Cancer Facts for Lesbian and Bisexual Women
Some of the cancers that most often affect women are breast, colorectal, endometrial, lung, cervical, skin, and ovarian cancers. Lesbian and bisexual women may be at increased risk for breast, cervical, and ovarian cancer compared to heterosexual women. Knowing about these cancers and what you can do to help prevent them or finding them early (when the cancer is small, has not spread, and might be easier to treat) may help save your life.
Recognizing barriers
Studies suggest that some lesbian and bisexual women get less routine health care than other women, including breast, colorectal, and cervical cancer screening tests. Some of the reasons for this include:
- Fear of discrimination: Some 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.
- Low rates of health insurance: Some health insurance policies don’t cover unmarried partners. This makes it harder for many lesbian and bisexual women to get quality health care.
- 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 sometimes harder to treat.
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. Women can do things to help reduce their cancer risk and be healthy.
Breast cancer
Who is at risk?
Some risk factors for breast cancer include being a woman and getting older. A woman whose mother, sister, or daughter has or had breast cancer is at higher risk. Being overweight, especially after menopause, not being physically active, drinking alcohol, or using certain types of birth control may add to the risk. Additionally, there may be a higher breast cancer risk for women who have used some hormone therapy after menopause. Women who haven’t had children or haven’t breast-fed, and women who are older than 30 when they first give birth, are also at a slightly higher risk.
What you can do
The American Cancer Society recommends the following guidelines for breast cancer early detection for women at average risk:
Women ages 40 to 44 should have the choice to start annual breast cancer screening with a mammogram if they wish to do so.
Women age 45 to 54 should get a mammogram every year.
Women 55 and older can switch to a mammogram every 2 years, or can continue to get a yearly mammogram.
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 understand what to expect when getting a mammogram for breast cancer screening – what the test can and cannot do. They should also be familiar with how their breasts normally look and feel and report any changes to a health care provider right away.
Women at high risk for breast cancer – because of their family history, a genetic mutation, or other risk factors – should be screened with MRI along with a mammogram. Talk with a healthcare provider about your risk for breast cancer and the best screening plan for you.
Colorectal cancer
Who is at risk?
Being older, having a personal history of colorectal polyps, or having a personal or family history of colorectal cancer (sometimes called either colon cancer or rectal cancer) are risk factors for developing colorectal cancer. Being overweight, eating a diet high in red and processed meats, heavy alcohol use, smoking, and not being physically active also increase risk. Studies also show having type 2 diabetes, irritable bowel syndrome, or certain hereditary syndromes can also increase a person's risk for colorectal cancer.
What you can do
Know your risk. Talk to your health care team about your risk factors.
Getting to and staying at a healthy weight, following a healthy eating pattern, being active, not smoking, and avoiding alcohol might help lower your risk of colorectal cancer.
Regular colorectal cancer screening is one of the most powerful weapons against colorectal cancer. Colorectal cancers often start with a polyp – a small growth on the lining of the colon or rectum. Screening can help find colorectal cancer early, when it's smaller, hasn't spread, and might be easier to treat. Certain screening tests can also help prevent cancer by finding and removing polyps before they turn into cancer.
The American Cancer Society recommends the following for people at average risk for colorectal cancer:
- People should start regular screening at age 45.
- People who are in good health and with a life expectancy of more than 10 years should continue regular colorectal cancer screening through age 75.
- For people ages 76 through 85, the decision to be screened should be based on their preferences, life expectancy, overall health, and prior screening history.
- People over age 85 should no longer get colorectal cancer screening.
Stool-based tests
- Highly sensitive fecal immunochemical test (FIT) * every year, or
- Highly sensitive guaiac-based fecal occult blood test (gFOBT) * every year, or
- Multi-targeted stool DNA test (MT-sDNA) every 3 years*
Visual (structural) exams of the colon and rectum
- Colonoscopy every 10 years, or
- CT colonography (virtual colonoscopy) every 5 years*, or
- Flexible sigmoidoscopy every 5 years*
*If you choose to be screened with a test other than colonoscopy, any abnormal test result should be followed up with colonoscopy.
If you are at high risk of colorectal cancer based on family history or other factors, you may need to start testing before age 45, be screened more often, or get specific tests. Talk to a health care provider about your risk for colorectal cancer to know when you should start screening.
There are some differences between these tests to consider, but the most important thing is to get screened, no matter which test you choose. Talk to a health care provider about which tests might be good options for you, and to your insurance provider about coverage.
Lung cancer
Who is at risk?
Lung cancer is the second most common cancer and a leading cause of cancer death in the US and around the world. It's important to know that anyone can get lung cancer, including people who have never smoked and don't currently use tobacco products. Still, smoking is by far the leading cause of lung cancer, and is known to be linked to 12 other types of cancer. Some evidence suggests that lesbian and bisexual women are about twice as likely to smoke compared to heterosexual women. Smoking is also linked to heart disease, bronchitis, stroke, and emphysema.
Exposure to radon, asbestos, or air pollution can put a person at higher risk for lung cancer, too. Having a personal or family history of lung cancer or previous radiation to the chest or lungs can also increase a person's risk for lung cancer.
What you can do
Avoid exposure to tobacco smoke and other harmful chemicals. If you don’t smoke, don’t start, and avoid breathing in other people's smoke. If you or your loved ones smoke, call the American Cancer Society at 1-800-227-2345 for help quitting.
The American Cancer Society recommends screening for certain people at higher risk for lung cancer. If you smoke or did smoke, are between ages 50 and 80 and in fairly good health, you might benefit from screening for lung cancer with a yearly low-dose CT scan. If you still smoke, talk to a health care provider about your risk for lung cancer, how you can quit smoking, the possible benefits, limits, and harms of lung cancer screening, and where you can get screened.