LGBT Cancer Research Articles

Overall Satisfaction with Cancer Care Among Sexual and Gender Minority People and Their Utilization of Identity-Tailored Health Education Materials.

Purpose: This study was conducted to understand whether health education materials made specifically for members of sexual and gender minority (SGM) groups play a pivotal role in SGM cancer survivors' care satisfaction and experiences. Methods: We identified 2250 SGM cancer survivors who completed the "OUT: National Cancer Survey," conducted by the National LGBT Cancer Network in 2020-2021, and classified participants by their self-reported satisfaction with overall cancer care. We examined care satisfaction in relation to use of SGM-tailored health education resources and factors surrounding their SGM identities, which may influence their satisfaction, including feelings of safety with care teams. Results: Regardless of satisfaction with overall care, substantial proportions of survivors reported lacking vital health education resources specific to their SGM identities in areas of mental health (69%), physical activity (91%), tobacco use cessation (89%), and alcohol consumption (86%), despite attributing value to these materials. Contextualizing SGM survivor satisfaction with care, it was notable that among SGM survivors who felt safe with members of their care team knowing their SGM identity, only 3% were less than satisfied with their overall cancer care, compared to 38% who felt unsafe. Conclusion: SGM survivors value tailored information and health education resources that incorporate their intersectional identities. More research must be done to elucidate why SGM survivors do not receive these materials, while creating spaces where they feel safe receiving care. Increased delivery of SGM-tailored materials and prioritization of SGM safety in health care may have implications for overall cancer care satisfaction among SGM survivors.

Palliative and End-of-Life Care for LGBT+ Cancer Patients: Scoping the Problems and Identifying the Solutions

ObjectivesPeople who identify as lesbian, gay, bisexual, and transgender (LGBT+) face inequalities in healthcare and are receiving less palliative and end-of-life care than others with a comparable need. Since the global resolution to improve palliative care made by the World Health Assembly, the World Health Organization, and member states, some progress has been made. However, LGBT+ people are discriminated and marginalized, which leads to suboptimal palliative care. Research on the needs of LGBT+ people and their access to palliative care is limited. Therefore, the aim of this discussion article is to scope unique problems around palliative and end-of-life care for LGBT+ people and identify possible solutions to address these problems with direct links to nursing practice. Data sourcesJournal articles and author experience were used for this discussion article. ConclusionOncology nurses need to be educated in communication skills, specific assessment tools, and awareness of the history of LGBT+ people. Increasing knowledge for cancer nurses is pivotal because this affects their views, needs, and perceptions in providing palliative and end-of-life care. Implications for Nursing PracticeOncology nurses have a pivotal role in caring for all cancer patients at the end of their life. LGBT+ patients and their caregivers need competent nurses to support them, especially during transitions. Implementing LGBT+-inclusive education, training, and practice will improve outcomes for LGBT cancer patients and their caregivers, and potentially all patients. More research is needed to implement such training in nursing education. (“LGBT+” has been used throughout the article. There are many arguments in favor of using different variations of the acronym, but for purposes of understanding and ease, LGBT+ is the acronym of choice here.)

Review of LGBT Populations and Cancer in the Global Context.

LGBT HealthAhead of Print Review of LGBT Populations and Cancer in the Global Context—Reviewed by NFN Scout—Reviewed by NFN ScoutAddress correspondence to: NFN Scout, MA, PhD, National LGBT Cancer Network, 11 S. Angell Street, Suite 377 Providence, RI 02906 USA E-mail Address: scout@cancer-network.orgSearch for more papers by this authorPublished Online:19 Jun 2023https://doi.org/10.1089/lgbt.2022.0376AboutSectionsView articleView Full TextPDF/EPUB Permissions & CitationsDownload CitationsTrack CitationsAdd to favorites Back To Publication ShareShare onFacebookTwitterLinked InRedditEmail View article"Review of LGBT Populations and Cancer in the Global Context." LGBT Health, , pp. FiguresReferencesRelatedDetails Volume 0Issue 0 InformationCopyright 2023, Mary Ann Liebert, Inc., publishersTo cite this article:—Reviewed by NFN Scout.Review of LGBT Populations and Cancer in the Global Context.LGBT Health.ahead of printhttp://doi.org/10.1089/lgbt.2022.0376Online Ahead of Print:June 19, 2023PDF download

Unique Issues Facing Sexual and Gender Minorities in Cancer.

