Sexual Orientation Affects Cancer Survivorship

Gay men have a higher prevalence of cancer compared with heterosexual men, and lesbian and bisexual female cancer survivors report lower levels of health than heterosexual female cancer survivors. Those are the conclusions of a new study published early online in CANCER, a peer-reviewed journal of the American Cancer Society. The study’s findings shed light on the types of programs and services that are needed to assist lesbian, gay, and bisexual cancer survivors.

Cancer surveillance studies don’t ask questions about sexual orientation, which means there is scarce information about how many cancer survivors identify as lesbian, gay, or bisexual. Hoping to fill this information gap, Ulrike Boehmer, PhD, of the Boston University School of Public Health and her colleagues examined the prevalence of cancer survival by sexual orientation in California. They also investigated how the health of cancer survivors differs depending on sexual orientation.

The study included data from the California Health Interview survey from 2001, 2003, and 2005. This survey is the largest state health survey conducted in the United States. A total of 7,252 women and 3,690 men reported a cancer diagnosis as adults. The researchers found no significant differences in cancer prevalence by sexual orientation among women, but lesbian and bisexual female cancer survivors were 2.0 and 2.3 times more likely to report fair or poor health compared with heterosexual female cancer survivors. Among men, gay men were 1.9 times as likely to report a cancer diagnosis than heterosexual men. Male cancer survivors’ self-reported health did not significantly differ by sexual orientation.

“This information can be used for the development of services for the lesbian, gay, and bisexual population,” said Dr. Boehmer. “Because more gay men report as cancer survivors, we need foremost programs for gay men that focus on primary cancer prevention and early cancer detection. Because more lesbian and bisexual women than heterosexual women with cancer report that they are in poor health, we need foremost programs and services that improve the well-being of lesbian and bisexual cancer survivors,” said Dr. Boehmer.

Dr. Boehmer noted that the results raise questions that should be addressed by future studies. For example, do more gay men report a history of cancer because more are receiving cancer diagnoses, or are more surviving a diagnosis compared with heterosexual men? Similarly, are lesbian and bisexual women just as likely as heterosexual women to receive a cancer diagnosis, or does the similarity of cancer survivorship speak to differences in the survival of lesbian and bisexual women?