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Cancer survivors’ access to care and quality of life: Do sexual minorities fare worse than heterosexuals?
Author(s) -
Boehmer Ulrike,
Gereige Jessica,
Winter Michael,
Ozonoff Al
Publication year - 2019
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.32151
Subject(s) - sexual minority , sexual orientation , medicine , lesbian , behavioral risk factor surveillance system , odds ratio , odds , demography , quality of life (healthcare) , gerontology , logistic regression , population , psychology , environmental health , social psychology , nursing , sociology , psychoanalysis
Background Adults with poor access to care are known to have worse quality of life (QOL). The purpose of the current study was to determine differences in cancer survivors’ access to care by sexual orientation and to examine the association between access to care and QOL. Methods The current secondary data analysis used 4 years of Behavioral Risk Factor Surveillance System data regarding adult men and women who self‐reported a history of cancer. Among the 70,524 cancer survivors, a total of 1931 self‐identified as sexual minorities, defined as lesbian, gay, bisexual, or other nonheterosexual orientation. Results Sexual minority women had significantly more access deficits compared with heterosexual women (42.7% vs 28.0%; P < .0001), whereas men of different sexual orientations had similar access to care. Among sexual minority women, those with access deficits had higher odds of poor physical QOL compared with heterosexual women (odds ratio [OR], 2.0 [95% CI, 1.2‐3.4] vs OR, 1.3 [95% CI, 1.2‐1.5]), poor mental QOL (OR, 1.8 [95% CI, 1.1‐3.1] vs OR, 1.5 [95% CI, 1.3‐1.7]), and difficulties concentrating (OR, 2.0 [95% CI, 1.2‐3.5] vs OR, 1.7 [95% CI, 1.4‐1.9]). Sexual minority men with access deficits had greater odds of difficulty concentrating compared with heterosexual men (OR, 4.3 [95% CI, 2.0‐9.3] vs OR, 1.5 [95% CI, 1.2‐1.9]). Among men, sexual minority status increased the odds of poor mental QOL (OR, 1.49 [95% CI, 1.11‐2.01]). Conclusions Access to care among sexual minority cancer survivors needs improvement. Sexual minority women should be a focus of future research because their poor access to care more strongly relates to worse QOL.