27 November 2023
5 minutes of reading
According to a report published in JCO Oncology Practice, significant progress has been made in reducing cancer treatment disparities among sexual and gender immigrants since ASCO’s 2017 place statement on the subject.
Charles S. Kamen, PhD, co-chair of the ASCO Sexual and Gender Minorities Task Force and the report’s lead artist, asserts that there is still much work to be done.
In an interview with Healio, Kamen stated that” ASCO recognized the need to look thoroughly at sexual and gender majority cancer patients and getting a sense of what the requirements are for this individual people.” In order to truly consider where we stood in terms of providing high-quality cancer treatment to sexual and gender majority people, what the spaces were, and where ASCO is best positioned to make an impact,” they convened a team that was led by Jennifer J. Griggs, MD, MPH, Shail Maingi, PhD.”
Quality improvement, workforce development and diversity, patient education and support, research, and policy were the five main areas identified in the 2017 position paper for potential improvement in sexual and gender minority (SGM ) patient care. The ASCO Sexual and Gender Minorities Task Force was established in 2019 with the intention of achieving the objectives outlined in the place declaration for 2017. Kamen and Healio discussed the advancements made in these areas as well as the ongoing developments.
What five pillars were identified in the 2017 location statement, and how have they been strengthened?
Kamen: The initial foundation was excellent enhancement. Over the past six years, the series of sexual orientation and gender identification information has received a lot of attention in addressing discrepancies in SGM populations. The fundamental tenet of this is that a gap that you cannot see cannot be addressed. There is no way to predict whether your clients will experience worse benefits from their cancer treatment if you are not compiling information on which individuals are sexual or gender minority. They cannot be guaranteed to have access to clinical studies at the same price as patients who are homosexual or transgender. It is impossible to tell if their care partners are receiving the same treatment as partners who are homosexual or cis.
For the past six years, we have concentrated on gathering high-quality sexual orientation and gender identity information. Because so much has happened in that area since we wrote the State of Cancer Care in America ( SOCCA ) manuscript, that ended up being the first pillar we discussed.
A funding opportunity has been established by the National Cancer Institute for cancer centers to consider how to implement sexual orientation and gender identity ( SOGI ) data collection. ASCO has been assisting us and visiting oncology facilities all over the nation to conduct interviews with participants about the challenges they encounter when gathering SOGI files. The base of the quality enhancement foundation is therefore SOGI data set.
What can you show us about the status of the remaining columns, Healio?
Workforce growth and variety are the following wall, according to Kamen. The oncology labor is trained and equipped to work with SGM people in a culturally sensitive and polite manner thanks to this pillar’s emphasis on diversity, equity, and participation. Additionally, it is concentrated on ensuring that SGM individuals have access to a network and help in the oncology workforce, allowing them to advance and be happy with their work.
The second-largest study area in the last six years has been SOGI data set education for oncology providers. People have been discussing how we can ensure that oncology specialists and those working in public health care are ready to collaborate with SGM individuals. In this area, some thoughtful and thorough education programs have been created and distributed.
There is still a lot of work to be done because attendees of these training classes frequently now comprehend the need to enhance treatment for the SGM inhabitants. Getting this education for the individuals who need it the most is the challenging part. The other half is giving SGM oncology employees training and support. I believe that portion of the wall has been supported by the DEI activity across the nation. In addition to racial and ethnic diversity, some organizations even consider sexual orientation, gender identification, and illness.
Support and patient education are the fourth wall. It is obvious that sexual and gender minority people require supplies and interventions. There has been some advancement; in the past, husbands and wives were mentioned in papers for caretakers. The wording is now much more inclusive. Although the materials are now much easier to access for SGM groups than they once were, there is still a need for patient training and assistance with regard to issues that are specific to the group. For instance, a trans patient receiving chemotherapy may be curious as to whether they can continue taking their gender-affirming hormones. Or a gay man with intestinal cancer may be curious about the safest time to begin anal sex. We have come a long way, but there is still room for more attention in this area.
Because we need to comprehend the disease of cancer in SGM populations, the third pillar—research—is focused on the collection of SOGI information. We also struggle to ensure that SGM people are fairly included in medical trials without SOGI data. The good news is that NCI is interested in this field and that they have awarded a grant especially to educate SGM cancer experts. Since some of these questions regarding individual training and assistance can only be addressed through research, it is obvious that there is still a need for more study.
Plan is the second pillar. Since 2017, this is where we’ve seen the most back and forth. More anti-SGM rules are currently in effect than they were in 2017.
Therefore, it is obvious that there is still a need for specialists to participate on the plan front. Doctors can look within to make sure that their organization’s plans ensure equality for SGM communities and their caregivers, despite the fact that there are significant events occurring nationally that are n’t really friendly to those who have SGA. You can also work to enact policies that are supportive of SGM patients even if you are unable to participate in regional lobbying.
What does our expert readers do to enhance the care provided to their SGM patients, asks Healio?
Kamen: I did emphasize the value of gathering SOGI information. If doctors regularly gather information on physical orientation and gender identity, they can take that into account. They may think about where it is kept in the medical history and how to use it to guide the provision of high-quality attention.
I should also point out that overcompensating by assuming things is different from knowing everything about a victim’s orientation or gender identity. The best course of action is to begin generically by inquiring about their chosen nouns. You should n’t assume your patient is gay if he is a man and his caregiver is another man. Who do we have with us now, you may ask? And allow the person to create the other person however it is convenient for them.
Additionally, I would advise oncologists to review the nondiscrimination policies at your institution to make sure they take gender identity and sexual orientation into account as statuses that wo n’t be discriminated against.
The last point I want to make regarding SGM health ownership is that we need to consider intersectionality. This is crucial for any majority standing, but when discussing SGM health equity, it has turned into a linchpin for us. In a program that is also racist, misogynistic, or biased on any other basis, we are unable to handle homophobia or transphobia.
References:
More details are available:
At the University of Rochester Medical Center, School of Medicine and Dentistry, 601 Elmwood Ave., Box 658, Rochester, NY 14642, Charles S. Kamen, PhD, MPH, can be reached via internet at [email protected]. university.
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