This article provides an overview of the current literature on seven cancer sites that may disproportionately affect lesbian, gay, bisexual, transgender/transsexual, and queer/questioning (LGBTQ) populations. For each cancer site we present and discuss the descriptive statistics, primary prevention, secondary prevention and preclinical disease, tertiary prevention and late stage disease, and clinical implications. Finally, an overview of psychosocial factors related to cancer survivorship is offered as well as strategies for improving access to care.
African Americans are disproportionately affected by prostate cancer, yet less is known about the most salient psychosocial dimensions of quality of life. The purpose of this study was to explore the perceptions of African American prostate cancer survivors and their spouses of psychosocial issues related to quality of life. Twelve African American couples were recruited from a National Cancer Institute Comprehensive Cancer Center registry and a state-based non-profit organization to participate in individual interviews. The study was theoretically based on Ferrell's Quality of Life Conceptual Model. Common themes emerged regarding the psychosocial needs of African American couples. These themes were categorized into behavioral, social, psychological, and spiritual domains. Divergent perspectives were identified between male prostate cancer survivors and their female spouses. This study delineated unmet needs and areas for future in-depth investigations into psychosocial issues. The differing perspectives between patients and their spouses highlight the need for couple-centered interventions.
Purpose
Identify the influence of medical mistrust, fears, attitudes, and sociodemographic characteristics on unwillingness to participate in colorectal cancer (CRC) screening.
Design
Cross-sectional disproportionally allocated, stratified, random-digit dial telephone questionnaire of non-institutionalized households.
Setting
New York City, NY; Baltimore, MD; San Juan, Puerto Rico.
Subjects
Ethnically diverse sample of 454 adults ≥ 50 years of age.
Measures
Health status, cancer screening effectiveness, psychosocial factors (i.e., perceptions of pain, fear, trust), and CRC screening intentions using the Cancer Screening Questionnaire which addresses a range of issues related to willingness of minorities to participate in cancer screening.
Analysis
Multivariate logistic regression was used to model the probability of reporting unwillingness to participate in CRC screening.
Results
Fear of embarrassment during screening (OR = 10.72; 95% CI: 2.15–53.39), fear of getting AIDS (OR = 8.75; 95% CI: 2.48–30.86), fear that exam might be painful (OR=3.43; 95% CI: 1.03–11.35), and older age (OR = 1.10; 95% CI: 1.04 – 1.17) were positively associated with unwillingness to participate in CRC screening. Fear of developing cancer (OR = 0.12; 95% CI: 0.03 – 0.57) and medical mistrust (OR =0.19; 95% CI: 0.06 – 0.60) were negatively associated with unwillingness to screen.
Conclusions
Findings suggest that CRC health initiatives should focus on increasing knowledge; addressing fears, mistrust, normalize CRC screening as a beneficial preventive practice; and increase focus on older adults.
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