Cancer Facts for Lesbians and Bisexual Women
Protect yourself and the people you care about.
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Recognizing barriers. Helping to save lives.
Some of the most common types of cancer among women are breast, colon, endometrial (uterine), cervical, lung, and skin cancer. Knowing about these cancers and what you can do to help prevent them or find them early (when they are small and easier to treat) may help save your life.
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 tests.2 Some of the reasons for this include:
- Low rates of health insurance: Many health insurance policies don’t 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 don’t tell their health care providers 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 screening tests 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. All women can do things to help reduce their cancer risk and stay well.
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 haven’t had children and haven’t breast-fed, haven’t 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 hasn’t spread. That’s when cancer is easiest to treat. The American Cancer Society recommends the following guidelines for breast cancer early detection:
Women ages 40 to 44 should have the choice to start annual breast cancer screening with mammograms if they wish to do so.
Women age 45 to 54 should get mammograms every year.
Women 55 and older should switch to mammograms every 2 years, or can continue yearly screening.
Screening should continue as long as a woman is in good health and is expected to live at least 10 more years.
All women should be familiar with the known benefits, limitations, and potential harms linked to breast cancer screening. They should also be familiar with how their breasts normally look and feel and report any changes to a health care provider right away.
Some women at high risk for breast cancer – because of their family history, a genetic tendency, or certain other factors – should be screened with MRIs along with mammograms. (The number of women who fall into this category is very small.) Talk with a health professional about your risk for breast cancer and the best screening plan for you.
Who is at risk?
Most colon and rectal cancers (commonly known simply 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. Being overweight, a diet high in red and processed meats, alcohol use, 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 help save lives by finding polyps before they become cancer. If pre-cancerous polyps are removed, colon cancer can be prevented.
The American Cancer Society recommends all people at average risk for colon cancer get 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
- CT colonography (virtual colonoscopy) every 5 years*
Tests that find mainly cancer:
- Guaiac-based fecal occult blood test (gFOBT) or fecal immunochemical test (FIT) every year*, **
- Stool DNA test (sDNA) every 3 years*
* If the test is positive, a colonoscopy should be done.
** The multiple stool take-home method should be used. One test done by a health care provider isn’t enough.
Tests that are designed to find both polyps and cancer should be your first choice when possible. Talk with a health care provider to find out which test is right for you.
If you’re at high risk of colon cancer based on family history or other factors you may need to be tested at a younger age with colonoscopy. Talk to a provider about your risk for colon cancer to know when you should start testing.
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 a woman. It occurs in women who have had a virus called HPV (human papilloma virus), although most women with this virus don’t develop cervical cancer. Cervical cancer is also more likely in women who smoke, have HIV or AIDS, or don’t get 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 health care provider.
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 health care provider if you have any of these symptoms.
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. It’s also important to 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 the chances of quitting for good.
Certain women at high risk for lung cancer may want to talk to a health care provider about whether getting a yearly low-dose CT scan to test for early lung cancer is right for them. Screening tests may benefit adults who are active or former smokers between the ages of 55 and 74, who are in good health, 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 testing with a provider before it’s done.
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 as children 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 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 health care provider. 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 health care provider 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 help 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, visit www.cancer.org or call us at 1-800-227-2345.
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 Revised: 10/20/2015