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

Boehmer, Ulrike; Ozonoff, Al; Winter, Michael; Berklein, Flora; Potter, Jennifer; Hartshorn, Kevan L.; Ward, Kevin C.; Ceballos, Rachel M.; Clark, Melissa A.

doi:10.1002/cncr.33762

Cited by 7 publications

(12 citation statements)

References 51 publications

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“…Four studies included EOCRC patients only, with two of these including only patients under the age of 40 years 8 , 15 , 19 , 21 . The remaining studies included both EOCRC and LOCRC patients, but with varying cut-off ages for their age comparison analysis, with some under 40 14 , 24 , under 45 25 , or under 50 years 13 , 16 , 18 , 20 , 23 , 26 . Studies were mainly from English-speaking countries with eight from the USA 8 , 13 , 14 , 19 , 20 , 22 , 24 , 26 .…”

Section: Resultsmentioning

confidence: 99%

Quality of life in early-onset colorectal cancer patients: systematic review

Waddell

Mclauchlan²,

McCombie

et al. 2023

BJS Open

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Background There is an increasing incidence of early-onset colorectal cancer; however, the psychosocial impacts of this disease on younger adults have been seldom explored. Methods A systematic review was conducted according to the PRISMA guidelines. The Cochrane Central Register of Controlled Trials, MEDLINE, Embase, CINAHL, PubMed, and Scopus were searched, and papers were included if published in English within the last 10 years and if they reported results separately by age (including early-onset colorectal cancer, defined as colorectal cancer diagnosed before the age of 50 years). Critical appraisal of all studies was done using the Joanna Briggs Institute tools. The primary outcome of interest was the global quality of life in patients with early-onset colorectal cancer. Secondary outcomes included the effect on sexual function, body image, finances, career, emotional distress, and social and family functioning. Results The search yielded 168 manuscripts and 15 papers were included in the review after screening. All studies were observational, and included a total of 18 146 patients, of which 5015 were patients with early-onset colorectal cancer. The studies included scored highly using Joanna Briggs Institute critical appraisal tools, indicating good quality and a low risk of bias, but data synthesis was not performed due to the wide range of scoring systems that were used across the studies. Six papers reported significant negative impacts on quality of life in patients with early-onset colorectal cancer. Three of the four studies that compared the quality of life in patients with early-onset colorectal cancer with older patients found that the younger group had worse mean quality-of-life scores (P ≤ 0.05). Secondary outcomes measured in five studies in relation to sexual dysfunction, body image, financial and career impacts, and social and family impacts and in eight studies in relation to emotional distress were found to be more severely impacted in those with early-onset colorectal cancer compared with those with late-onset colorectal cancer. Conclusion Whilst data are limited, the impact of colorectal cancer is different in patients with early-onset colorectal cancer compared with older patients in relation to several aspects of the quality of life. This is particularly prominent in areas of global quality of life, sexual functioning, family concerns, and financial impacts.

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Section: Resultsmentioning

confidence: 99%

Quality of life in early-onset colorectal cancer patients: systematic review

Waddell

Mclauchlan²,

McCombie

et al. 2023

BJS Open

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“…For SD men and women several recent studies reported higher odds of anxiety and depression [21 ▪▪ ,27,28 ▪ ]. However, one of these studies found that when considering covariates specific to SGD survivors, there was no difference in anxiety and depression between SD survivors and heterosexual survivors [29].…”

Section: Resultsmentioning

confidence: 99%

“…Recent research has focused for example on questionnaire development for PCa survivors addressing SD PCa survivors’ sexual quality of life which include investigating topics such as receptive and insertive anal intercourse and urinary incontinence during sex [40,41 ▪▪ ]. Looking at differences between SGD patients’ and heterosexual patients’ personal factors, environmental factors, health characteristics and body function and structure might help predicting quality of life of SGD survivors and has been considered a future research priority [29].…”

