Cancer Screening Considerations and Cancer Screening Uptake for Lesbian, Gay, Bisexual, and Transgender Persons

Ceres, Marc; Quinn, Gwendolyn P.; Loscalzo, Matthew; Rice, D.W.

doi:10.1016/j.soncn.2017.12.001

Cited by 55 publications

(28 citation statements)

References 45 publications

(46 reference statements)

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“…One observed barrier for cancer control in this population is gaps in cancer screening among LGB individuals. 5,34,35 According to Ceres et al, 34 distress caused by health care professionals due to denied health care or derogatory language may be reasons for screening gaps in this population. Reports from Johnson et al 36 indicate that lesbian, bisexual, or queer women and transgender men who did not participate in routine cervical cancer screening felt more discrimination from health care providers than those who were screened routinely.…”

Section: Discussionmentioning

confidence: 99%

“…LGB individuals who face discrimination in health care settings are less likely to engage with health care services, which can further exacerbate health disparities in this population. 5,34 To address these issues, there are emerging standards to ensure that providers are culturally competent, not only in providing a welcoming environment, but also in being knowledgeable about the specific health needs of LGBT patients. 37,38 At the federal policy level, the Affordable Care Act has prohibited insurers from denying coverage due to a person's sexual orientation or gender identity; however, the long-term enactment of these protections is uncertain.…”

Section: Discussionmentioning

confidence: 99%

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Disparities in Health Information-Seeking Behaviors and Fatalistic Views of Cancer by Sexual Orientation Identity: A Nationally Representative Study of Adults in the United States

et al. 2019

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Purpose: A lack of national data makes it difficult to estimate, but LGB adults appear to have a higher risk of cancer. Although limited research exists to explain the disparity, we aimed to explore potential differences in access to and utilization of health information and in cancer-related beliefs and behaviors. Methods: We used data from the Health Information National Trends Survey 5, Cycle 1 conducted from January 25 through May 5, 2017. Using survey-weighted logistic regression, we explored potential differences in health information-seeking behavior, trusted sources of health care information, engagement with the health care system, awareness of cancer risk factors, cancer fatalism, cancer-related health behaviors, and historical cancer screening between 117 LGB and 2857 heterosexual respondents. Results: LGB respondents were more likely to report looking for information about health or medical topics than heterosexual respondents (adjusted odds ratio [aOR]: 3.12; confidence interval [95% CI]: 1.07-9.06), but less likely to seek health information first from a doctor (aOR: 0.17; 95% CI: 0.06-0.50) after adjusting for age, race, and sex. LGB persons were less likely to report that they trust receiving health or medical information from friends and family and more likely to be worried about getting cancer (aOR: 2.30; 95% CI: 1.04-5.05). Conclusions: Our findings indicate a growing need for the production of tailored cancer prevention and control materials for members of sexual minority groups. More work is needed to understand barriers that LGB populations face in accessing this health information and building informative social support networks.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Disparities in Health Information-Seeking Behaviors and Fatalistic Views of Cancer by Sexual Orientation Identity: A Nationally Representative Study of Adults in the United States

et al. 2019

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“…[8][9][10] The sparse but growing body of evidence demonstrates the LGBTQ population is associated with increased risk and poorer outcomes for certain cancers. 1,[10][11][12] Despite the increased risk, the LGBTQ population is less likely to engage in early detection and cancer screening 10,[13][14][15] and often engages in behaviors associated with increased cancer risk, including elevated rates of smoking, alcohol use, obesity, and nulliparity (among SGM assigned female at birth); anal receptive sex (among SGM assigned male at birth); and lower rates of exercise. 1,[16][17][18][19][20] With respect to health care experiences, LGBTQ populations have reported lower satisfaction with cancer care treatment 21,22 and higher rates of psychological distress in survivorship, 22 are less likely to have insurance coverage, 23,24 and report higher rates of perceived discrimination in the health care setting.…”

Section: Introductionmentioning

confidence: 99%

National Survey of Oncologists at National Cancer Institute–Designated Comprehensive Cancer Centers: Attitudes, Knowledge, and Practice Behaviors About LGBTQ Patients With Cancer

