Italian oncologists are generally aware of and inclusive towards LGBTQIA+ issues, but gaps and disparities remain that require attention and targeted training, particularly when gender identity affects the professional environment rather than patient care.

These themes were discussed at the 27th National Congress of the Italian Association of Medical Oncology (AIOM), held in Rome, Italy, from 7 to 9 November 2025, where the results of the IN.C.L.U.D.E. (Inclusion, Awareness, Work, Union, Diversity, and Equity) study were presented.

The data, presented at the European Society for Medical Oncology (ESMO) congress in October, were based on a survey of 1470 oncologists, with 233 responses (15.8%), providing one of the first nationwide assessments of workplace inclusivity and awareness in Italian oncology.

“This response rate might seem low and suggest a lack of interest in the topic among the oncology community, but it is actually in line with other surveys administered by AIOM,” said Lorenzo Belluomini, MD, PhD, affiliated with the Department of Engineering for Innovation Medicine at the University of Verona, Verona, Italy, and is a member of the Working Group AIOM.

Speaking with Univadis Italy, part of the Medscape Professional Network, Belluomini said that interest in the topic arose after reviewing the limited available data, mostly from Anglo-Saxon countries, showing that 1 in 3 healthcare professionals do not feel safe, protected, or comfortable expressing their gender identity.

“Furthermore, having to hide one’s gender identity reduces job satisfaction, a factor that could add to the burnout to which oncologists as a professional category are already particularly exposed,” said Belluomini.

Workplace Inclusion

The survey captured responses from a young population of oncologists (median age, 33 years), reflecting AIOM demographics, which state that over 50% of respondents are younger than 40 years.

Overall, 75% identified as heterosexual and 25% belonged to the LGBTQIA+ community. More than half (54%) had not witnessed discrimination in the workplace.

However, 37% of LGBTQIA+ respondents reported observing discriminatory behaviour compared with 21% of heterosexual colleagues.

Belluomini noted that 20% of respondents, all heterosexual, were unsure whether they had witnessed discrimination. “This likely reflects a lower awareness of the phenomenon among heterosexuals,” he said.

Knowledge Gaps

The questionnaire also revealed good familiarity with concepts such as “gender identity” and “homophobia,” but uncertainties persisted around the origins of gender and sexual orientation diversity.

“Less than 50% can accurately distinguish all the letters in the acronym LGBTQIA+,” Belluomini said, emphasising the need for targeted training.

No significant differences emerged by age group because more than 80% of respondents were younger than 35 years, nor between geographical region or professional hierarchy. However, some patterns did appear between smaller and larger hospitals, although the differences were not statistically significant. “Large hospitals, where most of the survey participants work, are generally more inclusive, perhaps also because they have had more experience with the LGBTQIA+ community,” Belluomini noted.

Growing Initiatives

IN.C.L.U.D.E. is not the first initiative undertaken by AIOM oncologists to support the LGBTQIA+ community and strengthen awareness of gender issues, including those relevant to patient care.

The AIOM also has a working group on gender-sensitive oncology, which has published AIOM recommendations in ESMO Open.

This effort reflects a broader and growing focus on gender inclusivity in Italian oncology. “I’ve noticed a big difference in recent years in the attitude of colleagues: Since the group on gender-sensitive oncology was created, attention to the topic has grown, and many colleagues ask for information and want to participate in the initiatives. We’ve managed to create a positive movement around this group,” said Alberto Giovanni Leone, Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.

Momentum continues to build through both national and international efforts. Belluomini stated, “We are already planning to extend the survey to the European level, in collaboration with the ESMO youth group and with the Italian Association of Epidemiology and the Istituto Superiore di Sanità (ISS) to broaden the scope of the survey to other medical specialties.” “We have also established a collaboration with the ISS and other scientific societies, and we have created a national working group on transgender screening, with the aim of breaking down the bureaucratic and administrative barriers that still block these people’s access to screening,” added Leone.

Leone reported having no relevant conflicts of interest. Belluomini reported having relationships with AstraZeneca, Amgen, Takeda, Regeneron, Eli Lilly and Company, BMS, Roche, and Novartis; advisory roles with AstraZeneca, Amgen, and Novartis; consultancy roles with Takeda and Eli Lilly and Company; travel support from Takeda and Regeneron; and research funding from BMS and Roche.

This story was translated from Univadis Italy.