Cancer Care for the LGBTQI+ Community: Addressing Inequalities
In the wake of increasing recognition of inequalities affecting healthcare, addressing inequalities in oncology for LGBTQI+ identities is a topic that has only recently received attention within the healthcare sphere. This report presents outcomes from a workshop organised by the Inequalities Network of the European Cancer Organisation, dedicated to exploring and addressing the inequalities faced by LGBTQI+ individuals within the realm of oncology.
The workshop, attended by LGBTQI+ advocates, clinicians, researchers, and policymakers, aimed to shed light on the unique challenges encountered by this community in accessing equitable cancer care and to strategise ways to mitigate these disparities. Different European and international organisations contributed to the event with presentations, including Utrecht University (UU), the University of Amsterdam (UvA), OUTpatients, the International Lesbian and Gay Association-Europe (ILGA-Europe), the Organisation Intersex International Europe (OII Europe), Transgender Europe (TGEU), the Italian Association of Medical Oncology (Associazione Italiana Oncologia Medica - AIOM) and the American Association for Clinical Oncology (ASCO).
Context
The LGBTQI+ community continues to confront significant disparities in healthcare access and outcomes, with cancer care being no exception. Historically, LGBTQI+ individuals have faced barriers such as discrimination, lack of culturally competent care, and limited access to healthcare services. Moreover, societal stigma and marginalisation have contributed to delayed diagnoses, inadequate screening, and suboptimal treatment options for LGBTQI+ individuals with cancer. For example, a recent publication from the European Union Agency for Fundamental Rights, showed that both mammography and cervical smear tests are taken up at a lower rate among LGBTQI+ people, compared to the general population, with only 10% of the LGBTQI+ population declaring to have had a mammography in the previous year in 2023 (vs. 36% for the general population) and 27% of LGBTQI+ people reporting to have undergone a cervical smear test in the previous 12 months, compared to 36% of the general population. Additionally, the report showed that the rate of intersex people who said they were diagnosed with cancer in the past year was 2%, which is higher than for the general population, which was 0.6%.
The data show that LGBTQI+ people are indeed at risk of experiencing inequalities in cancer care, from the very starting point of the cancer care pathway. Nevertheless, despite this recent publication, the majority of data produced come from North America, with the European region lagging behind when it comes to quantifying and tackling the issue. The persistence of systemic challenges in healthcare, including within oncology, conflicts with the European goal of ensuring that each individual, regardless of sexual orientation, sex characteristics, gender expression or gender identity, receives equitable and compassionate care. Failure to address these disparities not only perpetuates injustice but also undermines efforts to improve health outcomes and reduce the burden of cancer within the LGBTQI+ community.
Consequently, it is essential that the oncology community in Europe improves its awareness of inequities faced by the LGBTQI+ community, as well as for inequities faced by other marginalised communities. This will ensure more equitable cancer care for all.