Schabath

Blackburn

Sutter

et al. 2019

JCO

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115

124

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PURPOSE To identify potential gaps in attitudes, knowledge, and institutional practices toward lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) patients, a national survey of oncologists at National Cancer Institute–Designated Comprehensive Cancer Centers was conducted to measure these attributes related to LGBTQ patients and desire for future training and education. METHODS A random sample of 450 oncologists from 45 cancer centers was selected from the American Medical Association’s Physician Masterfile to complete a survey measuring attitudes and knowledge about LGBTQ health and institutional practices. Results were quantified using descriptive and stratified analyses and by a novel attitude summary measure. RESULTS Of the 149 respondents, there was high agreement (65.8%) regarding the importance of knowing the gender identity of patients, which was contrasted by low agreement (39.6%) regarding the importance of knowing sexual orientation. There was high interest in receiving education regarding the unique health needs of LGBTQ patients (70.4%), and knowledge questions yielded high percentages of “neutral” and “do not know or prefer not to answer” responses. After completing the survey, there was a significant decrease ( P < .001) in confidence in knowledge of health needs for LGB (53.1% agreed they were confident during survey assessment v 38.9% postsurvey) and transgender patients (36.9% v 19.5% postsurvey). Stratified analyses revealed some but limited influence on attitudes and knowledge by having LGBTQ friends and/or family members, political affiliation, oncology specialty, years since graduation, and respondents’ region of the country. CONCLUSION This was the first nationwide study, to our knowledge, of oncologists assessing attitudes, knowledge, and institutional practices of LGBTQ patients with cancer. Overall, there was limited knowledge about LGBTQ health and cancer needs but a high interest in receiving education regarding this community.

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“…10 Inequalities in cancer screening and care amongst LGBTQ2S+ populations exist, and as such, overall cancer screening rates remain low. 11,12 The case of breast cancer among lesbians is perhaps one of the most researched, with clear evidence of homophobia (e.g. discriminating against the patient and/or her female partner because of their sexual orientation xx and heterosexism (e.g.…”

Section: Introductionmentioning

confidence: 99%

Improving the LGBTQ2S+ cultural competency of healthcare trainees: Advancing health professional education.

2020

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Background: Lesbian, Gay, Bisexual, Trans, Queer, and Two-spirit (LGBTQ2S+) populations experience worse health outcomes compared to age-matched heterosexual and cisgender peers. Health professionals’ deficient knowledge and negative attitudes can contribute to these inequities. Healthcare trainees report insufficient LGBTQS2+ cultural competence training. Methods: In this prospective, mixed-methods pre-post design, Atlantic Canadian health students were tested on knowledge, attitudes and self-reported behaviours towards LGBTQ2S+ populations in healthcare settings. Assessment included psychometric measurements and clinical cases involving normative and non-normative fictional patients. Participants were randomised to intervention or control groups. The intervention consisted of three training sessions lead by LGBTQ2S+ experts and elders from the community. The control group continued with usual training. Full assessment was repeated after training. We also held focus group discussions with students and faculty. Results: The intervention group significantly improved attitudes toward and knowledge of LGBTQ2S+ populations and changed relevant aspects of their performance in the simulated clinical situations. Focus groups identified key gaps in current local training. Conclusions: Integrating specific training related to LGBTQ2S+ health within health professions programs is an important step toward improving these populations’ accessibility to a competent, exhaustive and nurturing healthcare. Additional research on innovative means to expand and broaden the scope of our training is warranted.

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Cancer Screening Considerations and Cancer Screening Uptake for Lesbian, Gay, Bisexual, and Transgender Persons

Cited by 55 publications

References 45 publications

Disparities in Health Information-Seeking Behaviors and Fatalistic Views of Cancer by Sexual Orientation Identity: A Nationally Representative Study of Adults in the United States

Disparities in Health Information-Seeking Behaviors and Fatalistic Views of Cancer by Sexual Orientation Identity: A Nationally Representative Study of Adults in the United States

National Survey of Oncologists at National Cancer Institute–Designated Comprehensive Cancer Centers: Attitudes, Knowledge, and Practice Behaviors About LGBTQ Patients With Cancer

Improving the LGBTQ2S+ cultural competency of healthcare trainees: Advancing health professional education.

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