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Cancer Facts for Lesbians and Bisexual Women

Protect yourself and the people you care about.

Recognizing barriers. Saving lives.

The most common types of cancer among women are breast, colon, endometrial (uterine), cervical, lung, and skin cancer.

Studies have found that lesbians and bisexual women have higher rates of breast cancer than heterosexual women.1 They also get less routine health care than other women, including colon, breast, and cervical cancer screening.2 Some of the reasons for this include:

  • Low rates of health insurance: Many health insurance policies do not cover unmarried partners. This makes it harder for many lesbians and bisexual women to get quality health care. Many states now offer family health insurance plans that may help you get coverage in other ways.
  • Fear of discrimination: Many women do not tell their doctors about their sexual orientation, because they don’t want discrimination to affect the quality of health care they receive. This can make it harder to have a comfortable relationship with a provider. A lesbian, gay, bisexual, and transgender/transsexual (LGBT) community center or group may be able to refer you to LGBT-friendly health care providers.
  • Negative experiences with health care providers: Fear of having a negative experience with a health care provider can lead some women to delay or avoid medical care, especially routine care such as early detection tests. Missing routine cancer screenings can lead to cancer being diagnosed at a later stage, when it’s harder to treat. Today, there are many LGBT-friendly providers. Don’t give up – find the respectful care you deserve!

The American Cancer Society can help you learn more about the cancers that women are most at risk for, as well as how to find these cancers early (when they are small and easier to treat). All women can do things to help reduce their cancer risk and stay well.

Breast cancer

Who is at risk?

The 2 biggest risk factors for breast cancer are being a woman and getting older. A woman whose mother, sister, grandmother, or aunt has or had breast cancer is at higher risk. Smoking, being overweight, especially after menopause, or drinking alcohol may add to the risk. Women who have not had children and have not breast-fed, have not used oral contraceptives, and are older when they first give birth – all factors more likely to affect lesbians and bisexual women – are also at a slightly higher risk.3

What you can do

The best defense against breast cancer is to find it early – when it’s small and has not spread. This is when the disease is easiest to treat. The American Cancer Society recommends the following guidelines for breast cancer early detection:

  • Women age 40 and older should have a mammogram done every year and continue to do so as long as they are in good health.
  • Women in their 20s and 30s should have a clinical breast exam done as part of a regular check-up by a health professional, preferably every 3 years. Women 40 and older should have a breast exam by a health professional every year.
  • Women should know how their breasts normally look and feel and report any breast change to a health professional right away. Breast self-exam (BSE) is an option for women starting in their 20s. Talk to a doctor or nurse about benefits and limitations of BSE.

Some women who are at high risk for breast cancer – because of family history, a genetic tendency, or certain other factors – should be screened with MRI along with mammograms every year. Talk to a doctor about your risk and the best screening plan for you.

Colon cancer

Who is at risk?

Most colorectal cancers (commonly known as colon cancer) are found in people age 50 and older. People with a personal or family history of the disease, colon or rectal polyps, or inflammatory bowel disease are at greater risk. A diet high in red and processed meats, alcohol use, being overweight, smoking, and being inactive also increase risk.

What you can do

Colon cancer almost always starts with a polyp – a small growth on the lining of the colon or rectum. Testing can save lives by finding polyps before they become cancer. If pre-cancerous polyps are removed, colon cancer can be prevented. A diet that includes plenty of fruits and vegetables, whole grains, and limits red or processed meat may also lower risk.

The American Cancer Society recommends all people at average risk for colorectal cancer have 1 of the following tests starting at age 50:

Tests that find polyps and cancer:

  • Flexible sigmoidoscopy every 5 years
  • Double-contrast barium enema every 5 years
  • Colonoscopy every 10 years
  • A CT colonography every 5 years

OR

Tests that find mainly cancer:

  • Fecal occult blood test (FOBT) or fecal immunochemical test (FIT), also known as a stool blood test, every year
  • Stool DNA test (sDNA), interval uncertain (this test is currently not available)

Tests that have the best chance of finding both polyps and cancer should be your first choice when possible. Talk with a doctor or nurse to find out which test is right for you.

Gynecological cancers

Who is at risk?

The 3 most common types of cancer of the female reproductive organs (gynecological cancers) are cervical, endometrial (uterine), and ovarian cancer.

Cervical cancer can affect any woman who is – or has been – sexually active with a man or woman. It occurs in women who have had a virus called human papilloma virus (HPV), although most women with this virus do not develop cervical cancer. Cervical cancer is also more likely in women who smoke, have HIV or AIDS, or haven’t had regular Pap tests.

Endometrial cancer starts in the lining of the uterus. A woman’s hormone balance plays a part in the development of most endometrial cancers. This cancer is more likely in women who have taken estrogen therapy without progesterone, are obese, have never been pregnant, have never taken oral contraceptives, have polycystic ovarian syndrome (PCOS), or have a family history of hereditary non-polyposis colon cancer (HNPCC).

