Sexual, Gender Minority Cancer Survivors Have High Prevalence of Smoking, Binge Drinking.
Sexual, Gender Minority Cancer Survivors Have High Prevalence of Smoking, Binge Drinking
A new study showed that SGM cancer survivors have higher rates of these unhealthy behaviors than non-cancer SGM people, raising their risk for recurring and new cancers, depression, and other adverse health outcomes.
More than one million LGBTQ+ individuals are estimated to be living with cancer, but research on the health of sexual and gender minority (SGM) cancer survivors is limited, and often conflicting. Case-control studies of SGM cancer survivors compared to SGM individuals who have not had cancer are rare.
Now, a new study led by a School of Public Health researcher fills this knowledge gap with findings that show disproportionate rates of alcohol use, smoking, depression, and other adverse health behaviors and conditions among SGM cancer survivors, compared to non-cancer SGM people.
Published in the Journal of the National Cancer Institute, the study found that for all SGM populations except bisexual men, SGM cancer survivors engaged in more high-risk behaviors than non-cancer SGM people, and were twice as likely to have fair or poor compared to their respective SGM groups.
The study is the first to compare the health behaviors and outcomes among SGM cancer survivors to non-cancer SGM people. The findings suggest that many SGM cancer survivors are not adhering to recommended healthier behaviors following their cancer diagnoses, and are engaging in unhealthy behaviors that may be increasing their risk for recurring cancers, new cancers, or other adverse outcomes.
“While many studies show that SGM cancer survivors have worse health behaviors and worse mental health compared to heterosexual cisgender cancer survivors, the unique and alarming findings of this study are that SGM cancer survivors do worse than their SGM peers who do not have cancer,” says Ulrike Boehmer, adjunct associate professor of community health sciences. “This suggests SGM individuals with cancer do not recover psychologically and may be coping with cancer by drinking and smoking more and avoiding physical activity.”
For the study, Boehmer and colleagues analyzed annual national survey data on population health among transgender individuals and cisgender gay men, bisexual men, lesbian women, and bisexual women from 2014 to 2021. The team focused on cancer-related risk behaviors including smoking, heavy alcohol use, binge drinking, physical inactivity, being overweight or obese, and psychological well-being.
Overall, these risk behaviors were highest among cancer survivors who were bisexual women or transgender men and women. Transgender survivors were more than twice as likely than non-cancer transgender people to engage in heavy alcohol use and physical inactivity, and experience fair or poor health.
Depression was particularly common among many SGM cancer survivors. Lesbian and bisexual female survivors were significantly more likely to experience depression to their non-cancer peers, as 52 percent of lesbian and 58 percent of bisexual female cancer survivors reported that they struggled with this mental health issue. Similarly, 43 percent of transgender and 40 percent of gay male survivors also reported depression.
About 78 percent of lesbian female survivors reported being overweight or obese, the highest among all SGM groups. This population also experienced the highest prevalence of heavy alcohol use, at 13 percent.
Notably, the researchers found that bisexual male cancer survivors were the only group whose health outcomes were similar or better compared to their matched non-cancer counterparts.
“Overall, this study shows an urgency to develop interventions that improve SGM cancer survivors’ health behaviors and their mental health,” Boehmer says.
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