University of Rochester Medical Center, Rochester, NY.
Legorreta Cancer Center at Brown University and Lifespan Cancer Institute, Providence, RI.
JCO Oncol Pract. 2023 Nov;19(11):959-966. doi: 10.1200/OP.23.00435. Epub 2023 Oct 4.
In 2017, ASCO issued the position statement, Strategies for Reducing Cancer Health Disparities Among Sexual and Gender Minority Populations, outlining five areas of recommendations to address the needs of both sexual and gender minority (SGM, eg, LGBTQ+) populations affected by cancer and members of the oncology workforce who identify as SGM: (1) patient education and support; (2) workforce development and diversity; (3) quality improvement strategies; (4) policy solutions; and (5) research strategies. In 2019, ASCO convened the SGM Task Force to help actualize the recommendations of the 2017 position statement. The percentage of the US population who publicly identify as SGM has increased dramatically over the past few years. Although increased national interest in SGM health equity has accompanied a general interest in research, policy change, and education around diversity, equity, and inclusion, resulting from public concern over discrimination in health care against Black, Indigenous, and People of Color, this has been accompanied by a surge in discriminatory legislation directly impacting the SGM community. Although much progress has been made in advancing SGM cancer health equity since 2017, more progress is needed to reduce disparities and advance equity. The five focus areas outlined in the 2017 ASCO position statement remain relevant, as we must continue to promote and advance equity in quality improvement, workforce development, patient care, research, and SGM-affirming policies. This article reports on the progress toward reducing SGM cancer disparities and achieving equity across these five areas and identifies future directions for the work that still remains.
2017 年,美国临床肿瘤学会(ASCO)发布了立场声明《减少性少数群体和性别少数群体癌症健康差异的策略》,其中概述了五个方面的建议,以满足受癌症影响的性少数群体和自认为性少数群体(SGM,例如 LGBTQ+)的肿瘤学工作者的需求:(1)患者教育和支持;(2)劳动力发展和多样性;(3)质量改进策略;(4)政策解决方案;(5)研究策略。2019 年,ASCO 召集了 SGM 工作组,以帮助落实 2017 年立场声明中的建议。过去几年,公开表示自己属于 SGM 的美国人口比例大幅增加。尽管对 SGM 健康公平的全国性关注伴随着对多样性、公平和包容性的研究、政策变革和教育的普遍兴趣,但这也伴随着针对黑人和少数族裔的医疗保健歧视的公众关注,导致了歧视性立法的激增,直接影响了 SGM 社区。尽管自 2017 年以来,在推进 SGM 癌症健康公平方面已经取得了很大进展,但仍需要进一步努力减少差距,实现公平。2017 年 ASCO 立场声明中概述的五个重点领域仍然相关,因为我们必须继续在质量改进、劳动力发展、患者护理、研究和支持 SGM 的政策方面促进和推进公平。本文报告了在减少 SGM 癌症差距和实现这五个领域公平方面的进展,并确定了仍需开展的工作的未来方向。