There are few resources available that help providers understand unique issues sexual and gender minority (SGM) people face related to cancer screening and care. This article helps fill the gap by providing some of the top-line issues providers and policymakers should know, as assembled by one of the leading experts in this field, the executive director of the National LGBT Cancer Network. The sexual and gender minority (SGM) cancer field has matured significantly in recent years, providing greater insight into the barriers and challenges experienced by this population. Not only are risks of cancer for the population higher, but SGM people also experience low access to tailored resources and ultimately lower satisfaction with care after treatment. This article will lay out key issues related to cancer and this population, including changing demographics, no presumption of care, other access to care barriers, systematic data suppression, and then the lack of population-specific cancer research. It will also review the first step in building a more welcoming clinical practice and give resources for additional steps.

Abstract B112: Overall satisfaction with cancer care in a lesbian, gay, bisexual, transgender, queer and intersex population

Abstract Background: Lesbian, gay, bisexual, transgender, queer, and intersex (LGBTQI+) people living with cancer have unique health considerations that must be assessed to provide high quality, individualized patient care. LGBTQI+ health education materials may play a pivotal role in cancer survivors’ (“persons on a cancer journey”) experiences throughout their cancer care continuum. Methods: We identified 2,500 LGBTQI+ persons on a cancer journey who completed the “OUT: National Cancer Survey,” conducted by the National LGBT Cancer Network in 2020-2021, and classified participants by their self-reported level of satisfaction with their overall cancer care. We examined care satisfaction in relation to patient access to LGBTQI+-tailored health education resources and the influence of gender identity and/or sexual orientation on survivors’ experiences before, during, and after cancer treatment. Results: Most persons on a cancer journey reported lacking access to vital health education resources specific to their LGBTQI+ identities in areas of mental health (70%), physical activity (91%), tobacco cessation (89%), and alcohol consumption (86%), regardless of their satisfaction with overall care. Further, the majority of participants believe it would be valuable to receive tailored LGBTQI+ education materials specifically in areas of mental health (80%) and physical activity (67%), while also incorporating information specific to LGBTQI+ individuals into their post-treatment care plans (74%). Conclusion: LGBTQI+ persons on a cancer journey value information and health education materials that are tailored. Increased access to such materials may have large implications for the satisfaction of LGBTQI+ cancer persons on a cnacer journey with their overall cancer care. Citation Format: Colin Burnett, William Jesdale. Overall satisfaction with cancer care in a lesbian, gay, bisexual, transgender, queer and intersex population [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr B112.

Special Healthcare Services for Lgbt Cancer Patients

<p>In the UK, a concern of prejudice, as well as a lack of gender identity and sexual orientation documentation, implies that LGBT persons mostly hidden to health-care providers. One of a review was carried out to examine primary literature on the psychological support requirements of LGBT cancer patients when receive treatment and after. Important findings: Key topics that have been mentioned include the negative impact on mental health, health care professional education and the absence of inclusive support groups, the pervasiveness of discriminatory practices within healthcare services. The research demonstrates how LGBT cancer patients are being failed by healthcare professionals in terms of psychological support, resulting in unmet requirements. There are some suggestions use to guarantee an LGBT inclusive atmosphere in cancer care, as well as the development of support programmes for LGBT people with cancer. Practical connotation: LGBT wellness and awareness education should be offered for HCP personnel. The registration and tracking of gender identity and sexual orientation is critical to ensuring that LGBT persons are not 'invisible' in cancer, radiation, and continued studies. LGBT cancer groups and services should be established, since information from the study indicated that LGBT individuals are actively seeking these services.</p>

Impacts of psychological wellbeing with HIV/AIDS and cancer among sexual and gender minorities: A systematic review and meta-analysis.

