Nelson Nicolas G, Lombardo Joseph F, Shimada Ayako, Ruggiero Marissa L, Smith Alexandria P, Ko Kevin, Leader Amy E, Mitchell Edith P, Simone Nicole L
Department of Radiation Oncology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA 19107, USA.
Division of Biostatistics and Department of Experimental Pharmacology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA 19107, USA.
Cancers (Basel). 2023 Jun 1;15(11):3017. doi: 10.3390/cancers15113017.
The LGBTQ+ community experiences cancer disparities due to increased risk factors and lower screening rates, attributable to health literacy gaps and systemic barriers. We sought to understand the experiences, perceptions, and knowledge base of healthcare providers regarding cancer screening for LGBTQ+ patients. A 20-item IRB-approved survey was distributed to physicians through professional organizations. The survey assessed experiences and education regarding the LGBTQ+ community and perceptions of patient concerns with different cancer screenings on a 5-point Likert scale. Complete responses were collected from 355 providers. Only 100 (28%) reported past LGBTQ+-related training and were more likely to be female ( = 0.020), have under ten years of practice ( = 0.014), or practice family/internal medicine ( < 0.001). Most (85%) recognized that LGBTQ+ subpopulations experience nuanced health issues, but only 46% confidently understood them, and 71% agreed their clinics would benefit from training. Family/internal medicine practitioners affirmed the clinical relevance of patients' sexual orientation (94%; 62% for medical/radiation oncology). Prior training affected belief in the importance of sexual orientation ( < 0.001), confidence in understanding LGBTQ+ health concerns ( < 0.001), and willingness to be listed as "LGBTQ+-friendly" ( = 0.005). Our study suggests that despite a paucity of formal training, most providers acknowledge that LGBTQ+ patients have unique health needs. Respondents had a lack of consensus regarding cancer screenings for lesbian and transgender patients, indicating the need for clearer screening standards for LGBTQ+ subpopulations and educational programs for providers.
由于风险因素增加和筛查率较低，LGBTQ+群体面临癌症差异，这归因于健康素养差距和系统性障碍。我们试图了解医疗服务提供者对LGBTQ+患者进行癌症筛查的经历、看法和知识基础。通过专业组织向医生发放了一份经机构审查委员会批准的包含20个条目的调查问卷。该调查通过5分量表评估了与LGBTQ+群体相关的经历和教育，以及对患者对不同癌症筛查担忧的看法。从355名提供者那里收集到了完整的回复。只有100人（28%）报告曾接受过与LGBTQ+相关的培训，并且更有可能是女性（P = 0.020）、执业年限不足十年（P = 0.014）或从事家庭/内科医学（P < 0.001）。大多数人（85%）认识到LGBTQ+亚群体存在细微的健康问题，但只有46%的人自信地理解这些问题，71%的人同意他们的诊所将从培训中受益。家庭/内科医学从业者肯定了患者性取向的临床相关性（94%；医学/放射肿瘤学为62%）。先前的培训影响了对性取向重要性的信念（P < 0.001）、对理解LGBTQ+健康问题的信心（P < 0.001）以及被列为“对LGBTQ+友好”的意愿（P = 0.005）。我们的研究表明，尽管缺乏正规培训，但大多数提供者承认LGBTQ+患者有独特的健康需求。受访者在针对女同性恋和跨性别患者的癌症筛查方面缺乏共识，这表明需要为LGBTQ+亚群体制定更明确的筛查标准，并为提供者开展教育项目。
