Patient nondiscrimination policies at cancer centers are not always inclusive of the LGBTQ+ community, according to a study published in the Journal of the National Comprehensive Cancer Network.

Of the 64 cancer centers studied, 56% had a nondiscrimination policy that was designated LGBTQ+ friendly by the National LGBT Cancer Network.

The study included National Cancer Institute (NCI)-designated cancer centers that provided direct patient care in 2019. Researchers conducted a web-based analysis of patient nondiscrimination policies at these centers from July to September 2020, specifically looking at representation of sexual and gender minority (SGM) or LGBTQ+ patients.

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Most centers — 82% — had a patient nondiscrimination policy posted on their website. For 83% of those centers, the policy did not differ from the policy of their affiliated academic institution. From the cancer center’s homepage, an average of 2.61 clicks were required to locate the policy.

Of the nondiscrimination policies available on centers’ websites, 89% mentioned the term “sex,” 69% mentioned “sexual orientation,” and 67% mentioned “gender identity.” The terms “sex assigned at birth” or “LGBTQ/SGM identity” were not present in any of the policies. 

In all, 65% of the online policies included both “sexual orientation” and “gender identity” as protected groups. Specific protections for sexual orientation or gender identity were significantly more likely to be present in policies from academic institutions compared with nonacademic institutions — 100% and 79%, respectively (P =.005).

Other common categories listed as protected under nondiscrimination policies were race (98%), age (94%), national origin (87%), skin color (80%), disability (74%), and religion (65%). 

“Our study shows that patient nondiscrimination policies across NCI-designated cancer centers are not always accessible to patients and their families online and, similar to state laws, do not consistently represent SGM people in their content,” the researchers concluded.

“Because the SGM population is both at higher risk for cancer and for discrimination in the health care setting, it is crucial to create inclusive, safe, and equitable cancer care environments for this group. Administrators and clinicians should view the patient nondiscrimination policy as an opportunity to offer expansive protections to SGM people that extend beyond those offered in federal and state laws.”

Disclosures: One study author declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.


Berrahou IK, Snow A, Swanson M, Obedin-Maliver J. Representation of sexual and gender minority people in patient nondiscrimination policies of cancer centers in the United States. J Natl Compr Canc Netw. Published online February 15, 2022. doi:10.6004/jnccn.2021.7078