Cancer care in transgender and gender-diverse persons: results from two national surveys among providers and health service users by the Italian Association of Medical Oncology.

BACKGROUND

Transgender and gender-diverse (TGD) population represents an underserved group across the cancer care continuum. To assess the perspective of both oncology health care providers (OHPs) and TGD individuals in Italy, we conducted two national surveys: one among 2407 OHPs about their attitudes, knowledge and behavior toward TGD patients, and one among TGD persons about their health needs, experiences and barriers encountered in the use of health services across the cancer continuum.

MATERIALS AND METHODS

The surveys were self-compiled web-based computer-aided web interview, conducted in Italy within the 'OncoGender-Promoting Inclusion in Oncology' project, led by the Italian national cancer society [Associazione Italiana di Oncologia Medica (AIOM)]-associated researchers. All members of AIOM were invited by e-mail to participate in the OHP survey. TGD persons were reached through advocacy groups and consumers' panel. The recruitment was completed on a voluntary basis. Survey data were collected and managed using an online platform managed by ELMA Research, an independent pharmaceutical marketing agency.

RESULTS

A total of 305 OHPs (13% of AIOM members) and 190 TGD individuals participated in the surveys. Only 19% of OHPs felt competent in providing care to TGD patients and 21% declared not to feel comfortable in treating TGD patients. Seventy-one percent of TGD persons reported that they had never joined any cancer screening program; 32% reported one or more acts of discrimination by health care providers. Seventy-two percent of OHPs recognized the lack of specific education on cancer care for TGD patients and deemed it necessary to receive adequate training.

CONCLUSIONS

A general lack of knowledge among OHPs about TGD health issues seems to be the main driver of difficulties in providing assistance and of discriminatory attitudes against TGD individuals. Ultimately, this whole issue generates access barriers and contributes to lack of trust in health care services. Educational interventions and an implementation of person-centric cancer policies are urgently needed.

Informations de copyright

Copyright © 2023 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Déclaration de conflit d'intérêts

Disclosure ML acted in a consulting/advisory role for Roche, Novartis, Lilly, Pfizer, Merck Sharp and Dohme (MSD), Seagen, Gilead, Exact Sciences, AstraZeneca and received speakers’ honoraria from Takeda, Ipsen, Roche, Lilly, Novartis, Pfizer, Sandoz, Libbs, Knight. FPe reports grants from Roche and Pfizer; personal fees from Sandoz, Celgene, Pierre Fabre and Janssen Cilag; grants and personal fees from Incyte and AstraZeneca; and grants, personal fees and non-financial support from Bayer. NLV reports grants from Eisai; speaker bureau from GSK; travel expenses for conferences from Gentili, Celgene, Pfizer; advisory role from Novartis and Celgene; advisor role, travel expenses for conference from Pfizer; advisory board from MSD, Roche, Novartis and Astrazeneca. DD reports grants from Gentili, and travel expenses from Roche, Gentili and Eisai. FM has served as speaker for Servier. MDM received honoraria from Pfizer, Takeda, AstraZeneca, Janssen, Eisai, Novartis, Roche, Astellas Pharma, MSD; research grants from Tesaro and GlaxoSmithKline; acted in a consulting/advisory role for AstraZeneca, Pfizer, Takeda, Janssen, Eisai, Novartis, Roche, MSD, Amgen. FPi received honoraria from Amgen, Merck-Serono, Sanofi, Lilly, Bayer, Servier, Astrazeneca, MSD, BMS, Astellas, Organon, Pierre-Fabre; research grants from Astrazeneca, BMS, Incyte, Agenus. RB received honoraria and/or research grant from BI, EISAI, MSD, Amgen, Roche, Pfizer, Astra Zeneca, Lilly, GSK, BMS. GDB received honoraria and/or research grants from Roche, MSD, Tahio, Servier, Celgene, Ipsen, Sanofi; acted in consultory/advisory role for Roche, Lilly, Eisai, Incyte; has served as speaker for Servier, Clovis Oncology, Ipsen, Lilly, Merck Serono, Amgen, Novartis, BMS. MM declares ELMA is a for-profit agency. All other authors have declared no conflicts of interest.