Ovarian cancer is more likely to occur in women as they get older. Women who have never been pregnant; are obese; have had breast cancer or a family history of breast, ovarian, or colon cancer; have never taken oral contraceptives; have taken androgens (male hormones); or have taken estrogen therapy without progesterone are at higher risk for ovarian cancer.

What you can do

The Pap test is used to find cervical cancer; it does not find endometrial or ovarian cancer. The Pap test can find changes in the cervix before they become cancer. The American Cancer Society recommends that, starting at age 21, all women begin cervical cancer testing by getting a Pap test every 3 years.

Starting at age 30, the preferred way to screen is with a Pap test combined with an HPV test every 5 years. This should be done until age 65. Another reasonable option for women ages 30 to 65 is to get tested every 3 years with just the Pap test.

Yearly testing is no longer needed. But some women (such as those with a history of HIV infection, organ transplant, or DES exposure) may need to be tested more often. These women should follow the advice of a doctor or nurse.

Protecting yourself by using dental dams and condoms during sex may reduce exposure to HPV.

Be aware of symptoms of endometrial and cervical cancers, such as unusual discharge, spotting, or bleeding. Ovarian cancers tend to cause vague symptoms, such as swelling in the stomach area, unusual vaginal bleeding, pelvic pressure, back pain, leg pain, or digestive problems. See a doctor or nurse if you have any of these symptoms.

Lung cancer

Who is at risk?

People who smoke are at greatest risk for lung cancer. Current evidence suggests that lesbians and bisexual women are about twice as likely to smoke compared to heterosexual women.2 Smoking is responsible for 70% of lung cancer deaths among women. Smoking is also linked to many other types of cancer and causes other tobacco-related diseases, too, such as heart disease, bronchitis, stroke, and emphysema.

What you can do

Lung cancer is one of the few cancers that can often be prevented simply by not smoking. If you don’t smoke, don’t start. You can also reduce your exposure to secondhand smoke by seeking smoke-free places. If you or a loved one smokes, talk to a health care provider about quitting, or call 1-800-227-2345 to find out how we can help increase your chances of quitting for good.

Certain women at high risk for lung cancer may want to talk to a doctor about whether getting a low-dose CT scan to screen for early lung cancer is right for them. Screening may benefit adults who are active or former smokers between the ages of 55 and 74, who have no signs of lung cancer, and who have a 30 pack-year smoking history. (A pack-year is 1 pack of cigarettes per day per year. One pack per day for 30 years or 2 packs per day for 15 years would both be 30 pack-years.) You should discuss the benefits, limitations, and risks of screening with a doctor before testing is done.

Skin cancer

Who is at risk?

Anyone who spends a lot of time in the sun is at risk for skin cancer. People with fair skin, especially those with blond or red hair, are at greater risk than people with darker coloring. Those who have had close family members with melanoma or who had severe sunburns before the age of 18 are at higher risk for skin cancer.

What you can do

Most skin cancers can be prevented by staying out of the midday sun for long periods of time. Here are some other things you can do to help prevent skin cancer:

  • Protect your skin by wearing hats with wide brims, long-sleeved shirts, and sunglasses when you are outside.
  • Use broad-spectrum sunscreen with an SPF of 30 or higher on all exposed skin. Sunscreens should block both UVA and UVB sun rays, and should be applied at least 15 to 30 minutes before going outside. Be sure to wear sunscreen on cloudy or overcast days too because UV rays travel through clouds.
  • Avoid other sources of UV light, like tanning beds and sun lamps. These are dangerous and can damage your skin.
  • Know your skin, and report any skin changes to a doctor or nurse. Have a skin exam done during your regular health check-ups.

Finding cancer early

Early detection – finding cancer while it’s small, before you have symptoms, and before it has spread – gives you the best chance of getting treatment that works.

All women should see a doctor or nurse on a regular basis, learn about the benefits and limitations of testing, and get the cancer screening tests that are right for them. They should also try to make healthy lifestyle choices that help reduce cancer risk.

Knowing about these cancers and what you can do to help reduce your risk for cancer or find it early may save your life or the life of someone you love.

To learn more about what you can do to stay well and help reduce your cancer risk, call us at 1-800-227-2345.

Notes

1 Committee on Lesbian, Gay, Bisexual, and Transgender Health Issues and Research Gaps and Opportunities; Board on the Health of Select Populations. The Health of Lesbian, Gay, Bisexual, and Transgender People: Building a Foundation for Better Understanding. 2011; Institute of Medicine.

2 Blosnich JR, Farmer GW, Lee JG, Silenzio VM, Bowen DJ. Health inequalities among sexual minority adults: Evidence from ten U.S. states, 2010. Am J Prev Med. 2014;46(4):337-349.

3 Brandenberg DL, Matthews AK, Johnson TP, Hughes TL. Breast cancer risk and screening: a comparison of lesbian and heterosexual women. Women Health. 2007;45(4):109-130.


Last Medical Review: 08/11/2014
Last Revised: 08/11/2014