Cancer survivors’ access to care and quality of life: Do sexual minorities fare worse than heterosexuals?

Boehmer, Ulrike; Gereige, Jessica; Winter, Michael; Ozonoff, Al

doi:10.1002/cncr.32151

Cited by 25 publications

(10 citation statements)

References 32 publications

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“…WSW also reported that female partners were a singular and valuable source of support and were able to perceive partner distress, manage home and caretaking, and share a life beyond cancer [ 24 ]. In addition, WSW reported being less focused on body image, suffered fewer identity issues due to breast cancer and chose not to have reconstruction more often than heterosexual peers [ 22 , 29 , 30 ]. However, WSW reported more challenges with access to care [ 31 ] and experienced more physical complications related to mastectomy and radiation than heterosexual peers [ 15 ].…”

Section: Resultsmentioning

confidence: 99%

“…Limitations: Data collected only from one state; self-reported nature of the data. Boehmer et al (2019) [ 30 ] USA BRFSS respondents who had a past diagnosis of cancer ( n = 68,593 heterosexual women, n = 1,931 WSW) Quantitative Secondary data analysis of 2014-2017 years of BRFSS data. Survivors were categorized with an access deficit if any one of the following were true: no health insurance, delaying care, avoiding care due to cost, and lacking a trusted physician.…”

Section: Appendixmentioning

confidence: 99%

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Health outcomes of sexual and gender minorities after cancer: a systematic review

2021

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Purpose Cancer research on sexual and gender minority (SGM) populations is gaining momentum. The purpose of this systematic review was to examine what is currently known in the research literature regarding patient-reported health outcomes after cancer treatment among SGM populations. Methods In March 2021, a medical librarian conducted a systematic keyword search on PubMed, Embase, Scopus, Web of Science, PsycINFO, ClinicalTrials.gov, and the Cochrane Central Register of Controlled Trials. The primary inclusion criterion was assessment of at least one physical, psychosocial, emotional, or functional patient-reported health outcome related to the impacts of cancer diagnosis and/or treatment. Articles that met inclusion criteria were reviewed in their entirety, charted in a Word Table, and assessed for quality. Quality considerations included study design, sampling approach, diversity of sample, measures used, and analytic procedures. Studies were synthesized based on type of cancer study participants experienced. Results Sixty-four studies were included in the final analysis: most were quantitative, secondary analyses or cross-sectional studies with convenience samples, and focused on people with a history of breast or prostate cancer. Differences between sexual minority men and women in terms of coping and resilience were noted. Few studies reported on experiences of transgender persons and none reported on experiences of intersex persons. Conclusions A growing literature describes the patient-reported health outcomes of SGM people with a history of cancer. This study summarizes important between-group differences among SGM and heterosexual, cisgender counterparts that are critical for clinicians to consider when providing care. Implications for cancer survivors Sexual orientation and gender identity are relevant to cancer survivors’ health outcomes. Subgroups of SGM people have differential experiences and outcomes related to cancer and its impacts.

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Section: Resultsmentioning

confidence: 99%

Section: Appendixmentioning

confidence: 99%

Health outcomes of sexual and gender minorities after cancer: a systematic review

2021

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“…18 Yet, a study using state-level Behavioral Risk Factor Surveillance System data found that nonheterosexual, or sexual minority women (SMW), survivors with less health care access reported poorer physical and mental quality of life than heterosexual women. 19 Other studies have demonstrated differences in specific components of HRQoL, including perceived stress 20 and selfreported health 21,22 ; however, no published studies have assessed differences in financial or social quality of life between heterosexual and LBW cancer survivors.…”

Section: Introductionmentioning

confidence: 99%

Differences in Health-Related Quality of Life and Health Behaviors Among Lesbian, Bisexual, and Heterosexual Women Surviving Cancer from the 2013 to 2018 National Health Interview Survey

et al. 2021

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Purpose: Health-related quality of life (HRQoL) and health behaviors contribute to cancer morbidity and mortality, which are elevated in lesbian and bisexual women (LBW). The purpose of this study was to assess differences in HRQoL and health behaviors between heterosexual and lesbian women and heterosexual and bisexual women cancer survivors. Methods: We pooled 2013-2018 National Health Interview Survey data. HRQoL comprised physical, mental, financial, and social health domains. Health behaviors included tobacco and alcohol use, physical activity, and preventive health care. Weighted, multivariable logistic regression models estimated odds ratios (ORs) with 95% confidence intervals (CIs). Results: The sample included 10,830 heterosexual, 141 lesbian, and 95 bisexual cancer survivors. Lesbian women reported higher odds of fair/poor self-rated health (

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“…In addition, WSW reported being less focused on body image, suffered fewer identity issues due to breast cancer and chose not to have reconstruction more often than heterosexual peers [14,25,54]. However, WSW reported more challenges with access to care [23] and experienced more physical complications related to mastectomy and radiation than heterosexual peers [18]. Counter to other studies, one study demonstrated an association between degree of "outness" (de ned in the study as the number of relationships in which people were open about their identity) and higher distress [30], which may suggest increased experiences of stigmatization when people were open about their identities.…”

Section: Breast Cancer Survivorshipmentioning

confidence: 99%

Health Outcomes of Sexual and Gender Minorities After Cancer: A Scoping Review

Pratt-Chapman

Rodríguez-Díaz

Alpert

2020

Preprint

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Purpose: Cancer research on sexual and gender minority (SGM) populations is gaining momentum. However, literature on patient-reported health outcomes for SGM people with a history of cancer is limited. The purpose of this review was to examine the nature and extent of research regarding patient-reported health outcomes after cancer treatment among SGM populations. Methods: A systematic search of key words, titles, abstracts, and/or major subjects was conducted in PubMed, Scopus, and CINAHL in September 2019 and in EMBASE in February 2020. Included studies investigated at least one physical, psychosocial, emotional, or functional patient-reported outcome related to cancer diagnosis and/or treatment. Articles that met inclusion criteria were reviewed in their entirety, charted in a Word Table, assessed for quality, and trends within and across studies were reported in addition to each study’s results. Results: Fifty-two studies were included in the final analysis; most were quantitative and focused on people with a history of breast and prostate cancer. Most studies were secondary analyses or cross-sectional studies of convenience samples, limiting generalizability. Conclusions: A growing literature describes the patient-reported health outcomes of SGM people with a history of cancer. This study summarizes important between-group differences among SGM and heterosexual, cisgender counterparts that are critical for clinicians to consider when providing care. Implications for cancer survivors: Sexual orientation and gender identity are relevant to cancer survivors’ health outcomes. Clinicians and researchers can build an evidence base to inform care improvements by collecting data on anatomy, sexual orientation, and gender identity in Electronic Health Records and population-based surveys.

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Cancer survivors’ access to care and quality of life: Do sexual minorities fare worse than heterosexuals?

Cited by 25 publications

References 32 publications

Health outcomes of sexual and gender minorities after cancer: a systematic review

Health outcomes of sexual and gender minorities after cancer: a systematic review

Differences in Health-Related Quality of Life and Health Behaviors Among Lesbian, Bisexual, and Heterosexual Women Surviving Cancer from the 2013 to 2018 National Health Interview Survey

Health Outcomes of Sexual and Gender Minorities After Cancer: A Scoping Review

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