1. Fuerst, Mark L.

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SAN FRANCISCO-People in the Lesbian, Gay, Bisexual, Transgender, Queer or Questioning, and Intersex (LGBTQI)+ Latinx community do not receive tailored cancer-related information and health care, according to the results of a new survey. Most LGBTQI+ Latinx patients have been afraid to share their gender identity and/or sexual orientation with healthcare providers, and most have never received tailored information on cancer prevention and screening.


LGBTQI+ individuals are at higher risk of developing cervical and oral cancers, and Latinx people have higher risk of developing viral-associated cancers, including in the liver and stomach. Yet substantial cancer health disparities exist for both LGBTQI+ individuals and for Latinx people, said Mayra Serrano, MPH, CHES, Manager of the Center of Community Alliance for Research & Education at City of Hope in Duarte, Calif.


"Together, this group is a double minority whose increased risk for certain cancers, unfortunately, is not currently being addressed," said Serrano, who led the ongoing survey project. "We hope that our survey results add to a conversation that needs to be had about how people-regardless of their gender, sexuality, race, or ethnicity-should receive equal and appropriate health treatment and disease prevention education."


Serano presented the survey results at the 12th AACR Conference on The Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved.


Research Details

"If we are to overcome cancer health disparities for the LGBTQI+ Latinx community, we must first understand the needs of the community," said Serrano. "Working with the LatinX Task Force, which is a collaboration between organizations and agencies in the Los Angeles area to create awareness and prevention of cancer in marginalized populations, we conducted a needs assessment survey to help guide future outreach and education efforts to better meet the needs of the LGBTQI+ Latinx community."


The researchers generated an online needs assessment survey to understand cancer-related knowledge and behavior within the LGBTQI+ Latinx community. Respondents were recruited at outreach events throughout Southern California. Upon completion of the survey, respondents were entered into a raffle to win a $50 gift card.


As of June 2019, 176 respondents have completed the survey. Three-quarters of the respondents identified as Latinx; one in five did not specify their racial/ethnic identity; 4 percent identified as mixed race; and one identified as Asian, one as European, one as Native American, and one as Pacific Islander. The majority (82%) identified as cisgender, meaning they exclusively identified as their sex assigned at birth, 40 percent identified as gay, and 28 percent identified as queer.


Three-quarters of the respondents reported having been afraid to share their gender identity and/or sexual orientation with a healthcare provider.


"This strongly suggests that most health care providers are not culturally competent," said Serrano. Examples of a lack of health care provider cultural competency include not using gender neutral terms during conversation and in written materials, and assuming that individuals identify as cisgender and heterosexual during conversations about sexual activity and the need for birth control.


Among the key responses related to knowledge of cancer prevention and screening, according to Serrano, included the following:


* 91 percent of respondents had never received cancer information tailored to the LGBTQI+ community.


* 60 percent of respondents ages 21-29 who were eligible for Pap testing had not had a test in the past 3 years, compared with 22 percent of all eligible individuals in the U.S.


* 50 percent of respondents eligible for a mammogram had not had one in the past 2 years, compared with 29 percent of all eligible individuals in the U.S.



"The survey results show that there is an urgent need for LGBTQI+ Latinx cultural competency training for health care providers and for information tailored to the LGBTQI+ community regarding cancer screening and prevention," said Serrano. "We are collaborating with the Latinx Task Force and local LGBTQI+ organizations to develop educational materials tailored to the LGBTQI+ Latinx community and to develop cultural competency training guides for health care providers."


The main limitations of the study were its small size and its lack of generalizability to all Latinx LGBTQI+ populations because it involved only those in Southern California, she noted.


Conference chair Laura Fejerman, PhD, Associate Professor in the Department of Medicine at University of California, San Francisco, stated: "A huge challenge is availability of data on minority populations. As of today, we don't have as much data available for ethnic minorities as we do for other populations. This significantly limits what we can learn about their disease and circumstances."


Mark L. Fuerst is a contributing writer.


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