The agony and economic strain of cancer and HIV/AIDS therapies severely impact patients' psychological wellbeing. Meanwhile, sexual minorities experience discrimination and mental illness. LGBT individuals with cancer and HIV/AIDS play two roles. It is important to understand and examine this groups mental wellbeing. The purpose of this study is to synthesize current studies on the impact of HIV/AIDS and cancer on LGBT patients' psychological wellbeing. This research uses a systematic literature review at first and later stage a meta-analysis was run on the same review. In this study, data from Google academic and Web of Science has been used to filter literature. PRISMA 2020 Flow Diagram seeks research on LGBT cancer and HIV/AIDS patients. The above sites yielded 370 related papers, some of which were removed due to age or inaccuracy. Finally, meta-analyses was done on 27 HIV/AIDS and 33 cancer patients's analyse. The research included 9,898 LGBT cancer sufferers with AIDS and 14,465 cancer sufferers with HIV/AIDS. Using meta-analysis, we discovered the gap in psychological wellbeing scores between HIV/AIDS LGBT and non-LGBT groups ranged from -10.86 to 15.63. The overall score disparity between the HIV/AIDS LGBT and non-LGBT groups was 1.270 (95% CI = 0.990-1.560, Z = 86.58, P < 0.1). The disparity in psychological wellbeing scores between cancer LGBT group and general group varies from -8.77 to 20.94 in the 34 papers examined in this study. Overall, the psychological wellbeing score disparity between the cancer LGBT subset and the general group was 12.48 (95% CI was 10.05-14.92, Test Z-value was 268.40, P-value was <0.1). Inflammation and fibrosis in HIV/AIDS and cancer sufferers adversely affect their psychological wellbeing.

Development and assessment of the effectiveness of an LGBT cultural sensitivity training for oncologists: The COLORS training.

11000 Background: Published studies report oncologists have limited knowledge about LGBT health and cancer needs but also report high interest in receiving education regarding the unique health needs of LGBT patients with cancer. As such, our group developed the Curriculum for Oncologists on LGBT populations to Optimize Relevance and Skills (COLORS), an interactive web-based LGBT cultural sensitivity training for oncologists that focused on focused on improving knowledge and communication skill-building. We report here on the results from two single-arm feasibility/acceptability trials and one randomized pragmatic trial (RPT) demonstrating effectiveness of the COLORS training. Methods: The first single-arm trial included 44 oncologists from three cancer centers in Florida and the second single-arm trial included 50 oncology fellows recruited through ASCO. The RPT included 225 oncologists randomly selected for equal distribution across the U.S., and participants were randomly assigned to either the COLORS training or a publicly available, web-based LGBT comparison training. Each of these studies included pre- and post-training assessments of LGBT-related knowledge, attitudes, and affirming practices. The RCT included a 3-month follow-up assessment to gauge retention of LGBT-affirming knowledge, attitudes, and practices over time. Results: Both single arm trials demonstrated that the COLORS training was feasible, acceptable, and results from the pre- and post-training assessments suggested the training improved knowledge, attitudes, and affirming practice behaviors. In the RPT, those randomized to COLORS demonstrated significant improvements in LGBT-related attitudes pre- to post-training (p &lt; 0.01), and no significant changes in attitudes were observed among those randomized to the comparison training (p = 0.98). Both trainings yielded significant (p &lt; 0.01) increases from pre- to post-training in LGBT-affirming practice behaviors. Likewise, both trainings yielded significant (p &lt; 0.01) improvements in knowledge from pre- to post-training. Similar significant findings were observed when we analyzed the 3-month follow-up assessment. Conclusions: Results from the prior single-arm trials and the current RCT demonstrate that the COLORS training is effective in improving oncologist knowledge, attitudes, and affirming clinical practices related to the care of LGBT patients with cancer. Part of this work was funded by the Bristol Myers Squibb (BMS) Foundation and BMS Company.

Developing Standards for Cultural Competency Training for Health Care Providers to Care for Lesbian, Gay, Bisexual, Transgender, Queer, Intersex, and Asexual Persons: Consensus Recommendations from a National Panel

Purpose:Lesbian, gay, bisexual, transgender, queer, intersex, and/or asexual and other sexual and gender diverse persons (LGBTQIA+ or SGD persons) experience barriers to equitable health care. The purpose of this article is to describe a collaborative process that resulted in core cultural competency recommendations addressing training for those who provide health care and/or social services to LGBTQIA+ patients.Methods:In 2018 and 2019, Whitman-Walker Health, a Federally Qualified Community Health Center in Washington, DC, and the National LGBT Cancer Network purposively selected leaders of community clinics and community-based organizations, cultural competency trainers, and clinicians and researchers with expertise in SGD health with diverse lived experiences to develop consensus-based cultural competency recommendations. Recommendations were developed through a synthesis of peer-reviewed studies, publicly accessible curricula, and evaluations of SGD cultural competency trainings; two in-person convenings; and iterative feedback from diverse stakeholders.Results:Five anchoring recommendations emerged: (1) know your audience; (2) develop and fine-tune the curriculum; (3) employ both adult and transformational learning theories; (4) choose multiple effective trainers; and (5) evaluate impact of training. These recommendations promote an ongoing process of individual and organizational improvement and a stance of humility rather than competence to be mastered.Conclusion:By setting core cultural competency standards for all persons involved in health care and social services, these recommendations complement existing clinical competency recommendations to advance SGD health equity.

