ASPO Abstracts
Opportunities and Challenges for Creating Sexual and Gender Minority Cancer Health Equity: Patient and Caregiver Perspectives from a Qualitative Pilot Study
Category: Culture and Cancer
Conference Year: 2021
Abstract Body:
Purpose of the Study: Estimates of up to 1,000,000 Americans with a history of cancer identify as
lesbian, gay, bisexual, or transgender (i.e. Sexual and Gender Minorities (SGM)). SGM
populations experience disproportionate risks for, and rates of, anal, breast, cervical, colorectal,
endometrial, lung, and prostate cancers, as well as cancers affecting transgender persons who
have undergone sex-reassignment procedures. This pilot study documents how SGM patients and
their informal caregivers experience diagnosis, treatment, and the lasting effects of cancer. Based
on in-depth patient and caregiver interviews, we explore to what degree this cancer journey is
influenced by SGM identities, and seek to understand how interdependence between SGM
patients and caregivers effects stress. The goal of this research is to design a multilevel
intervention to improve SGM patient health outcomes, cancer care, and enhance supports for
informal cancer caregivers.
Methods: We are currently documenting the cancer and survivorship care needs of 25 dyads of
SGM cancer patients and their caregivers (n=50) using qualitative interviews to gain insight into
physical, psychosocial, cancer, and SGM specific issues they experience.
Results: Preliminary results from this on-going pilot reveal patient and caregiver apprehension
when entering cancer care. Feelings including anxiety, medical mistrust and trauma are linked to
previous healthcare interactions and/or experiences of stigma and discrimination. Even so, dyads
interviewed are optimistic about improving SGM cancer care, and offer suggestions for
intervention development including: 1) patient and caregiver messaging and self-advocacy; 2)
oncology staff and provider cultural training and communications regarding sexuality and function;
3) caregiver inclusivity; and 4) clinic and system level representation and policy. Dyads also
discuss COVID-19 as an influence in current cancer treatment and recovery.
Conclusions: Although patient/caregiver dyads interviewed to date are satisfied with care received,
our participant number remains too small to cover a full range of patient/caregiver experiences.
Data collected clearly points to understudied and underdeveloped areas in cancer care that must
be addressed to create SGM cancer equity.
Keywords: Sexual and Gender Minorities, Cancer Disparities, Patients and Caregivers