Section: Resultsmentioning

confidence: 99%

Sexual and gender diversity in cancer care and survivorship

Schulz-Quach

Kennedy

Lyver

2023

Current Opinion in Supportive &Amp; Palliative Care

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Purpose of the review Sexual and gender diverse (SGD) cancer patients possess unique identities and needs that must be considered during their cancer care. This narrative review explores the current literature on sexual and gender diversity in cancer care and survivorship, in addition to providing recommendations encouraged by the current literature. Recent findings We performed a literature search for articles published in English between January 2021 and June 2022 in Medline ALL and Embase. Fifty-two studies were included in this review. The many identities encapsulated in 2SLGBTQIA+ (2 Spirited, Lesbian, Gay, Bisexual, Transgender, Queer, Intersexual, Asexual, Agender, Aromantic and all gender identities and sexual orientations that are not listed) communities each have their own unique backgrounds, needs and disparities in cancer care and survivorship. However, we also identified specific protective factors in the cancer experience of SGD patients such as reports of higher resiliency and stronger support networks. Much of the recent research features recommendations on improving cancer care by creating inclusive patient questionnaires, improving in-person and online resources, and educating healthcare providers and patient-facing staff on inclusive care. Summary SGD patients have their own specific challenges during and following their cancer care. As the research continues to grow, we gain a better understanding of the needs of these patients and future steps to take to improve SGD patients’ cancer experience.

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“…For our primary aim, we evaluated the bivariate associations between the sexual minority–specific factors and each outcome. We then followed our previously established methods for selecting a multivariable model that adjusts for covariates of interest (Boehmer et al, 2021; Boehmer, Ozonoff, et al, 2022). Although years of sexual minority identity had significant associations with several outcomes, we eliminated this variable from further consideration owing to its associations with age, an important covariate for all outcomes.…”

Section: Methodsmentioning

confidence: 99%

“…Colorectal cancer (CRC) affects either sex and all race/ethnicity groups, and it is the third leading cancer in the United States (Siegel et al, 2019). Previous studies of CRC survivors reported unadjusted results that showed sexual minority survivors had poorer mental quality of life, worse health-related anxiety, and worse general anxiety compared with heterosexual survivors (Boehmer, Ozonoff, et al, 2022;Boehmer et al, 2021). However, none of the initial differences by sexual orientation remained after controlling for relevant factors from the biopsychosocial model identified by other CRC survivor studies (Bours et al, 2016;Niedzwiedz et al, 2019), including personal factors (e.g., age), health condition characteristics (e.g., stage), body function (e.g., bloating), and environmental factors (e.g., social support).…”

mentioning

confidence: 99%

Sexual minority–specific experiences of colorectal cancer survivors.

Boehmer¹,

Clark²,

Winter³

et al. 2022

Health Psychology

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Objective: To examine how sexual minority-specific factors relate to colorectal cancer survivors' health-related quality of life, psychological adjustment, and quality of care. Method: One hundred twenty-seven sexual minority survivors diagnosed with stage I, II, or III colorectal cancer were recruited from four cancer registries. An average of 3 years after diagnosis, eligible survivors participated in a telephone survey, which measured survivors' outcomes, consisting of physical and mental quality of life, anxiety, depression, self-rated fair or poor health, and quality of care. We considered sexual minorityspecific factors (e.g., outness, discrimination) as correlates for each survivorship outcome using forward selection with generalized linear or logistic regression models. Results: After adjusting for confounders, accumulation of lifetime discrimination experiences had negative associations with survivors' physical and mental quality of life, anxiety, and depression. Sexual minority-specific discrimination experiences were negatively associated with perceived quality of care after adjusting for confounders. Sexual minority survivors' self-rated fair or poor health and their rating of care as excellent were independent of sexual minority-specific factors. Conclusion: Addressing and counteracting sexual minority-specific and other lifetime discrimination experiences may be a pathway to improving sexual minority cancer survivors' quality of care, quality of life, and psychological adjustment.

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

Cited by 7 publications

References 51 publications

Quality of life in early-onset colorectal cancer patients: systematic review

Quality of life in early-onset colorectal cancer patients: systematic review

Sexual and gender diversity in cancer care and survivorship

Sexual minority–specific experiences of colorectal cancer survivors.

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