Care delivery, patient experiences, and health outcomes among sexual and gender minority patients with cancer and survivors: A scoping review

Abstract

Sexual and gender minorities (SGMs) face a disproportionate burden of cancer, yet little is known about the experiences and specific needs of these underserved populations in cancer care delivery. The authors conducted a scoping review to characterize the literature on cancer care delivery, health outcomes, and health care experiences for patients with cancer and survivors identifying as SGM. In total, 1176 peer‐reviewed citations were identified after a systematic search of the PubMed/Medline, PsycInfo, Cumulative Index of Nursing and Allied Health Literature (CINAHL), and Web of Sciences databases without restriction on publication date. The details captured included study aims, design, population, cancer site, and main findings. Thirty‐seven studies published from 1998 to 2017 met the study criteria. Most studies were conducted in the post‐treatment survivorship phase of the continuum (n = 30), and breast cancer was the most common cancer site (n = 20). There were only 2 intervention studies. The studies reviewed were classified under the following areas of focus: 1) disclosure of sexual orientation and gender identity, 2) quality of care, 3) psychosocial impact of/ adjustment to cancer, 4) social support, 5) sexual functioning, and 6) health risks/health behavior. Very little research reported an assessment of gender minority status or included a focus on gender minorities (n = 7). This review revealed substantial research gaps given a lack of population‐based data and small sample sizes, likely related to the absence of systematic collection of sexual orientation and gender identity information in the cancer care context. Deficient research in this area likely perpetuates health disparities. Further research is needed to identify and remove the barriers to delivering high‐quality care to SGM individuals with cancer.

Health outcomes of sexual and gender minorities after cancer: a systematic review

“…The study did not include studies that focused only on experiences of care (such as patient satisfaction) unless at least one health-related patient-reported outcome was also included as an endpoint. For a recent review that includes studies of patient satisfaction [ 101 ], care decision-making [ 102 , 103 ], provider training for improved SGM care [ 104 ], supportive care needs [ 104 , 105 ], and other disparities affecting SGM persons [ 106 ], see Kent et al [ 107 ]. These studies were not included here, because our focus was on patient-reported outcomes as a result of cancer and treatment rather than satisfaction or care experiences in treatment.…”

Addressing the needs of cancer survivors during the COVID-19 pandemic

“…Notwithstanding the potential benefits of technology in this setting, it is important to recognize that the current crisis may pose further challenges to communities that have under "normal circumstances" faced barriers to healthcare access, such as those living in rural environments, as well those low-income, uninsured or underinsured, racial/ethnic minority, and sexual minority medically underserved cancer survivors [27,28]. Whereas for some populations, rapidly developing implementation of telemedicine options may provide new ways to access care and help to break down existing barriers, not all will be served by such measures.…”

Every urologist and oncologist should know about treating sexual and gender minority prostate cancer patients: translating research findings into clinical practice

“…To facilitate research on SGM disparities, NIH has encouraged clinics to routinely collect SOGI in the patient electronic record (61). Some clinics have resisted this citing acceptability concerns about their conservative, cisgender, heterosexual patients being offended by being asked about their sexual orientation or seeing a non-binary question on gender.…”