Comparing the Mental Health of Sexual Minority and Heterosexual Cancer Survivors: A Systematic Review

Abstract

Purpose: Sexual minority (SM) individuals are more likely to experience mental health concerns than heterosexual individuals. However, little is known to date about the psychological needs of SM cancer survivors. The objective of this systematic review was to identify whether SM cancer survivors experience disparate psychological outcomes compared with heterosexual cancer survivors. Methods: PubMed/MEDLINE, PsycINFO, CINAHL, Web of Science, and ProQuest databases were searched systematically to identify studies that compared mental health outcomes between SM and heterosexual survivors. A standardized data extraction form was used to extract data from eligible articles. The Joanna Briggs Institute Checklist for Analytical Cross Sectional Studies was used to assess study quality. Results: Twelve studies met the inclusion criteria and assessed distress, depression, anxiety, perceived stress, and mental and emotional quality of life (QOL). Most studies enrolled survivors diagnosed either with female breast cancer or with prostate cancer. Most studies reporting on mental health among women found no differences between SM and heterosexual survivors. Studies conducted among men found that SM survivors experienced higher distress, depression, and anxiety, and lower emotional/mental QOL than heterosexual survivors. Conclusion: The findings of the present synthesis suggest that mental health disparities may exist among SM men diagnosed with cancer, particularly prostate cancer. More research is required to identify mental health disparities among SM survivors diagnosed with other cancers, as well as predisposing and protective factors. In addition, mental health screening and interventions are needed for SM men after cancer diagnosis.

Health‐related quality of life among colorectal cancer survivors of diverse sexual orientations

“…The review found divergent findings of no significant sexual orientation differences in anxiety in a sample of men and women with diverse cancers and among breast cancer survivors, whereas significant sexual orientation differences in anxiety among prostate cancer survivors were noted. 8 In comparison, findings in the general (noncancer) population are consistent with our findings, in that sexual minorities report greater anxiety in comparison with the heterosexual population. 36,42 The combination of these sexual minorityspecific findings, all of which are linked to better MCS, could be leveraged by the development of culturally tailored psychological interventions to improve the well-being of sexual minority survivors.…”

“…Third, this study fills an important gap in cancer research, in that CRC affects both men and women, whereas previous studies of sexual minority cancer survivors mostly have drawn on breast cancer for women and prostate cancer for men. 8 Fourth, our findings suggest modifiable factors that differ between sexual minority and heterosexual cancer survivors and can be used in the development of interventions to enhance quality of life for diverse populations of cancer survivors.…”

“…[5][6][7] Previous studies of sexual minority cancer survivors' quality of life have often been gender-specific and predominantly focused on breast or prostate cancer, and this has resulted in divergent findings. 8,9 Breast cancer studies have revealed similar quality of life for sexual minority and heterosexual women survivors, 8,[10][11][12][13] with sexual orientation having indirect associations through interaction effects. 10 In contrast, prostate cancer studies have shown some differences, with sexual minority men reporting worse quality of life than heterosexual men.…”

“…10 In contrast, prostate cancer studies have shown some differences, with sexual minority men reporting worse quality of life than heterosexual men. 8,[14][15][16] In the absence of known and validated conceptual frameworks for understanding sexual minority cancer survivors' quality of life, we chose to use the biopsychosocial framework of quality of life. More specifically, we were guided by a systematic review of CRC survivors' quality of life, which provided strong evidence that 4 domains-personal factors, environmental factors, health condition characteristics, and body function and structure-predict CRC survivors' quality of life.…”

Differences in Health-Related Quality of Life and Health Behaviors Among Lesbian, Bisexual, and Heterosexual Women Surviving Cancer from the 2013 to 2018 National Health Interview Survey

“…22 The higher relative odds of severe psychological distress among bisexual women cancer survivors contradict existing literature. 48,49 In a systematic review, Gordon et al noted mental health disparities in male, but not female, sexual minority survivors. 48 Many studies assessing psychological health in females evaluated breast cancer survivors 20,[50][51][52][53] and reported no significant differences [50][51][52][53] ; however, Jabson and Bowen found that SMW breast cancer survivors reported higher perceived stress than heterosexual women.…”