Take Charge

Moffitt Tackles LGBTQ Health Care Disparities Through Education

January 16, 2019

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By Kim Polacek

The lesbian, gay, bisexual, transgender and queer/questioning (LGBTQ) community has long been a medically underserved minority population in the United States. Disparities experienced by LGBTQ patients, especially in cancer care, can lead to poorer outcomes and overall health. Moffitt Cancer Center is leading the nation in addressing the issues facing this group of patients through research and the creation of new educational programs.

Moffitt launched the first nationwide survey to identify potential gaps in attitudes, knowledge and institutional practices for LGBTQ patients. The results were published today in the Journal of Clinical Oncology. The research team, led by Matthew Schabath, Ph.D., surveyed 450 oncologists from 45 National Cancer Institute-designated cancer centers and received 149 (33.1 percent) responses. The results show that while a majority of oncologists (95.3 percent) were comfortable treating lesbian, gay and bisexual patients, only half (53.1 percent) were confident they knew the health needs of that patient population. And that number dropped dramatically for transgender patients; just over a third of oncologists (36.9 percent) surveyed felt they understood the needs of transgender patients.

Other key findings include:

  • 8 percent of oncologists agreed it is important to know the gender identity of their patients
  • 6 percent of oncologists said it is important to know a patient’s sexual orientation
  • 4 percent of oncologists were interested in receiving education regarding the unique health needs of LGBTQ patients

“Three to 12 percent of the U.S. adult population identifies as LGBTQ. Studies show the LGBTQ population has an increased risk and poorer outcomes for certain cancers, but despite that increased risk, they are less likely to go to the doctor for screenings. This group also reported lower satisfaction with cancer care,” said Schabath, lead study author. “Our survey identified there is need and a desire among oncologists for education and training about LGBTQ patients.” 

Utilizing the information gathered in the survey, Moffitt researchers teamed with Sylvester Comprehensive Cancer Center at the University of Miami and UF Health Cancer Center at the University of Florida to create an online cultural competency training program to improve knowledge of LGBTQ-related issues among the cancer care community.

The Curriculum for Oncologists on LGBTQ populations to Optimize Relevance and Skills, or COLORS Training Program for short, contains four 30-minute modules. Two modules cover general topics, such as sexual orientation and gender identity. The remaining two modules discuss oncology-focused topics, including fertility and hormone therapy for LGBTQ patients undergoing cancer treatment. 

“The COLORS training program can substantially improve oncologists’ knowledge and attitudes regarding LGBT cancer patients, which in turn can lead to better care for this patient population,” said Schabath.

In the pilot study, 20 Florida oncologists participated in the online training and provided feedback. The oncologists ranged in age from 38 to 71, and three-quarters of them identified as heterosexual and cisgender (people whose gender identity match the sex they were assigned at birth).

Prior to online training 33 percent of participants could answer more than 90 percent of the LGBTQ knowledge items correctly. After training that finding jumped to 85 percent. And 95 percent of the group said they would refer another oncologist to the training.

The survey study was supported by a Miles for Moffitt Milestone Award and Moffitt’s Cancer Center Support Grant from the National Cancer Institute. Funding for the COLORS Training Program was provided by the Florida Academic Cancer Center Alliance. The researchers are seeking additional funding to expand the training program to reach oncologists across the U.S.