Assessing the effectiveness of a LGBT cultural competency training for oncologists: study protocol for a randomized pragmatic trial

BackgroundLGBT patients may have unique psychosocial cancer care needs, and healthcare providers should have knowledge and understanding of these unique needs to effectively address disparities through the delivery of personalized healthcare. As such, our group developed and piloted a web-based LGBT cultural competency training designed specifically for oncologists called the Curriculum for Oncologists on LGBT populations to Optimize Relevance and Skills (COLORS). We designed a randomized pragmatic trial for oncologists to compare the effectiveness of the COLORS training versus a general online LGBT cultural competency training in improving LGBT-related knowledge, attitudes, and clinical practices.Methods/designStudy procedures include an 8-step approach for recruitment, randomization, retention, and completion of the interventions. Oncologists of any subspecialty who are currently practicing physicians will be identified from the American Medical Association Masterfile. Approximately 5000 oncologists will be sent a FedEx envelope with an invitation letter and study timeline. Electronic consent is obtained using a secure REDCap (Research Electronic Data Capture) portal hosted at the Moffitt Cancer Center (Tampa, FL) where the oncologists will complete the eligibility questionnaire, pre-training assessments, and then will be randomized to complete the COLORS training or an online general healthcare training offered by the National LGBT Health Education Center. Effectiveness of both trainings will be assessed utilizing self-reported measures of LGBT-related knowledge, attitudes, and affirming clinical practices. The measures will be collected before and directly after training completion, as well as 3-month post-training completion. The primary outcomes are changes in knowledge, attitudes, and practice behaviors regarding LGBT cancer patients from pre-test to post-test training in the COLORS training vs. the comparison training.DiscussionThe overarching premise of this trial is to assess the effectiveness of the COLORS cultural competency training program. If successful, among oncologists who completed the COLORS training should yield statistically significantly improvements in knowledge, attitudes, and affirming practice.

Abstract IA-14: Findings from Out: The National Cancer Survey

Abstract For approximately six months in 2020-21 The National LGBT Cancer Network fielded Out: The National Cancer Survey. A total of 2,700 respondents were received. While only a small fraction of the estimated 100,000 LGBTQI people in the U.S. who are diagnosed with cancer every year, this represents the largest such survey of its kind, yielding new insights into the experiences of LGBTQI people with cancer. Top themes of responses included the following: while many reported welcoming care trans or BIPOC people reported less welcome; getting support for our families of choice was more complicated; few could access desired tailored resources; and there was a reported level of rudeness that may represent micro-aggressions. This presentation will give an overview of the major findings and further areas of inquiry emerging from these findings and present back reflections on what these data say about future areas of mainstream and LGBTQI cancer research. Citation Format: Scout. Findings from Out: The National Cancer Survey [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr IA-14.

Impact of an LGBTQ Cultural Competence Training Program for Providers on Knowledge, Attitudes, Self-Efficacy, and Intensions

ABSTRACT This paper describes the development and implementation of a robust lesbian, gay, bisexual, transgender, and queer (LGBTQ) cultural competence curriculum for training health and human service providers across New York State. Between 2013–2018, The National LGBT Cancer Network developed and published Best Practices in Creating and Delivering LGBTQ Cultural Competency Trainings for Health and Social Service Agencies and designed a training curriculum. They also conducted Train the Trainer sessions, and evaluated pre- and post- curriculum knowledge, attitudes, self-efficacy and intentions of individuals who attended educational sessions conducted by the certified trainers. Most respondents improved from pretest to posttest, with significant improvements in knowledge, attitudes, self-efficacy and intentions. An increase in self-efficacy was significantly associated with pre- to posttest improvement in respondent intention. Future research should focus on what components specifically bolster self-efficacy and intention. Increasing the number of health and human service providers who are trained to address the needs of this population is an important step toward providing culturally competent care.

