ESTRO 2025 - Abstract Book

S812

Clinical - Gynaecology

ESTRO 2025

Purpose/Objective: Reports continue to emerge regarding the disparities in post-cancer sexual healthcare for women, especially those identifying within the LGBTQIA+ community. To better understand Italian healthcare professionals' awareness and attitude to address the needs of this population when affected by gynaecological malignancies, as well as the potential barriers to providing adequate care, we developed an online survey on behalf of the Multicenter Italian Trials in Ovarian cancer and gynecologic malignancies group (MITO) and Gynecology Study Group of the Italian Association of Radiation Oncology (AIRO). Material/Methods: A 13-item open survey was designed following the CHERRIES guidelines. This included general questions to gather data about the physicians and specific questions based on the 5As framework (Ask, Advise, Assess, Assist, Arrange), which is an evidence-based communication model for patient counselling. Chi-squared or Fisher tests were applied for statistical differences in demographic data. A stepwise multivariable logistic regression (using Akaike Information Criteria) assessed the relationship between variables and each query. Results: A total of 184 clinicians participated in the survey, with a response rate of 20.8%. Gender identity (GI) and sexual orientation (SO) were rarely explored, though gynaecologists (GOs) were more likely to address these issues compared to radiation (ROs) and medical oncologists (MOs). The main barriers included the perception that these topics were unimportant (48.7% for GI, 61.9% for SO), lack of personal awareness (27.6% for GI, 8.7% for SO), and discomfort in discussing them (18.4% for GI, 15.9% for SO). The 39.7% of respondents reported moderate to severe difficulty discussing the iatrogenic potential of sexual dysfunction, with ROs and GOs showing greater willingness compared to MOs (p<0.001). Communication timing also varied: ROs typically discussed it before treatment (94.34%), while GOs and MOs did so after or upon request (43.86% and 31.58%, respectively). To improve sexual health care for gynaecological cancer patients, respondents emphasized the need for professional education (67.9%), training for residents (31%), integrating sexual health into tumour board discussions (40.2%), and engaging patients through associations (23.4%). Conclusion: Despite a strong commitment to improving sexual health care for gynaecological cancer survivors, confidence in addressing the specific needs of LGBTQIA+ individuals is low. This underscores the urgent need for targeted training and clear guidelines to support sexual health in gynaecological oncology, especially for patients from sexual and gender minorities. References: 1.Lindau ST, Abramsohn EM, Matthews AC (2015) A manifesto on the preservation of sexual function in women and girls with cancer. Am J Obstet Gynecol 213:166–174 2.Bober SL, Varela VS (2012) Sexuality in adult cancer survivors: challenges and intervention. J Clin Oncol Off J Am Soc Clin Oncol 30:3712–3719 3.Saloustros E et al (2024) An assessment of the attitudes, knowledge, and education regarding the health care needs of LGBTQ patients with cancer: results of an ESMO/SIOPE global survey. ESMO open, 9(8), 103618 4.Leone AG et al (2023) Position paper of the Italian association of medical oncology on health disparities among transgender and gender-diverse people: the Assisi recommendations. EClinicalMedicine 65:102277 Keywords: women's well-being, sexual health, LGBTQIA+