ASPO Abstracts
Pink is one of my least favorite colors
Category: Cancer Health Disparities
Conference Year: 2023
Abstract Body:
Purpose: We aimed to 1) describe the experiences of LGBTQ+ breast/chest cancer survivors and support people (informal caregivers) and 2) examine oncology clinicians' perceptions about LGBTQ+ breast/chest cancer care needs. Methods: This prospective qualitative study leveraged a community-engaged approach. We collected clinical and sociodemographic data and performed semi- structured interviews with LGBTQ+ breast cancer survivors (n=16), support persons (n=10), and providers (n=20) regarding LGBTQ+ breast/chest oncology care. Interview transcripts were independently coded using NVivo qualitative software and analyzed with grounded theory qualitative analysis to identify emergent themes. Results: Only 38.5% of survivors disclosed sexual orientation or gender identity to all cancer providers, with a majority (76.9%) indicating that clinic staff did not collect this information at registration. While support persons often felt included in medical decisions (88.9%), only 66.7% reported being very satisfied with medical care overall. Only 7.7% reported that patient education materials reflected people like themselves or their family. Qualitative themes related to the influence of LGBTQ+ identity on care among our survivors and support people were: 1) survivor agency in shared decision making, 2) inclusion of support people in care, 3) sources of breast cancer knowledge, and 4) effects of treatment on sex, gender, the body, and intimate relationships. There was variability in clinician training, experiences, and comfort level in providing LGBTQ+ cancer care across clinical disciplines. Majority (61.5%) of respondents reported confidence treating LGBTQ+ patients, but only (38.5%) report being knowledgeable about transgender health needs, with a majority (92.3%) expressing interest in further education. We found five themes from clinicians related to gaps in care for LGBTQ+ survivors: 1) training in care of LGBTQ+ people, 2) disclosure of patient SOGI, 3) involvement of support person, 4) resources for patients, families, and clinicians, and 5) dating, body image, and sexual function. Conclusion: This work reinforces the need for clinical education, resources, and interventions for care of LGBTQ+ people with breast/chest cancer.
Keywords: Sexual and gender minority, Cancer survivorship, Breast cancer, Cancer care delivery, Health disparities