Abstract IA12: Cancer in LGBT populations: Differences, disparities, and strategies for change

Abstract In discussions of cancer research, prevention, and treatment, the needs and experiences of lesbian, gay, bisexual, and transgender (LGBT) people are routinely overlooked. The American Cancer Society estimates, however, that there are more than 130,000 newly diagnosed cases of cancer and more than 45,000 cancer deaths among LGBT people in the U.S. every year. Evidence indicates that LGBT populations are disproportionately affected by specific cancers, such as anal cancer in gay and bisexual men, breast cancer in lesbian women, and viral infection–induced cancers in LGB and transgender people. The drivers of these cancer disparities include risk factors that are often more common among LGBT people, such as tobacco use, nulliparity, and HIV. These risk factors are also compounded for LGBT populations by exposure to social determinants of health that include discrimination and other minority stressors—especially for Black, Indigenous, and other LGBT people of color, who experience discrimination that targets their race or ethnicity as well as their sexual orientation and/or gender identity—lower rates of insurance and other barriers to health care services, and inaccurate assumptions among providers about cancer risk and appropriate screenings, particularly for lesbian and bisexual women and transgender people. For LGBT people who have been diagnosed with cancer, a lack of cultural responsiveness in clinical settings and social and economic challenges outside the doctor’s office can exacerbate the difficulty of navigating cancer treatment. Because data on sexual orientation and gender identity are not routinely collected in cancer registries, clinical records, and other sources of cancer data, the full spectrum of cancer risks, prevention, treatment, outcomes, and survivorship in LGBT communities remains unexplored. LGBT people are also often rendered invisible in cancer research by data collection that does not include sexual orientation or gender identity, by study protocols that make the tacit or overt assumption that all participants are cisgender and heterosexual, and by barriers to participation such as being overlooked in recruitment or even outright excluded from consideration. This presentation provides an overview of cancer disparities in LGBT populations; describes patient-, provider-, and structural-level barriers to effective cancer prevention and treatment; and identifies promising opportunities to expand the evidence base and address LGBT cancer disparities. Citation Format: Kellen Baker. Cancer in LGBT populations: Differences, disparities, and strategies for change [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr IA12.

“Coming out” against cancer: How local outreach to the LGBT community can reduce cancer disparities.

131 Background: Lesbian, Gay, Bisexual, and Transgender (LGBT) individuals make up an estimated 4% of the population, qualifying them as a sexual minority. LGBT individuals are also more likely to be a racial or gender minority, to live in poverty, and to have less social support than their heterosexual peers. LGBT populations are disproportionately affected by mental health issues such as depression, which are correlated not only with behavioral risk factors, but with less likelihood to comply with healthcare screening or treatment. Approximately 30% of LGBT adults do not seek health care services or lack a regular health care provider, compared with 10% of heterosexuals. Research studies demonstrate that knowledge about increased risks and need for screening is low in LGBT populations. Sub-populations are less likely to have had a recent mammogram, anal or cervical Pap, or a prostate exam. Methods: We implemented a population-oriented program into our community outreach team in 2019 to address LGBT cancer disparities. A program manager partnered with community resources and leaders, including the Cleveland LGBT Community Center, Plexus LGBT Chamber of Commerce, and Trans Ohio. First year programming included a mammogram clinic for sexual/gender minority (SGM) women, “Cancer is a DRAG” show, and a tobacco-free campaign for LGBT pride month. Results: Creating meaningful partnerships was extremely important to community leaders and organizations. Strategic plans include direct community input and engagement through a community council, in conjunction with the LGBT Community Center, a breast cancer awareness campaign, in conjunction with local entertainers, and a tobacco cessation program, through our Center for LGBT Care. We educated over 150 people and screened over 85 within the first year. Conclusions: When our healthcare institution met local LGBT people within their community, the result was quite impactful. This pilot program proved successful at educating members of the community about their increased cancer risk, which resulted in higher cancer screening rates for LGBT people. More programs tailored to LGBT-specific health concerns are important to continue reaching these populations and eventually decrease health disparities in the community.

Abstract C021: Characteristics of malignancy in lesbian, gay, bisexual, and transgender/transsexual (LGBT) population

