Cancer and lesbian, gay, bisexual, transgender/transsexual, and queer/questioning (LGBTQ) populations

Quinn, Gwendolyn P.; Sánchez, Julián; Sutton, Steven K.; Vadaparampil, Susan T.; Nguyêñ, Giang T.; Green, B. Lee; Kanetsky, Peter A.; Schabath, Matthew B.

doi:10.3322/caac.21288

Cited by 359 publications

(318 citation statements)

References 142 publications

(183 reference statements)

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“…Whilst identity and behaviour are overlapping categories, they must be distinguished in future research. An important implication is that sexual orientation should be routinely recorded as part of data collection in cohort studies, alongside medical records, to allow more large‐scale interpretation of disease patterns (and potential confounders) as previous authors have also concluded 28, 50. More work is required in developing countries, although matters such as routine recording may be problematic due to stigma or illegality of homosexuality.…”

Section: Resultsmentioning

confidence: 99%

Lesbian and bisexual women's gynaecological conditions: a systematic review and exploratory meta‐analysis

Robinson

Galloway

Bewley

et al. 2016

BJOG

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BackgroundLittle is known about the gynaecological health of lesbian and bisexual (LB) women.ObjectivesTo examine differences in incidence and/or prevalence of gynaecological conditions in LB compared with heterosexual women.Search strategyThe systematic review protocol was prospectively registered (PROSPERO‐CRD42015027091) and searches conducted in seven databases.Selection criteriaComparative studies published 2000–2015, reporting any benign (non‐infectious) and/or malignant gynaecological conditions with no language or setting restrictions.Data collection and analysisInclusions, data extraction and quality assessment were conducted in duplicate. Meta‐analyses of condition prevalence rates were conducted where ≥3 studies reported results.Main resultsFrom 567 records, 47 full papers were examined and 11 studies of mixed designs included. No studies directly addressing the question were found. Two chronic pelvic pain studies reported higher rates in bisexual compared with heterosexual women (38.5 versus 28.2% and 18.6 versus 6.4%). Meta‐analyses showed no statistically significant differences in polycystic ovarian syndrome, endometriosis and fibroids. There was a higher rate of cervical cancer in bisexual than heterosexual women [odds ratio (OR) = 1.94; 95% CI 1.46–2.59] but no difference overall (OR = 0.76; 95% CI 0.15–3.92). There was a lower rate of uterine cancer in lesbian than heterosexual women (OR = 0.28; 95% CI 0.11–0.73) and overall (OR = 0.36; 95% CI 0.13–0.97), but no difference in bisexual women (OR = 0.43; 95% CI 0.06–3.07).ConclusionsMore bisexual women may experience chronic pelvic pain and cervical cancer than heterosexual women. There is no information on potential confounders. Better evidence is required, preferably monitoring sexual orientation in research using the existing validated measure and fully reporting results.Tweetable abstractLesbians have less uterine cancer than heterosexual women; bisexuals have more pelvic pain and cervical cancer.

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Section: Resultsmentioning

confidence: 99%

Lesbian and bisexual women's gynaecological conditions: a systematic review and exploratory meta‐analysis

Robinson

Galloway

Bewley

et al. 2016

BJOG

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“…Human immunodeficiency virus infections are common among transgender people, particularly transwomen who have some of the highest laboratory-confirmed prevalence estimates in the world (29). For all of the above reasons, HPV-related cancers are expected to occur more frequently in transgender people than in the general population (30).…”

Section: Human Papillomavirus Infectionsmentioning

confidence: 99%

Cancer in Transgender People: Evidence and Methodological Considerations

Braun

Nash

Tangpricha

et al. 2017

Epidemiologic Reviews

165

122

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Transgender people comprise a diverse group of individuals whose gender identity or expression differs from that originally assigned to them at birth. Some, but not all, transgender people elect to undergo medical gender affirmation, which may include therapy with cross-sex hormones and/or surgical change of the genitalia and other sex characteristics. As cross-sex hormones administered for the purposes of gender affirmation may be delivered at high doses and over a period of decades, the carcinogenicity of hormonal therapy in transgender people is an area of considerable concern. In addition, concerns about cancer risk in transgender patients have been linked to sexually transmitted infections, increased exposure to well-known risk factors such as smoking and alcohol use, and the lack of adequate access to screening. Several publications have identified cancer as an important priority in transgender health research and called for large-scale studies. The goals of this article are to summarize the evidence on factors that may differentially affect cancer risk in transgender people, assess the relevant cancer surveillance and epidemiologic data available to date, and offer an overview of possible methodological considerations for future studies investigating cancer incidence and mortality in this population.

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“…This inequality is evident in terms of access to the healthcare system and use of preventive health services [3,4]. As such, patients who identify as lesbian, gay, bisexual or transgender (LGBT) are at an increased risk for cancer, mental health disorders, substance abuse, and sexually transmitted infections [2,5,6]. Data shows that LGBT individuals receive poorer healthcare and often report a considerable degree of discrimination by medical students and practicing physicians.…”

Section: Introductionmentioning

confidence: 99%

Medical students’ perception of lesbian, gay, bisexual, and transgender (LGBT) discrimination in their learning environment and their self-reported comfort level for caring for LGBT patients: a survey study

Nama

MacPherson

Sampson

et al. 2017

Medical Education Online

103

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Background: Historically, medical students who are lesbian, gay, bisexual or transgendered (LGBT) report higher rates of social stress, depression, and anxiety, while LGBT patients have reported discrimination and poorer access to healthcare. Objective: The objectives of this study were: (1) to assess if medical students have perceived discrimination in their learning environment and; (2) to determine self-reported comfort level for caring for LGBT patients. Design: Medical students at the University of Ottawa (N = 671) were contacted via email and invited to complete a confidential web-based survey. Results: Response rate was 15.4% (103/671). This included 66 cis-gender heterosexuals (64.1%) and 37 LGBT students (35.9%). Anti-LGBT discrimination had been witnessed by 14.6% and heterosexism by 31.1% of respondents. Anti-LGBT discrimination most often originated from fellow medical students. Respondents who self-identified as LGBT were more likely to have perceived heterosexism (favoring opposite-sex relationships) (OR = 8.2, p < 0.001) or anti-LGBT discrimination (OR = 6.6, p = 0.002). While half of LGBT students shared their status with all classmates (51.4%), they were more likely to conceal this from staff physicians (OR = 27.2, p = 0.002). Almost half of medical students (41.7%) reported anti-LGBT jokes, rumors, and/or bullying by fellow medical students and/or other members of the healthcare team. Still, most respondents indicated that they felt comfortable with and capable of providing medical care to LGBT patients (≥83.5%), and were interested in further education around LGBT health issues (84.5%). Conclusion: Anti-LGBT discrimination and heterosexism are noted by medical students, indicating a suboptimal learning environment for LGBT students. Nonetheless, students report a high level of comfort and confidence providing health care to LGBT patients.

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Cancer and lesbian, gay, bisexual, transgender/transsexual, and queer/questioning (LGBTQ) populations

Cited by 359 publications

References 142 publications

Lesbian and bisexual women's gynaecological conditions: a systematic review and exploratory meta‐analysis

Lesbian and bisexual women's gynaecological conditions: a systematic review and exploratory meta‐analysis

Cancer in Transgender People: Evidence and Methodological Considerations

Medical students’ perception of lesbian, gay, bisexual, and transgender (LGBT) discrimination in their learning environment and their self-reported comfort level for caring for LGBT patients: a survey study

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