showed that UK oncologists feel comfortable treating LGBTQ+ patients but may fail to identify these patients in their clinic, making it more difficult to meet LGBTQ+ healthcare needs. There is self-awareness of deficits in knowledge of LGBTQ+ healthcare and a willingness to address this through postgraduate training. Educational resources collated and developed in accordance with this study would potentially improve the confidence of oncologists in treating LGBTQ+ patients and the cancer care these patients receive.
英国有超过 100 万人自认为是 LGBTQ+（女同性恋、男同性恋、双性恋、跨性别、酷儿或疑问）。研究表明，与非 LGBTQ+患者相比，这一人群的癌症风险因素不同，并且在癌症护理方面仍然存在不平等现象。关于这一群体的医疗需求，肿瘤学家对其了解的相关文献有限；我们的研究旨在评估英国肿瘤学家对 LGBTQ+患者的知识、态度和行为。
通过一个安全的在线平台提供了一个包含 53 个问题的调查。问题涵盖了受访者的人口统计学、知识、态度和行为，其中大部分回答采用了李克特量表。通过专业机构的电子邮件和社交媒体推广来招募肿瘤学家。在获得知情同意并对回复进行完全匿名后，使用多因素有序逻辑回归和 Fisher 确切检验来评估人口统计学和回复之间的相互作用，并使用 Holm-Bonferroni 多重检验校正。
共收到 258 份完整的回复。受访者的中位年龄为 43 岁（范围 28-69 岁）；65%是顾问，35%是住院医师；42%是医学肿瘤学家，54%是临床肿瘤学家。84%的人觉得可以治疗 LGBTQ+患者，但只有 8%的人同意他们对特定的 LGBTQ+患者医疗需求有信心。关于性取向（5%）、性别认同（3%）和首选代词（2%）的常规询问率较低。68%的肿瘤学家认为 LGBTQ+医疗需求应该是研究生培训的必修部分。
这项调查表明，英国的肿瘤学家在治疗 LGBTQ+患者方面感到舒适，但可能无法在诊所中识别这些患者，从而更难满足 LGBTQ+的医疗需求。人们意识到在 LGBTQ+医疗知识方面存在不足，并愿意通过研究生培训来解决这一问题。根据这项研究收集和开发的教育资源可能会提高肿瘤学家治疗 LGBTQ+患者的信心，以及这些患者接受的癌症护理水平。
