Cancer survivors’ health behaviors and outcomes: A population-based study of sexual and gender minorities
Menée par enquête auprès de 4 507 patients ayant survécu à un cancer et appartenant à des minorités sexuelles ou de genre, cette étude cas-témoins analyse leurs comportements de santé et leur état de santé physique et psychique
Résumé en anglais
Background: Most case-control studies compare cancer survivors to general population controls without considering sexual orientation or gender identity. This case-control analysis compared health risk behaviors and health outcomes among sexual and gender minority (SGM) cancer survivors to those of matched SGM non-cancer controls.
Methods: Using data from the 2014-2021 Behavioral Risk Factor Surveillance System, a population-based sample of 4,507 cancer survivors who self-identified as transgender, gay men, bisexual men, lesbian women, or bisexual women were 1:1 propensity score matched, using age at survey, race/ethnicity, marital status, education, access to health care, and US census region. Within each SGM group, behaviors and outcomes were compared between survivors and controls and survivors’ odds ratios (ORs) and 95% confidence intervals (CIs) calculated.
Results: Gay male survivors had higher odds of depression, poor mental health, limited usual activities, difficulty concentrating, and fair or poor health. Few differences were observed between bisexual male survivors and controls. Compared to controls, lesbian female survivors had greater odds of overweight-obese status, depression, poor physical health, and fair/poor health. Bisexual female survivors had the highest rates of current smoking, depression, poor mental health, and difficulty concentrating across all SGM groups. Significantly different from transgender controls, transgender survivors had greater odds of heavy alcohol use, physical inactivity, and fair or poor health.
Conclusions: This analysis revealed an urgent need to address the high prevalence of engaging in multiple health risk behaviors and not following guidelines to avoid second cancers, additional adverse outcomes, and cancer recurrences among SGM cancer survivors.