Sexual minority experiences of cancer care: A systematic review

Abstract

a b s t r a c tThere is a lack of published evidence from within the UK examining the needs of LGB cancer patients. A full systematic review of the worldwide literature was carried out with the aim to ascertain the experiences of sexual minority cancer patients and identify specific needs required.Key databases were searched with a variety of terms relating to the sexual minority cancer experience. Suitable literature was reviewed and references within all articles were search to ensure as inclusive a review as possible. Articles were subject to critical appraisal and scoring using The Support Unit for Research Evidence (SURE 2013) critical appraisal tools to assess eligibility for inclusion within the review. Twenty-five articles were selected for inclusion and were analysed. The papers were categorised into the emerging themes from the literature: Experiences of care (n = 6), Coping and Wellbeing (n = 6), Emotional Support (n = 4), Body Image (n = 3), and Sexual Function (n = 6). The data extraction revealed contrasting views and experiences of LGB individuals' experience of cancer care. Lesbian and gay individuals have different perspectives of cancer care and needs from heterosexuals. Discriminatory attitudes were found to be present in many studies as well as inequalities and gaps within care and support.There is evidence that supports the development of sexual minority specific cancer support groups. Further research of sexual minorities affected by cancer in the UK should be carried out to increase the evidence base and better identify the needs in this cultural group.

Co‐producing knowledge of lesbian, gay, bisexual, trans and intersex (LGBTI) health‐care inequalities via rapid reviews of grey literature in 27 EU Member States

“…LGBTI people feared negative consequences such as being treated as different or as 'other' whilst accessing (or attempting to access) health care. 11,40 Due to the effects of discrimination and stigma, research reported that specialist mental health or psychological support services for LGBTI people where they could make meaning of adversity were lacking. [2][3][4]11,12 Rapid reviews were consistent with wider academic literature in reporting that gay, bisexual and trans people can be deterred from accessing health care such as seeking HIV testing and treatment if they feared discrimination or encountering the stigmatizing attitudes of health professionals.…”

“…LGB people who survived cancer may benefit from additional support post-treatment to help them regain a sense of well-being. 9,11 A review of trans health needs indicated that across global health-care settings, trans people experienced significant health inequalities with higher rates of HIV and other STIs, mental distress, substance use and experiences of abuse (violence and discrimination) compared with non-trans or cisgender people. 2 In relation to mental health, research suggests that LGBT people are at higher risk of poor mental health compared to the general population with the incidence of suicidal ideation, anxiety and deliberate self-harm markedly raised.…”

“…International research trends suggest that LGB people are at a higher risk of developing certain types of cancer commonly diagnosed at a younger age compared with the general population, where gay and bisexual men are twice as likely to report a diagnosis of anal cancer with those who are HIV‐positive being at the highest risk . Those LGB people who survived cancer may benefit from additional support post‐treatment to help them regain a sense of well‐being …”

Importance of sexuality in colorectal cancer: predictors, changes, and response to an intimacy enhancement intervention

“…Finally, detailed information on the sexual orientation of participants was not available. Given that quality of life effects of cancer-including on sexual outcomesmay be influenced by patients' sexual orientation [36][37][38][39], future studies could examine whether the associations reported here are found for survivors of differing sexual orientation.…”

Culturally Competent Care for Sexual and Gender Minority Patients at National Cancer Institute-Designated Comprehensive Cancer Centers

“…9 In addition, many sexual minority cancer survivors experience discrimination, gaps in care, insufficient social support, and increased social isolation. 10 Patient centeredness is a fundamental feature of quality healthcare and an important aspect of high-quality oncology care. 11,12 Central to patient-centered care is a meaningful engagement with patients and their families by healthcare providers to coordinate treatment and survivorship plans that are considerate of an individual's medical, social, and cultural needs.…”