ESTRO 2024 - Abstract Book

S5668

RTT - Patient experience and quality of life

ESTRO 2024

Cancer Patient Experience Survey (CPES) scores also show inequity, particularly in factors relating to feeling informed, having support, and being able to have loved ones involved in their care.2 Likewise, 23% of LGBT+ patients have witnessed discriminatory remarks and 38% of trans people report poorer experiences due to their identity. Poor experience can lead to avoidance with 14% of LGBT+ people avoiding healthcare,10 escalating to 57% for trans people, even when unwell. 45% of trans and 55% of non-binary people do not feel their GP understands their health needs,12 echoed by intersex people who report healthcare professionals not being supportive or knowing how to refer them for care.11 In 2017, IR(ME)R was updated to reflect the gender diversity of patients and the need for more inclusive and safer practices. In respect to pregnancy checks, a recognition of “making enquiries of individuals of childbearing potential to establish whether the individual is or may be pregnant or breastfeeding” was welcomed, but the procedures of how to do so were deferred to employers and spontaneous patient disclosure. The lack of a clear procedure led to at least one known incident where a trans man underwent CT whilst pregnant. To protect patient safety, the Society College of Radiographers (SCoR) worked with radiographers across the country and charities including OUTpatients (formerly Live Through This), the UK’s LGBTIQ+ cancer charity, Transactual, and Intersex Equality Rights UK. Released in 2021, the Inclusive Pregnancy Status (IPS) Guideline attempts to support better employer’s procedures. Through an iterative process, the national working group drafted and piloted proposed methods in trusts associated with lead authors. The forms were well received and were subsequently released for use. OUTpatients developed and delivered webinars for breast screening clinics to address the core knowledge deficit. The webinar educated AHPs around the core concepts of LGBTIQ+ language, through to cancer risk modulation as an effect of gender affirming care. OUTpatients training evaluated well and were repeatedly commissioned in London, forming core content of a local training programme. Webinars are available nationally online and receive scores of 95%+ when rated for content, speakers, and likelihood to affect practice. Despite these interventions being welcomed by multiple LGBTIQ+ organisations and positively impacting practice across the UK, there has been sociopolitical resistance to its impact. The previous Health Secretary has said the IPS “doesn’t make any sense”, despite it being in service of meeting IR(ME)R obligations. Where departments have not implemented the guidelines, concerning comments around the fact that it is too much to implement for a minority population and consider the risk of radiation harm to trans patients to be acceptable. Material/Methods: Results:

Conclusion:

Allyship from health institutions and practitioners is vital.

There are many systems that continue to exclude the LGBTIQ+ community, such as the lack of a pathway to routine breast screening for trans men without mastectomy, or the lack of support or training in late effects for