Identifying and breaking barriers: Addressing disparities in the care of patients with gynecologic cancers

IF 1.2 Q3 OBSTETRICS & GYNECOLOGY

Gynecologic Oncology Reports Pub Date : 2025-06-30 DOI:10.1016/j.gore.2025.101799

Bhavana Pothuri , Michele Muir , Jean Hurteau , John Farley , Michelle D.S. Lightfoot , Summer Dewdney , Tara Castellano , John K. Chan , Sharad Ghamande , Al Asante-Facey , Marina Stasenko , B.J. Rimel , Electra D. Paskett

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Abstract

Background

Significant disparities exist in the care of patients with gynecologic malignancies. Higher incidences of gynecologic malignancies among underrepresented subpopulations (eg, racial, ethnic, and/or LGBTQAI+) and lack of representative enrollment within clinical trials have highlighted the need to improve healthcare equity. We aimed to identify barriers to equitable health care and clinical trial participation for specific diverse populations of patients with gynecologic malignancies and to identify potential solutions for overcoming these barriers.

Methods

A series of 4 live and 3 asynchronous advisory boards facilitated by GSK was conducted between January 2023 and July 2024; live advisory boards were population specific. Gynecologic oncologists, health researchers, advanced practice providers, patients, and patient advocacy group representatives who worked with and/or were themselves members of the focus population participated. Insights were compiled and analyzed to identify barriers and potential solutions across and within populations.

Results

Common barriers to equitable health care across all populations included cost, transportation, level of health literacy, and provider biases; 11 population-specific barriers were noted, with LGBTQAI+ patients described as facing the most barriers. Patient navigator involvement was identified as a feasible and highly impactful solution for breaking multiple barriers across various diverse populations.

Conclusions

Most barriers to equitable health care were population specific, affirming the need for continued consultation and discussions with members of communities and with individuals to address specific barriers and enact effective solutions. Engagement of patient navigators was identified as an important way to improve disparities within the care of gynecologic malignancies across all underrepresented patients.

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识别和打破障碍：解决妇科癌症患者护理中的差异

背景妇科恶性肿瘤患者的护理存在显著差异。妇科恶性肿瘤在代表性不足的亚人群（如种族、族裔和/或LGBTQAI+）中发病率较高，且临床试验中缺乏代表性的纳入，这突出了改善医疗公平的必要性。我们的目的是确定妨碍公平医疗保健和临床试验参与特定的妇科恶性肿瘤患者不同人群的障碍，并确定克服这些障碍的潜在解决方案。方法在2023年1月至2024年7月期间，GSK组织了4个现场和3个非同步咨询委员会；现场咨询委员会是针对特定人群的。参与研究的是妇科肿瘤学家、健康研究人员、高级执业医师、患者和患者权益团体代表，他们与重点人群一起工作和/或本身就是重点人群的成员。对见解进行了汇编和分析，以确定人群之间和人群内部的障碍和潜在解决方案。结果所有人群中公平医疗保健的常见障碍包括成本、交通、卫生素养水平和提供者偏见；11个特定人群障碍被注意到，LGBTQAI+患者被描述为面临最多障碍。患者导航员参与被认为是一种可行且高度有效的解决方案，可以打破不同人群之间的多重障碍。结论：妨碍公平医疗保健的大多数障碍是针对特定人群的，因此需要继续与社区成员和个人进行磋商和讨论，以解决具体障碍并制定有效的解决办法。患者导航员的参与被认为是改善所有代表性不足的患者在妇科恶性肿瘤护理中的差异的重要途径。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Gynecologic Oncology Reports OBSTETRICS & GYNECOLOGY-

CiteScore

2.00

自引率

0.00%

发文量

183

审稿时长

41 days

期刊介绍： Gynecologic Oncology Reports is an online-only, open access journal devoted to the rapid publication of narrative review articles, survey articles, case reports, case series, letters to the editor regarding previously published manuscripts and other short communications in the field of gynecologic oncology. The journal will consider papers that concern tumors of the female reproductive tract, with originality, quality, and clarity the chief criteria of acceptance.