Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
Department of Biostatistics for Clinical Research, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
ESMO Open. 2023 Jun;8(3):101578. doi: 10.1016/j.esmoop.2023.101578. Epub 2023 Jun 2.
Transgender and gender-diverse (TGD) population represents an underserved group across the cancer care continuum. To assess the perspective of both oncology health care providers (OHPs) and TGD individuals in Italy, we conducted two national surveys: one among 2407 OHPs about their attitudes, knowledge and behavior toward TGD patients, and one among TGD persons about their health needs, experiences and barriers encountered in the use of health services across the cancer continuum.
The surveys were self-compiled web-based computer-aided web interview, conducted in Italy within the 'OncoGender-Promoting Inclusion in Oncology' project, led by the Italian national cancer society [Associazione Italiana di Oncologia Medica (AIOM)]-associated researchers. All members of AIOM were invited by e-mail to participate in the OHP survey. TGD persons were reached through advocacy groups and consumers' panel. The recruitment was completed on a voluntary basis. Survey data were collected and managed using an online platform managed by ELMA Research, an independent pharmaceutical marketing agency.
A total of 305 OHPs (13% of AIOM members) and 190 TGD individuals participated in the surveys. Only 19% of OHPs felt competent in providing care to TGD patients and 21% declared not to feel comfortable in treating TGD patients. Seventy-one percent of TGD persons reported that they had never joined any cancer screening program; 32% reported one or more acts of discrimination by health care providers. Seventy-two percent of OHPs recognized the lack of specific education on cancer care for TGD patients and deemed it necessary to receive adequate training.
A general lack of knowledge among OHPs about TGD health issues seems to be the main driver of difficulties in providing assistance and of discriminatory attitudes against TGD individuals. Ultimately, this whole issue generates access barriers and contributes to lack of trust in health care services. Educational interventions and an implementation of person-centric cancer policies are urgently needed.
跨性别和性别多样化（TGD）人群在癌症护理全过程中代表了一个未得到充分服务的群体。为了评估意大利肿瘤保健提供者（OHP）和 TGD 个体的观点，我们进行了两项全国性调查：一项是针对 2407 名 OHP 的调查，了解他们对 TGD 患者的态度、知识和行为；另一项是针对 TGD 个体的调查，了解他们在癌症全过程中使用卫生服务的健康需求、经验和遇到的障碍。
调查是在意大利进行的，由意大利国家癌症协会（Associazione Italiana di Oncologia Medica，AIOM）相关研究人员领导的“OncoGender-Promoting Inclusion in Oncology”项目中进行的两项全国性调查。通过电子邮件向 AIOM 的所有成员邀请参与 OHP 调查。通过宣传团体和消费者小组联系到 TGD 个人。招募工作是自愿完成的。调查数据通过由独立制药营销机构 ELMA Research 管理的在线平台进行收集和管理。
共有 305 名 OHP（AIOM 成员的 13%）和 190 名 TGD 个人参与了调查。只有 19%的 OHP 认为自己有能力为 TGD 患者提供护理，21%的 OHP 表示在治疗 TGD 患者时感到不舒服。71%的 TGD 个人报告称他们从未参加过任何癌症筛查计划；32%的人报告称他们受到过医疗保健提供者的一次或多次歧视行为。72%的 OHP 承认缺乏针对 TGD 患者的癌症护理特定教育，并认为有必要接受适当的培训。
OHP 对 TGD 健康问题普遍缺乏了解，这似乎是提供帮助和对 TGD 个人产生歧视态度的主要驱动因素。最终，所有这些问题都会产生获得服务的障碍，并导致对医疗保健服务缺乏信任。迫切需要教育干预和实施以患者为中心的癌症政策。
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