More Information About Cancer in LGBTQ People May Help Improve Prevention, Diagnosis, and Treatment

Grantee: Brittany M. Charlton, ScD
Institution: Boston Children's Hospital
Area of Focus: Cancer Control
Grant Term: 7/1/2017 to 9/26/2022

The Challenge: People who identify as lesbian, gay, bisexual, and queer (LGBTQ) may have a higher risk of getting cancer than those who identify as heterosexual or cisgender. Potential cancer disparities in cervical, breast, lung, and other types of cancer are largely due to discrimination and other factors.

The Research: Brittany M. Charlton, ScD, is studying information from various studies, including 4 large, national studies with nearly 200,000 people, of which 15,000 identify as LGBTQ.

Since the start of her grant, Charlton has published many studies in peer-reviewed journals. Here are a few of her discoveries.

About health insurance coverage, doctor-patient relationships, and cancer screening:

  • Compared to heterosexual, cisgender people, LGBTQ people are more likely to be unemployed, uninsured, lack access to health care, and delay heath care—including care that’s critical to help prevent cancer and screen for it.
  • Regardless of their sexual orientation, people whose health care providers knew their sexual orientation were more likely to have been encouraged to get cancer screenings compared to people whose providers didn’t know their sexual orientations.
  • Lesbian women were the only subgroup that was less likely than heterosexual women to be encouraged to receive cancer preventive care, such as HPV vaccinations and Pap tests.
  • Lesbian women are less likely than heterosexual women to have a Pap test, and when they are tested, the result is more likely to be abnormal.

About mammograms:

  • Compared to Black heterosexual women, Black bisexual women were more likely than to have had a mammogram in the last year. In fact, Black bisexual women had the highest prevalence of having a mammogram.
  • No differences were found between the receipt of a mammogram between Black lesbian women and Black heterosexual women or between Latina, lesbian women and Latina, heterosexual women.

Why Does It Matter? Charlton’s work is documenting persistent and pronounced cancer disparities among LGBTQ people. Her work points to ways that can help reduce these disparities such as training medical providers to care for all patients—particularly vulnerable populations like LGBTQ people.

Her studies are particularly helping to fill research gaps among understudied populations within the LGBTQ community, including adolescents, women, and people of color.  

Charlton’s results suggest that tailored health policies, public health programs, and clinical practices are needed to raise awareness of and access to cancer prevention information and screenings based on nuanced risk factors according to sexual orientation, gender orientation, race/ethnicity, and other sources of social Inequity.