In discussions of cancer research, prevention, and treatment, the needs and experiences of lesbian, gay, bisexual, and transgender (LGBT) people are routinely overlooked. The American Cancer Society estimates, however, that there are more than 130,000 newly diagnosed cases of cancer and more than 45,000 cancer deaths among LGBT people in the U.S. every year. Evidence indicates that LGBT populations are disproportionately affected by specific cancers, such as anal cancer in gay and bisexual men, breast cancer in lesbian women, and viral infection–induced cancers in LGB and transgender people. The drivers of these cancer disparities include risk factors that are often more common among LGBT people, such as tobacco use, nulliparity, and HIV. These risk factors are also compounded for LGBT populations by exposure to social determinants of health that include discrimination and other minority stressors—especially for Black, Indigenous, and other LGBT people of color, who experience discrimination that targets their race or ethnicity as well as their sexual orientation and/or gender identity—lower rates of insurance and other barriers to health care services, and inaccurate assumptions among providers about cancer risk and appropriate screenings, particularly for lesbian and bisexual women and transgender people. For LGBT people who have been diagnosed with cancer, a lack of cultural responsiveness in clinical settings and social and economic challenges outside the doctor’s office can exacerbate the difficulty of navigating cancer treatment.
Because data on sexual orientation and gender identity are not routinely collected in cancer registries, clinical records, and other sources of cancer data, the full spectrum of cancer risks, prevention, treatment, outcomes, and survivorship in LGBT communities remains unexplored. LGBT people are also often rendered invisible in cancer research by data collection that does not include sexual orientation or gender identity, by study protocols that make the tacit or overt assumption that all participants are cisgender and heterosexual, and by barriers to participation such as being overlooked in recruitment or even outright excluded from consideration.
This presentation provides an overview of cancer disparities in LGBT populations; describes patient-, provider-, and structural-level barriers to effective cancer prevention and treatment; and identifies promising opportunities to expand the evidence base and address LGBT cancer disparities.
Citation Format: Kellen Baker. Cancer in LGBT populations: Differences, disparities, and strategies for change [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr IA12.