Quality of cancer care for sexual and gender minorities

• Applicant: Dr. Andreas Köhler
• Subject Area: Public Health, Healthcare Research, Social and Occupational Medicine ; Hematology, Oncology
• Term: since 2024
• Project identifier: Deutsche Forschungsgemeinschaft (DFG) - Project number 538415499

Sexual and gender minority (SGM) individuals experience significant social disparities (e.g., discrimination, stigma, violence) that affect overall well-being and quality of life. With regard to healthcare, they often encounter limited access to certain healthcare services, refusal of care, a lack of culturally and SGM-competent care, and discrimination and bias from healthcare providers. Overall, these factors also lead to increased health risk factors (e.g., risk behaviors) and decreased healthcare utilization. With cancer as one of the leading causes of death globally, cancer care is a critical area in which addressing the specific needs of SGM individuals might be especially important. There is evidence that SGM populations have increased overall rates of cancer diagnoses, a higher incidence of specific cancers (e.g., HPV-associated cancers), and higher rates of certain cancer risk factors and behaviors (e.g., smoking). Even though there has been emerging research into several topics concerning SGM populations affected by cancer within the last few years, notable gaps in research still exist (e.g., regarding representative recruiting, measurement of healthcare quality). The manifold healthcare disparities faced by SGM populations and the existing gaps in research can be assumed to have an overall negative effect on the quality of cancer care in this population. The present study aims to outline the major research gaps and future study priorities regarding the quality of cancer care for SGM individuals. A systematic literature review, a cross-sectional survey of cancer care providers, and a cross-sectional survey of SGM individuals with cancer should be conducted. By applying a patient- and community-centered approach in an international, multi-center setting, we want to generate a comprehensive understanding of the cancer care-related needs and requirements of SGM individuals and their cancer care providers. The study aims to answer the following research questions: 1. What gaps in quality of care research in SGM individuals with cancer exist? 2. What educational preferences do cancer care providers have to improve their clinical preparedness and, therefore, the quality of care for SGM individuals with cancer? 3. What are the healthcare and research priorities of SGM individuals with cancer and their cancer care providers? The approach used in the present study should map out the direction of future quality of care research in SGM individuals with cancer and ensure that the priorities of healthcare providers and patients are sufficiently met in all their complexity. Clinically, the present study could improve cancer-related healthcare for SGM individuals by supporting the delivery of tailored and patient-centered approaches for this population.

• DFG Programme: WBP Fellowship
• International Connection: USA
• Host: Professor Kathryn Whetten, Ph.D.