Abstract
INTRODUCTION: The lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) community is a medically underserved population that suffers from cancer disparities. To identify potential gaps in attitudes, knowledge, and institutional practices toward LGBTQ patients, we conducted a mixed-methods survey of healthcare providers in the ECOG-ACRIN Cancer Research Group. METHODS: A validated, web-based survey was administered to members of the ECOG-ACRIN Cancer Research Group in late 2019. The survey was completed by 490 healthcare providers measuring attitudes and knowledge about LGBTQ health and institutional practices regarding collection of sexual orientation and gender identity data. Results were quantified using descriptive and stratified analyses. RESULTS: Among the 490 healthcare providers that completed the survey, 77% were White, 86% were non- Hispanic, 75% were female, 81% were heterosexual, and the mean age was 46 years. Approximately 47% of the respondents were medical oncologists, 39% practiced in academic medical centers (AMCs), and 49% were from the Midwest/Northeast. As reported by prior institutional and national survey studies, there was high interest (77%) in receiving education regarding the unique health needs of LGBTQ patients, an overall limited knowledge about LGBTQ health and cancer needs, and a significant decrease from survey assessment to postsurvey assessment for confidence in knowledge for LGBT health needs. There was high agreement (71%) regarding the importance of knowing gender identity, which was contrasted with a low agreement (48%) regarding the importance of knowing sexual orientation. Stratified analyses revealed significant differences of some attitude and knowledge items. For example, when stratified by licensure/terminal degree, MD/DO vs. RN/NP/PA were significantly more willing to be listed as a LGBTQ-friendly provider (81% vs. 50%) and reported to be knowledgeable about LGB health needs (69% vs. 53%). Providers at AMCs were significantly more willing to be listed as a LGBTQ-friendly provider (71% vs.53%) believe there should be mandatory education (72% vs. 60%) regarding care of LGBQ patients versus those at non-AMCs. Having family and/or friends who are LGBTQ (vs. none) and political affiliation (conservative vs. liberal) were strong effect modifiers resulting in significant differences for 9 and 8 items, respectively.
CONCLUSION: To our knowledge, this was the first study of cancer care providers in a large cancer clinical trials research group that assessed attitudes, knowledge, and institutional practices of LGBTQ patients with cancer. Consistent with prior studies, there was limited knowledge about LGBTQ health and cancer needs, but high interest in receiving education regarding this community. New and intriguing differences for many attitude and knowledge items were revealed when we stratified the responses by licensure/terminal degree, practice setting, LGBTQ friends and/or family members, and political affiliation.
Citation Format: Matthew B. Schabath, Jaileene Perez-Morales, Megan Sutter, Lynne Wagner, Melissa Simon, Ruth C. Carlos, Bruce J. Giantonio, Gwendolyn P. Quinn, Edith P. Mitchell. Survey of healthcare providers in the ECOG-ACRIN cancer research group: Attitudes, knowledge, and practice behaviors about LGBTQ patients with cancer [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 PO-068.