Researchers report that sexual minorities, particularly women, who are survivors of cancer face reduced access to care and correspondingly worse quality of life compared with their heterosexual counterparts.
The study, published in Cancer, used four years of data from the Behavioral Risk Factor Surveillance System regarding 70,524 adult men and women who self-reported a history of cancer. Among these, 1,931 individuals self-identified as sexual minorities, which included lesbian, gay, bisexual, and other nonheterosexual orientations.
"While we have extensive cancer surveillance in the US, sexual minority cancer survivors are excluded from surveillance, which means we have very limited information about this group," commented study author Jessica Gereige, MD, of the Department of Pulmonary, Allergy, Sleep and Critical Care Medicine at Boston Medical Center. "This study therefore provides much needed information about sexual minority cancer survivors."
The researchers found that sexual minority women had significantly increased deficits in access to care compared with heterosexual women (42.7% vs 28.0%); they were more likely to lack health insurance, lack a personal physician, avoid medical care for financial reasons, and go without an annual medical visit. While sexual minority men had similar access to insurance, personal physicians, and annual medical visits as their heterosexual counterparts did, sexual minority men were more likely to avoid medical care for financial reasons.
This lack of access to care was associated with poorer quality of life on several measures. Sexual minority women with access deficits were at increased risk of poor physical quality of life, poor mental quality of life, and difficulties concentrating compared with heterosexual women. Sexual minority men who lacked access to care were at increased risk of experiencing difficulty concentrating compared with heterosexual men. In addition, sexual minority status increased the odds of poor mental quality of life among men, regardless of deficits in access to care.
"Our study shows that sexual minority women suffer from poor access to care and that this is linked to worse quality of life. Since poor quality of life is linked to worse cancer survival rates, this calls for policy changes to improve access to care for sexual minority cancer survivors," stated the study's lead author, Ulrike Boehmer, PhD, Associate Professor of Community Health Services at Boston University School of Public Health. "Clinicians who are aware of these disparities and address them during clinic visits may have an impact on sexual minority women's survival rates, which are lower than their heterosexual counterparts' rates."
For More Information
Boehmer U, Gereige J, Winter M & Ozonoff A (2019). Cancer survivors' access to care and quality of life: do sexual minorities fare worse than heterosexuals? Cancer. [Epub ahead of print] DOI:10.1002/cncr.32151
Image credit: Mushi. Licensed under CC BY 2.0