Title : Improving cancer care for LGBTQIA patients: A scoping review
Abstract:
Background: LGBTQIA+ includes Lesbian, Gay, Bisexual, Transgender, Queer (or Questioning), Intersex, Asexual (or Aromantic/Agender), plus other diverse sexual orientations and gender identities (e.g., nonbinary, pansexual, two spirit, gender fluid, etc). Health inequities in cancer care remain significant among LGBTQIA+ adults. Barriers include healthcare provider (HCP nurses, radiation oncologists and technologists) competence.
Objective: To map and synthesize the available evidence on barriers and facilitators influencing the provision of inclusive radiotherapy care for adult LGBTQIA+ cancer patients.
Methods: A scoping review was conducted using methodological frameworks for evidence mapping with searches in Scopus, PubMed, ScienceDirect, CINAHL, and MEDLINE. Eligible studies included peer-reviewed research examining accessibility, healthcare delivery, patient experience, and inclusive oncology practices. The review synthesized literature published between 2022 and 2025, reflecting the time range of the included studies. Data were extracted and analysed using thematic synthesis to identify structural, organizational, and interpersonal factors influencing inclusive care.
Results: Only 5% of HCP answered all knowledge questions about LGBTQIA+ health correctly. 40% of clinicians reported difficulty in addressing sexual health topics. 80% expressed interest for SGM training and 54% preferred online education. 65% of LGBTQIA+ individuals were uncertain about what cancer screening they needed. 76% did not receive at least one dose of the Human Papilloma virus (HPV) vaccine. Structural barriers included inaccessible treatment environments, limited adaptive equipment, and insufficient institutional policies supporting accommodation. Interpersonal barriers involved inadequate provider training, communication challenges, and implicit bias affecting patient engagement and care delivery. System-level gaps in inclusive data collection and representation were also identified. Other key facilitators included adaptive technologies, inclusive clinical protocols and patient-centered communication.
Conclusion: Inclusive radiotherapy services require coordinated structural, clinical and educational interventions. Addressing accessibility, provider competence, and policy gaps is essential to reduce disparities and support equitable cancer treatment for adults LGBTQIA+ patients.
