Mapping disparities: identifying cancer care gaps in sexual and gender minority patients

Sexual and gender minority (SGM) patients face disparities in cancer care, partly due to the lack of sexual orientation and gender identity (SOGI) data collection. We sought to use electronic health record-based metrics, integrated with SOGI data to characterize the SGM cancer population with the future goal of addressing disparities within this population.

The cancer population was identified using Epic's active cancer registry at Thomas Jefferson University Hospital. Additional data elements linked included SOGI information, general demographics, alcohol and drug use, molecular diagnostic information, and census-level SDOH data. Z-tests assessed differences in cancer risk factors, social vulnerability index factors, and genomic testing between the 2 populations.

A total of 92 116 patients were identified from the active cancer registry with SOGI data available on 9544 patients (565 SGM and 8979 non-SGM patients). The SGM patients were younger, less likely to be married, and had higher rates of cancer associated risk factors. When comparing census-level social vulnerability data, SGM patients were overall more vulnerable. The groups had even representation of cancer types aside from higher anal cancer and Kaposi's sarcoma in the SGM population. No significant differences in cancer genomic testing were noted.

This study highlights the opportunities of integrating SOGI data with clinical and other data types, revealing disparities in cancer risk factors, social determinants of health, and specific cancer types. These findings emphasize the need for targeted interventions and personalized care to address the specific needs of SGM cancer patients and improve their health outcomes.