Abstract Background: LGBT people account for 4.5% of adult population in U.S. and face multiple challenges across different aspects of life. Although malignancy is the second most common cause of death in the U.S., only few studies that analyzed the characteristics of malignancies in the LGBT community exist. We aim to provide an overview of malignancy affecting LGBT patients. Methods: A retrospective chart review of LGBT patients with a diagnosis of malignancy treated at Medstar Health Hospitals was performed. Natural language processing with strings was utilized to retrieve patient charts with ICD-9 and ICD-10 codes for LGBT status and cancer. Results: A total of sixty-one patients (pts) were identified; (5 lesbian female, 49 gay male, 6 female transgenders and 1 male transgender). The median age was 49 (range: 19-79). 30 pts (49%) were Caucasian, 26 (43%) were African American and 5 (8%) were Hispanic. Among the female transgender patients, 3 received hormonal therapy for gender change and no patient underwent surgery to change the biological gender. 18 pts had human immunodeficiency virus (HIV) infection, 1 pt hepatitis B virus (HBV), 2 pts hepatitis C virus (HCV), 8 pts HIV/HCV, 2 pts HIV/HBV, and 1 pt HIV/HBV/HCV. Among the patients with HIV infection (n=29), 26 (90%) were receiving anti-retroviral treatment at last follow-up. 27 (44%) pts were active smokers, 10 (16%) pts former smokers and 24 (40%) never smoker. 27 (44%) reported a history of substance abuse with 9 (15%) pts with active substance abuse and 25 (41%) never used it. Employment status was employed (n=32), unemployed (n=20), retired (n=6), and not available (n=3). Tumor types included anal squamous cell carcinoma (anal SCC; n=15), Non-Hodgkin lymphoma (NHL; n=12), non-small-cell lung cancer (NSCLC; n=9), colorectal cancer (CRC; n=7), Kaposi sarcoma (n=4), brain cancer (n=3), breast carcinoma, small-cell lung cancer and pancreatic cancer (2 each), prostate carcinoma, testicular carcinoma, head and neck cancer, Hodgkin lymphoma and mesothelioma (1 each). Among the HIV-infected patients, tumor types include [NHL n=8, anal SCC n=6, NSCLC n=4, CRC n=4, Kaposi sarcoma n=3, head and neck cancer =1, prostate cancer n=1, pancreatic cancer n=1, Hodgkin lymphoma n=1]. Among the anal SCC group (n=15), 6 pts had human papilloma (HPV)-associated cancer, while 1 pt had non-HPV associated cancer and HPV status was not available in 8 pts. Conclusion: LGBT people with cancer have a high incidence of chronic viral infection and appear to have distinct patterns of malignancy compared to those in the general population. Larger studies are needed to verify the findings and to understand unique challenges facing the LGBT population. Citation Format: Ghassan Al-Shbool, Saira Farid, Ahmad Nassar, Chul Kim. Characteristics of malignancy in lesbian, gay, bisexual, and transgender/transsexual (LGBT) population [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr C021.

Abstract C092: Understanding the cancer needs of LGBTQ Latinx communities

Abstract Research targeting the needs of the LGBTQ community and their cancer prevention and screening behaviors is sparse, specifically the LGBTQ Latinx community. According to the National LGBT Cancer Network, the LGBT community is at a higher risk for cervical and oral cancers and are more likely to engage in risky behaviors contributing to these outcomes. Understanding the community’s knowledge and behavior, as well as their interactions with primary care providers (PCP’s), can help further the focus and tailor culturally appropriate educational programs and materials. The needs assessment was conducted in 2018 to better understand the LGBTQ Latinx community’s experience with cancer screening, prevention and risk reduction strategies. The purpose of this first step was to help guide outreach and education efforts to best meet the needs of this often-underrepresented community. The needs assessment survey was conducted using REDCap, a secure web based application designed for research. Respondents were recruited at outreach events throughout Southern California, and with the help of partnering organizations who serve the LGBTQ Latinx community. Upon completion of the survey, respondents were entered into a raffle to win a $50 gift card. A total of 176 respondents have completed the survey thus far. Most (74%) were Latinx, between the ages of 21-39 (57%), identified as cisgender (82%), identified as gay (40%) or queer (28%). Most had shared their gender identity or sexual orientation with all their providers (44%) but respondents who identified as bisexual were less likely to share that information (X2=18.1; p&amp;lt;0.000). Most respondents (73%) have been afraid to share their gender identity and/or sexual orientation with a healthcare provider. Those who identified as queer were more likely to be afraid to share their sexual orientation (X2=12.1 p&amp;lt;0.035). Most (71%) prefer to be seen by an LGBTQ-trained health provider. Most (91%) have never received LGBTQ-tailored cancer information. Of those between the ages 21-29, 60% have not had a Pap test in the last 3 years. Most (53%) have not received the HPV vaccine. Of those eligible, 50% have not had a mammogram in the last 2 years and a third are overdue for their routine colonoscopy. Almost 70% self-report binge-drinking within the last year, with gay men been being more likely to binge drink (X2=15.8; p&amp;lt;0.000). The smoking rate (20%) was almost twice the smoking rate in California (11%). Most (40%) report being exposed to environmental (or secondhand) tobacco smoke, with lesbian women being more likely to report exposure (X2=4.9; p&amp;lt;0.027). Most (78%) practice unprotected sex, with gay men being more likely to report (X2=6.3; p&amp;lt;0.012). Findings from this survey suggest that there is a critical need to educate the LGBTQ Latinx community, with LGBTQ-tailored information regarding cancer screening and prevention. It also suggests an urgent need to train healthcare providers on how to make their practice more culturally competent, safe, and welcoming for LGBTQ Latinx communities. Citation Format: Mayra Serrano, Jenifer Metz, Alejandro Fernandez, Eli Mendelson, Grizell Alvarado, Mireya Munoz, Erika Reyes, Rosario Quintanilla, Dayana Pelayo, Zul Surani. Understanding the cancer needs of LGBTQ Latinx communities [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr C092.

