Study Finds Sexual Orientation Is Associated with Cancer Survivorship Outcomes

Patients with a history of cancer who identify as lesbian, gay, and bisexual had worse survivorship than their heterosexual peers, facing challenges that are not as prevalent in the heterosexual community.

A study looking at more than 17.5 million U.S. cancer survivors analyzed survivorship characteristics by sexual orientation and sex. Of the included patients from the 2018 Behavioral Risk Factor Surveillance System, 1.52% identified as gay/lesbian and 1.41% as bisexual.

Bisexual survivors reported twice the rates for current smoking (32.3% vs. 13.6%) and binge drinking (17.1% vs. 9.1%) as heterosexual patients.

Lack of insurance was four times greater among bisexual compared with heterosexual patients (16.6 % vs. 4.1%; P<.0001). This finding corroborates “previous trends described by a study using the National Health Interview Survey between 2013 and 2015,” the researchers noted.

Researchers adjusted for socioeconomic, health-related behavioral risk, and health care access factors and found that bisexual females had poorer general health (odds ratio [OR]=1.33; 95% confidence interval [CI], 1.31-1.36) and poorer mental health (OR=2.43; 95% CI, 2.39-2.46). In contrast, bisexual males and gay males presented with better general health than their heterosexual counterparts.

“It would be interesting to further investigate the reason that the different sexes displayed such results in two different directions,” the researchers wrote.

Bisexual males were more than five times (OR=5.14) more likely to be diagnosed with depressive disorders compared to heterosexual counterparts, and this risk was more than three times higher for bisexual females (OR=3.23).

“In an effort to improve cancer survivorship, future research should explore ways to close the gap in educational attainments and to promote healthy lifestyles and tailor tobacco cessation and alcohol control programs to better serve lesbian, gay, and bisexual individuals, and particularly bisexual populations, which experience bi-negativity from both gay/lesbian and heterosexual communities,” the researchers concluded.