The lesbian, gay, bisexual, transgender/transsexual, and queer/questioning (LGBTQ) community, also referred to as sexual minorities, represents a growing and medically underserved population in the United States. In a recent study published in the journal CA: A Cancer Journal for Clinicians, a team of Moffitt Cancer Center researchers conducted a review of evidence on the current knowledge about cancers that may affect the LGBTQ community, and also provided suggestions for improving their healthcare.
Compared with non-LGBTQ heterosexuals, previous studies have reported that individuals in the LGBTQ population tend to have lower incomes and are less satisfied with their standard of living. Families of gay and lesbian couples are significantly more likely to be poor than heterosexual, married-couple families. Children in gay and lesbian households have poverty rates twice those of children in heterosexual married-couple households.
In addition, health and utilization of health care services among LGBTQ individuals are adversely affected by marginalization; and approximately 30% of LGBTQ adults do not seek health care services or lack a regular health care provider compared with 10% of age-matched heterosexuals.
In the review titled “Cancer and Lesbian, Gay, Bisexual, Transgender/ Transsexual, and Queer/Questioning (LGBTQ) Populations“, the researchers examined the available literature regarding prevention, early detection, diagnosis, treatment, survival and end-of life data for seven different cancers — cervical, breast, anal, colorectal, endometrial, lung, colon and rectal and prostate cancers, and found there is a lack of epidemiological data regarding cancer in the LGBTQ community.
Matthew B. Schabath, Ph.D., assistant member of the Cancer Epidemiology Program at Moffitt noted in a news release, “this is particularly important given the finding that some LGBTQ groups tend to have a higher prevalence of many cancer risk factors and behaviors, including higher rates of smoking, alcohol consumption, obesity and high-risk sexual behavior.”
According to the review, some LGBTQ subgroups have higher rates of incidence and death of certain types of cancer, particularly cervical cancer in lesbian and bisexual women, and anal cancer in gay men.
Because of the lack of evidence available in the literature, the researchers indicate that clinical teams should focus on eliciting patient preferences, concerns, and needs pertaining to treatment plans and end-of-life care. The team mentioned the importance for local, state and national surveys and registries to collect sexual orientation and gender identity of their study populations, and also indicate the need for changes in governmental policies with the aim to reduce health disparities for the LGBTQ community.
The authors also suggest that the LGBTQ community could access services including The Healthcare Equality Index and the Gay and Lesbian Medical Association’s database of physicians.
Gwendolyn P. Quinn, Ph.D., senior member of the Health Outcomes & Behavior Program at Moffitt, explained, “as a growing and medically-underserved population, the cancer related needs and concerns of the LGBTQ community are a crucial area to be addressed among both healthcare providers and the research community. Increased awareness of the cultural diversity of each group, as well as the collection of important demographic information from this group is necessary so larger repositories of research about each community are available, and programs and intervention can be designed to meet their unique needs.”