Lesbian, Gay, and Bisexual Cancer Survivors Face Challenges

Lesbian, gay, bisexual, and other non-heterosexual cancer survivors have a lower quality of life than heterosexual cancer survivors, according to a study by Boston University and Harvard University researchers. The study says this is especially true for women who are not heterosexual because their access to health care is worse, which is often more strongly related to poor quality of life. The study was published May 20, 2019 in CANCER, a peer-reviewed journal of the American Cancer Society.

The researchers conducted the study to learn more about differences in access to care between heterosexual and non-heterosexual cancer survivors. Access to care is an important factor in cancer survivors’ long-term outcomes, including how long they live, whether their cancer comes back, and their quality of life.

They looked at 4 years’ worth of data from an annual phone survey done by the Centers for Disease Control and Prevention called the Behavioral Risk Factor Surveillance Survey.

More than 712,000 people took part in the phone survey from 2014-2017, which asked if they were straight, lesbian or gay, bisexual, or “other.” More than 70,000 of the respondents were cancer survivors. Among this group, 1,931 people identified themselves as lesbian or gay, bisexual, or “other.” The authors refer to them as “non-heterosexual.” The authors noted there were not enough cancer survivors who identified themselves as transgender to compare to the other groups, so information reported by transgender people was not included.   

Compared to the heterosexual women, the women researchers described as non-heterosexual:

• were less likely to have health insurance, a personal doctor, or annual medical visits
• were more likely to avoid medical care due to costs
• had a stronger link between poor access to care and 3 quality of life indicators: poor physical quality of life, poor mental quality of life, and trouble concentrating.

Men described by the researchers as non-heterosexual were also more likely to avoid medical care due to costs. However, unlike the situation with women, both heterosexual and non-heterosexual men had similar access to care with respect to insurance status, quality of life, having a personal doctor, and completing annual medical visits. Those who reported having poor access to care were more likely to have trouble concentrating and poor mental quality of life.

The researchers are calling for increased awareness of the problems faced by the self-identified lesbian, gay, bisexual, and other non-heterosexual cancer survivors in this study. They urge policy makers and doctors to better address the needs of these people in accessing health care and managing quality of life issues, and to offer services designed to help them face the challenges of medical costs.