Abstract A063: Feasibility and acceptability of an online LGBT cultural competency training for oncologists: The COLORS training

Abstract Background: LGBT cancer survivors experience substantial disparities in cancer survivorship outcomes, including poorer overall health and lower satisfaction with their oncology care. Researchers and clinicians have called for increased LGBT competency training among oncologists to address health disparities within these underserved communities; however, presently there are few medical schools that require such training. Further, while some general LGBT cultural competency trainings are available, to date, no trainings are tailored to the needs of oncologists specifically. Recently our multi-institutional team developed an interactive online LGBT cultural competency training for oncologists (Curriculum for Oncologists on LGBT populations to Optimize Relevance and Skills [COLORS) and is now piloting the training among oncologists within three cancer centers in the state of Florida. Methods: The development of the online LGBT cultural competency training involved substantial input from LGBT community members and advocates. The training modules included both general and oncology-specific content. After the online training website was finalized, we recruited oncologists from Moffitt, Sylvester, and UF Health Cancer Centers to participate in the training and provide feedback via self-administered questionnaire. Here we report descriptive data on participant sociodemographic characteristics, pre- and post-training LGBT-related knowledge, attitudes, and practices, as well as participant evaluations of the online LGBT cultural competency training. As the study is ongoing, formal significance testing regarding pre-post changes is forthcoming. Results: To date, 20 oncologists, ages 38-71 (30% women; 30% Asian, 5% Black, 60% White, 5% Middle Eastern; 10% Hispanic; 75% cisgender and heterosexual) have completed the training. Pre-training knowledge was low among participants, with only 33% of participants answering &amp;gt;90% of knowledge items correctly. Participant knowledge increased following training completion, with 85% of participants answering &amp;gt;90% of knowledge items correctly. Similarly, changes in attitudes were mostly positive among participants, with 70% of participants reporting an increase in favorable perspectives toward LGBT people after completing the training. Moreover, 80% of participants reported increasing their endorsement of LGBT-serving clinical practices after completing the training. Overall, oncologist evaluations of the training were favorable, with 90% rating the training as either “excellent” or “very good,” and 95% stating they would refer another oncologist to the training. Conclusion: These pilot study results indicate online LGBT cultural competency training may be both feasible and acceptable for oncologists. Our findings will support a larger project to formally evaluate the effectiveness of this training in improving oncologist knowledge, attitudes, and practices, as well as survivorship outcomes for LGBT patients. Citation Format: Julia S. Seay, Matthew Schabath, Amanda Hicks, Merry-Jennifer Markham, Matthew Schlumbrecht, Meghan Bowman, Jennifer Woodard, Neysari Arana, Gwendolyn Quinn. Feasibility and acceptability of an online LGBT cultural competency training for oncologists: The COLORS training [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr A063.

