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收集癌症患者的性取向和性别认同信息的挑战:医院和中央癌症登记处摘要录入员的观点。

Challenges in collecting information on sexual orientation and gender identity for cancer patients: perspectives of hospital and central cancer registry abstractors.

机构信息

Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA, USA.

State Health Registry of Iowa, College of Public Health, University of Iowa, Iowa City, IA, USA.

出版信息

Cancer Causes Control. 2024 Nov;35(11):1433-1445. doi: 10.1007/s10552-024-01897-x. Epub 2024 Jul 2.

Abstract

PURPOSE

Sexual and gender minority (SGM) populations experience cancer treatment and survival disparities; however, inconsistent sexual orientation and gender identity (SOGI) data collection within clinical settings and the cancer surveillance system precludes population-based research toward health equity for this population. This qualitative study examined how hospital and central registry abstractors receive and interact with SOGI information and the challenges that they face in doing so.

METHODS

We conducted semi-structured interviews with 18 abstractors at five Surveillance, Epidemiology, and End Results (SEER) registries, as well as seven abstractors from commission on cancer (CoC)-accredited hospital programs in Iowa. Interviews were transcribed, cleaned, and coded using a combination of a priori and emergent codes. These codes were then used to conduct a descriptive analysis and to identify domains across the interviews.

RESULTS

Interviews revealed that abstractors had difficulty locating SOGI information in the medical record: this information was largely never recorded, and when included, was inconsistently/not uniformly located in the medical record. On occasion, abstractors reported situational recording of SOGI information when relevant to the patient's cancer diagnosis. Abstractors further noticed that, where reported, the source of SOGI information (i.e., patient, physician) is largely unknown.

CONCLUSION

Efforts are needed to ensure standardized implementation of the collection of SOGI variables within the clinical setting, such that this information can be collected by the central cancer registry system to support population-based equity research addressing LGBTQ + disparities.

摘要

目的

性少数群体(SGM)在癌症治疗和生存方面存在差异;然而,临床环境和癌症监测系统中不一致的性取向和性别认同(SOGI)数据收集,阻碍了针对该人群健康公平的基于人群的研究。本定性研究探讨了医院和中央登记处摘要编写者如何接收和处理 SOGI 信息,以及他们在处理这些信息时面临的挑战。

方法

我们对五个监测、流行病学和结果(SEER)登记处的 18 名摘要编写者,以及爱荷华州癌症委员会(CoC)认证医院项目的 7 名摘要编写者进行了半结构化访谈。访谈记录经过转录、清理和编码,使用了预设和新兴代码的组合。然后,这些代码用于进行描述性分析,并确定访谈中的各个领域。

结果

访谈显示,摘要编写者在病历中难以找到 SOGI 信息:这些信息大多从未记录过,而且即使有记录,也不一致/未统一地记录在病历中。在某些情况下,摘要编写者报告说,在与患者癌症诊断相关时,会临时记录 SOGI 信息。摘要编写者还注意到,报告的 SOGI 信息来源(即患者、医生)在很大程度上是未知的。

结论

需要努力确保在临床环境中标准化实施 SOGI 变量的收集,以便中央癌症登记系统能够收集这些信息,支持针对 LGBTQ+差异的基于人群的公平研究。

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