Background: Evidence suggests that people who self-identify as underrepresented sexual minorities have an increased cancer burden and more cancer risk factors than their sexual majority counterparts. We sought to determine whether cancer screening rates differed between LGBT patients who have discussed their sexual identity with their health care providers and those who did not.
Methods: An anonymous electronic survey was conducted through LGBT network organizations. The survey was designed to replicate questions regarding cancer screening behavior that were fielded in the 2010 National Health Interview Survey (NHIS) Cancer Supplement. It also included questions regarding (self-identified) sexual orientation and disclosure of sexual identity to health care providers. Correlations between disclosure and cancer screening rates were analyzed using non-parametric statistics (SPSS, Inc).
Results: A total of 320 LGBT people responded to the survey, of these; 148 identified as female, 158 identified as male, 14 as transgender or other. Rates of disclosure were similar across all groups: 70.9% men, 74.3% women, and 78.6% transgender/other informed their health care provider of their sexual identity (p=0.139). The median age of respondents was 29 (range: 16-74). Individuals who chose to disclose their sexual identity were more likely to be older (median age 32 vs. 24, p<0.005) and Caucasian (84.5% vs. 66.7%, p=0.006), and less likely to be uninsured (3.9% vs. 8.0%, p=0.014) than those who did not disclose their sexual identity. Across respondents, 50.8% believed that disclosure would not have an impact on their care, while 41.6% believed that disclosure would improve their care and 7.6% believed that it would negatively influence care. Among women ≥40 years, there was no significant difference in the rate at which respondents reported ever having had a mammogram between those who disclosed their sexual identity and those who did not (90.9% vs. 77.8%, respectively, p=0.391). For women ≥21 years of age, there was a trend towards a higher rate of reporting ever having had a Pap smear amongst those who disclosed their sexual identity to their doctor, although this did not reach statistical significance (94.3% vs. 82.8%, p=0.095). Among LGBT respondents 50 years or older, respondents who discussed their sexual identity with their provider were significantly more likely to have had a colonoscopy or a sigmoidoscopy (90.4% vs. 33.3%, p = 0.001) than those who did not reveal their sexual identity.
Conclusions: Nearly three quarters of LGBT individuals disclose their sexual identity to their doctors. Cancer screening is higher amongst individuals who openly discuss their sexual identity with their health care providers, particularly for colorectal screening.
Citation Format: Caroline Ong, Joel Winer, Eric Patridge, Feng Dai, Liz Margolies, Anees Chagpar. Disclosure and cancer screening rates among lesbian, gay, bisexual and transgender (LGBT) populations. [abstract]. In: Proceedings of the Twelfth Annual AACR International Conference on Frontiers in Cancer Prevention Research; 2013 Oct 27-30; National Harbor, MD. Philadelphia (PA): AACR; Can Prev Res 2013;6(11 Suppl): Abstract nr C08.