LGBT Youth Face Greater Cancer Risks, CCNY-Led Study

A new study led by City College of New York psychologist Margaret Rosario found that youths of same-sex orientation are more likely to engage in behaviors associated with cancer risk than heterosexuals. The peer-reviewed findings appear in the February 2014 issue of the “American Journal of Public Health.”

Titled “Sexual Orientation Disparities in Cancer-Related Risk Behaviors of Tobacco, Alcohol, Sexual Behaviors, and Diet and Physical Activity: Pooled Youth Risk Behavior Surveys,” the study pooled YRBS (Youth Risk Behavior Survey) data from 2005 and 2007. The YRBS is a national survey of high school students conducted biennially. 

Dr. Rosario, professor of psychology in CCNY’s Colin Powell School for Civic and Global Leadership and The Graduate Center, CUNY, and her research team then studied 12 cancer-risk behaviors in sexual minorities (youth with same-sex orientation) and heterosexuals in grades 9 through 12. Of an available sample of 65,871 youth, 7.6 percent were found to be a sexual minority.

The 12 cancer-risk behaviors included tobacco use, drinking alcohol, early sex, multiple sexual partners, higher body mass index (BMI) and lack of exercise.

The report found that for all 12, sexual minorities were more likely than heterosexuals to engage in the risky behavior.

“Sexual minorities are at risk for cancer later in life, I suggest, from a host of behaviors that begin relatively early in life,” said Professor Rosario. “No sex or ethnic racial group is at greater risk or protected for these behaviors. Overall, the study underscores the need for early interventions.”

The LGBT Community’s Disproportionate Cancer Burden
We do not know nearly enough about cancer in the LGBT community and we need to. None of the large national cancer registries and surveys of cancer incidence collect data about sexual orientation or gender identity, leaving lesbian, gay, bisexual and transgender cancer survivors embedded and invisible among the vast wealth of information these surveys provide to other groups. Other ethnic, geographic, and racial populations are able to use the data gleaned from these statistics to develop prevention and treatment programs dedicated to eroding the health disparities they face; they know precisely how prevalent cancer is in their communities. Lesbian, gay, bisexual and transgender people do not.

However, there is reason to believe that LGBT people are carrying a disproportionate cancer burden. There is adequate research to confirm that lesbian, gay, bisexual and transgender people have a unique “cluster of risk factors” that would lead us to have both greater cancer incidence and later stage diagnosis. We estimate that there are over 1 million LGBT cancer survivors in the country today. This disproportionate burden of disease is referred to as “health disparities”.

Health disparities in the LGBT community are caused by multiple factors. There are no biological or physiological differences between LGBT people and our heterosexual counterparts. Rather, the disparities are caused by a combination of social/economic factors and behaviors, many of which can be traced to the stress of living as a sexual/gender minority in this country.

For example, a study of health disparities in a statewide population of lesbian, gay, and bisexual women found that lesbian and bisexual women were more likely than heterosexual women to have poor physical and mental health, asthma, and diabetes, to be overweight, to smoke, and to drink excess alcohol. These women could be expected to be at especially greater risk for breast cancer, as well as other cancers that have been linked to smoking, obesity, and alcohol abuse.

Unfortunately, the existence of health disparities in the LGBT population does not stop with cancer diagnoses. For the 1 million LGBT cancer survivors in the country today, the impact of disease and treatment on quality of life is significantly different from that of our heterosexual counterparts in the areas of sexuality, social relationships, and dealings with the medical community.

LGBT Youth Face Greater Cancer Risks Her collaborators included researchers from Boston Children’s Hospital, the University of Illinois at Chicago, the Fenway Institute, and Northwestern University.

About The City College of New York
Since 1847, The City College of New York has provided low-cost, high-quality education for New Yorkers in a wide variety of disciplines. More than 16,000 students pursue undergraduate and graduate degrees in: the College of Liberal Arts and Sciences; the Bernard and Anne Spitzer School of Architecture; the School of Education; the Grove School of Engineering; the Sophie Davis School of Biomedical Education, and the Colin Powell School for Civic and Global Leadership. U.S. News, Princeton Review and Forbes all rank City College among the best colleges and universities in the United States.

Lesbians and breast cancer risk

So far, the information we have on breast cancer in lesbians has been both limited and contradictory. The large national cancer registries and surveys do not collect data about sexual orientation, leaving lesbians embedded and invisible among this vast wealth of information. Other ethnic, geographic and racial groups have been able to use the data gleaned from these statistics to develop programs to erode the health disparities they face. They know precisely how prevalent cancer is in their communities. We don’t.

Some research has been conducted that specifically addresses lesbian cancer risks and experiences, but the results have been inconsistent. In almost every case, the sample sizes have been too small for us to draw reliable conclusions. We need more organizations like the Lesbian Health Research Center at the UC Medical Center in San Francisco and major financial backing to develop solid data about lesbians and cancer.

While we still await definitive state-of-the-art research, some people currently believe that lesbians have an increased risk of developing breast cancer, based on a “cluster of risk factors” theory. Certainly, there is no physiological or genetic difference between lesbians and heterosexual women. The increased risks are a result of behaviors that are a result of the stress and stigma of living with homophobia and discrimination. Each of these behaviors carries with it an increased risk of cancer. Taken together, as a cluster, they could more than double a lesbian’s chance of getting cancer. Again, the data on these behaviors is mixed in its results and it important to remember that many people with known risk factors never develop cancer.

The four most-cited cancer risk factors in the research on lesbians and breast cancer risk are:

  Cigarette smoking - data suggest that lesbians smoke cigarettes at a substantially higher rate than heterosexual women.
  Alcohol use - some research reports higher rates of heavy drinking among lesbians than heterosexual women
  Obesity - some studies report that lesbians are more likely to be overweight or have a BMI over 25.
  Pregnancy - lesbians are less likely to have biological children before age 30, which would offer some protection against cancer.


Jay Mwamba
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