Breast cancer survivorship: the role of perceived discrimination and sexual orientation

Abstract

Breast cancer disproportionately affects sexual minority women (SMW) compared to heterosexual women and a small but growing literature indicates that SMW may have diminished survivorship outcomes; outcomes that are measurably and importantly different from heterosexual breast cancer survivors. However, it remains unknown how sexual orientation influences breast cancer survivorship outcomes such as quality of life. One possible route of influence is SMW's perceived discrimination in the health care setting. This cross-sectional study examines SMW perceptions of discrimination as one of the multiple facets of the breast cancer survivorship process. This study assessed SMW breast cancer survivor's perceptions of discrimination during their breast cancer treatment experience and secondarily, examined the role of this perceived discrimination on SMW's quality of life. Sixty-eight purposefully sampled sexual minority breast cancer survivors completed assessments of quality of life, perceived discrimination, perceived social support and perceived stress via an online survey. Statistical analyses point to perceived discrimination and perceived social support as important indicators for predicting SMW's quality of life. Future research on SMW's breast cancer survivorship should include measures of perceived discrimination.

A qualitative exploration of the meaning of the term “survivor” to young women living with a history of breast cancer

“…However, small qualitative studies such as the present research could inform the design of a larger study. Literature about black and minority ethnic, sexual minority and disabled women in the field of breast cancer is sparse but suggests that there may be particular ways that they make sense of their experience (Banning & Hafeez, ; Boehmer, Linde, & Freund, ; Davis et al., ; Fish, ; Jabson, Donatelle, & Bowen, ; Patel, Harcourt, Naqvi, & Rumsey, ; Rubin & Tanenbaum, ). The inclusion of five women who identified as belonging to these groups contributes their voices to the literature, but it would be wrong to suggest that such small numbers are representative of all minority women in Europe.…”

“…However, small qualitative studies such as the present research could inform the design of a larger study. Literature about black and minority ethnic, sexual minority and disabled women in the field of breast cancer is sparse but suggests that there may be particular ways that they make sense of their experience (Banning & Hafeez, 2010;Boehmer, Linde, & Freund, 2007;Davis et al, 2016;Fish, 2010;Jabson, Donatelle, & Bowen, 2011;Patel, Harcourt, Naqvi, & Rumsey, 2014;Rubin & Tanenbaum, 2011).…”

Sexual minority cancer survivors' satisfaction with care

“…Discrimination is also present in the healthcare setting. Over two-thirds of providers report that sexual minority patients receive poorer treatment because of their sexual orientation (Schatz, O’Hanlan, & American Association of Physicians for Human, 1994) and least one previous study has shown that sexual minority cancer survivors report experiencing discrimination during cancer treatment (Jabson, Donatelle, & Bowen, 2011). …”

Sexual minority experiences of cancer care: A systematic review

“…The ways in which LGB individuals are affected by cancer and how they cope were discussed within several papers, indicating many sexual minority attitudes are common with heterosexual cancer survivors, but sexual minorities may report poorer health [24,[26][27][28]53,54].…”

“…Levels of stress between heterosexuals and SMW have been compared in one study uncovered in this review. A further USA study compared 68 SMW and 143 heterosexual women levels of stress, and found that minority breast cancer survivors had higher perceived stress compared to heterosexual breast cancer survivors, had an uneven balance of participants and may influence the quality of the findings [54]. An analysis of pooled data from a USA California Health Interview survey from 2001, 2003, and 2005 examined and the self-reported health of sexual minority individuals were compared with heterosexuals [27].…”