Are we meeting the support needs of LGBT cancer patients and carers in radiotherapy and oncology? A service improvement report

Keywords: LGBT, Psychological, supportive care, healthcare, radiotherapy, oncology. Introduction: 3.6 million people in the UK identify as LGBT [1,2]. LGBT cancer patients are not represented as often as heterosexual patients in research or in provision of resources. Many services can exclude LGBT people and have a heterosexist environment. Mental health issues have been found to be more prevalent in the LGBT community [3, 4], and may indicate a higher incidence of psychological distress after a cancer diagnosis. This research sets out to investigate what current service provision is available within the author’s organisation in terms of psychological support, and how this relates to current guidance within the literature. Method: The methodology employed for this research was in the form of a service improvement proposal that evaluates the services and resources provided for by the author’s organisation for LGBT cancer patients and carers. This includes a literature search of three databases to evaluate current guidance for support needs. Results: Twelve studies were reviewed. The main themes included: health care professional (HCP) knowledge and training, inclusive support groups and resources, prevalence of heterosexism, and any increase in mental health issues. Discussion and Conclusion: Within this particular organisation it was found that inclusive support groups and resources were limited. It is suggested that psychological distress is higher in LGBT cancer patients than in heterosexual patients meaning psychological support and resources are needed for this group. HCPs should provide an inclusive environment where LGBT people can feel safe. Sufficient sexual orientation and gender identity monitoring should be standard to be able to collect data for research and health outcomes. Education of LGBT specific health issues is important in meeting the needs of patients. Recommendations have been made to improve the services to be inclusive within the radiotherapy and oncology department, as well as the need to develop support services for LGBT cancer patients and carers. Education and training must be improved to ensure all HCP’s and support services have sufficient knowledge of LGBT cancer specific issues in order to better support all patients. Numerical

Web‐based LGBT cultural competency training intervention for oncologists: Pilot study results

Lesbian, gay, bisexual, and transgender (LGBT) cancer patients experience substantial health disparities, including poorer overall health and lower satisfaction with their cancer care than their heterosexual and cisgender counterparts, which may be due in part to a lack of culturally competent providers. To address these disparities, a web-based LGBT cultural competency training tailored to oncologists was developed by an interdisciplinary team of scientists, LGBT cancer survivors, cultural competency experts, oncologists, a web designer, and an instructional designer. Oncologists (n=44) were recruited from 3 academic cancer centers in Florida. Participants were administered the LGBT cultural competency training Curriculum for Oncologists on LGBT populations to Optimize Relevance and Skills (COLORS) and completed pre- and posttraining measures regarding LGBT-related knowledge, attitudes (including general negative attitudes and health care-related attitudes), and clinical practices. After the training, participants completed training acceptability measures. Of the 44 participants, 33 (75%) completed the COLORS training. Participants were 55% non-Hispanic white, 63% male, and had a mean age of 47years. Participants demonstrated significant improvements in LGBT-related knowledge (t=-4.9, P<.001), attitudes (Z=-3.0, P=.002; t=-2.5, P=.019), and clinical practices (Z=-3.5, P<.001) after completing the COLORS training (Wilcoxon signed rank tests were used for nonnormally distributed variables). Moreover, training acceptability was high, with 82% of participants rating the training as high quality, and 97% being willing to recommend the training to a colleague. The COLORS training is both feasible to administer and acceptable for use with oncologists, and may improve oncologists' LGBT-related knowledge, attitudes, and clinical practices. Larger trials are needed to examine the training's effectiveness in reducing LGBT cancer disparities, as well as its applicability to other types of care providers.

Online health community experiences of sexual minority women with cancer.

The study sought to explore online health communities (OHCs) for sexual minority women (SMW) with cancer by conducting computational text analysis on posts. Eight moderated OHCs were hosted by the National LGBT Cancer Network from 2013 to 2015. Forty-six SMW wrote a total of 885 posts across the OHCs, which were analyzed using Linguistic Inquiry and Word Count and latent Dirichlet allocation. Pearson correlation was calculated between Linguistic Inquiry and Word Count word categories and participant engagement in the OHCs. Latent Dirichlet allocation was used to derive main topics. Participants (average age 46 years; 89% white/non-Hispanic) who used more sadness, female-reference, drives, and religion-related words were more likely to post in the OHCs. Ten topics emerged: coping, holidays and vacation, cancer diagnosis and treatment, structure of day-to-day life, self-care, loved ones, physical recovery, support systems, body image, and symptom management. Coping was the most common topic; symptom management was the least common topic. Highly engaged SMW in the OHCs connected to others via their shared female gender identity. Topics discussed in these OHCs were similar to OHCs for heterosexual women, and sexual identity was not a dominant topic. The presence of OHC moderators may have driven participation. Formal comparison between sexual minority and heterosexual women's OHCs are needed. Our findings contribute to a better understanding of the experiences of SMW cancer survivors and can inform the development of tailored OHC-based interventions for SMW who are survivors of cancer.