Raising Awareness for Cancer in the LGBTQ Community
As World Cancer Day approaches, Moffitt Cancer Center remains committed to supporting research that addresses the health care needs of LGBTQ patients who are at-risk or suffering from cancer.
The lesbian, gay, bisexual, transgender and queer/questioning (LGBTQ) community, also referred to as sexual and gender minorities (SGMs), is a growing and medically underserved population in the United States. It spans all races, ethnicities, ages, socioeconomic statuses, and regions of the United States and accounts for roughly 3% to 12% of the adult population. LGBTQ individuals have higher disease risk and worse health outcomes for many diseases than heterosexual and cisgender (having a gender identity that matches one’s sex assigned at birth) populations, especially when it comes to cancer. There are seven cancer types for which the LGBTQ population has increased risk.
1. Anal Cancer – Men who have sex with men are more likely to carry the HPV virus, the primary cause of anal cancer. Although anal Pap testing can save lives, it is not done routinely.
2. Breast Cancer – Women who identify as lesbian often do not seek routine healthcare and cancer screenings. This may be due to a variety of reasons including avoidance of health care, higher prevalence of risk factors such as obesity, or nulliparity (never having a child).
3. Cervical Cancer – HPV is the primary cause of cervical cancer. Women who only have sex with women may mistakenly believe they do not need Pap smears and routine gynecological care and thus may miss opportunities for prevention and early detection. Eligible lesbian and bisexual women are often overlooked for HPV vaccines.
4. Colon and Rectal Cancer – Obesity, smoking and excessive alcohol consumption are risk factors for colorectal cancer, all factors highly prevalent in the LGBTQ community.
5. Endometrial Cancer – Similar to reasons for breast and cervical cancer, lesbian women have a higher prevalence of endometrial cancer, likely due to lack of screening.
6. Lung Cancer – High rates of smoking in the LGBTQ community likely contribute to lung cancer.
7. Prostate Cancer – Gay and bisexual men get prostate-specific antigen (PSA) testing less frequently than heterosexual men.
The common theme of cancer within the LGBTQ population is elevated prevalence of cancer risk factors (e.g., smoking, alcohol consumption, obesity). Another theme is the avoidance of healthcare and early detection screening. For the transgender population, the lack of identification with body parts and fear of discrimination may also hinder seeking healthcare. An important factor in receiving good healthcare is the relationship with the provider. Not only should LGBTQ patients feel comfortable disclosing their sexual orientation and gender identity status, but providers and healthcare systems should create inclusive environments that encourage such disclosure.
Gwendolyn P. Quinn, PhD, is a Senior Member, Health Outcomes and Behavior and Scientific Director, Survey Methods Core, Moffitt Cancer Center.
Matthew B. Schabath, PhD, is an Assistant Member, Department of Cancer Epidemiology, Moffitt Cancer Center.