High prevalence of cancer in the LGBTQ+ population made invisible due to health disparities

High rates of cancer in the LGBTQ+ population are linked to health disparities. Defined by the National Cancer Institute (NCI) as “adverse differences between certain groups of the population in terms of measures of cancer [en este caso]”, represent a serious public health problem.

Incidence and prevalence, morbidity, mortality, survival, screening participation rates, and quality of life are all considered when determining cancer health disparities. Lack of reliable access to health services and diversity in participation in clinical investigations are some of the factors influencing the disproportionate burden of cancer among different population groups, as specified by the NCI.

“People who identify as LGBTQ+ may have a higher risk of getting cancer than those who identify as heterosexual and/or cisgender,” the Cancer Prevention Foundation (PCF) said in a press release. .

The publication refers to how the lack of data on sexual orientation and gender identity and the research on the experience of LGBTQ+ people with their health professionals influence the results of their care.

For his part, the Kit of information and resources on the main health problems of the LGBT population, from the Substance Abuse and Mental Health Services Administration (SAMHSA), points out the “significantly increased risk” of developing breast cancer in lesbian women compared to heterosexual women.

Similarly, information released by the agency shows that “a study conducted in the United States with women aged 50 to 79 indicated that bisexual women are more likely to report higher rates of cancer, particularly breast cancer “.

Among the risk factors considered for this high prevalence are fewer full-term pregnancies. “It is believed that these hormones [las que son liberadas durante el embarazo y la lactancia] protect women from different types of cancer”.

For its part, the NCI specifies that rates of smoking and alcohol consumption – risk factors for cancer – are higher in lesbian and bisexual youth than in heterosexual youth. “Studies suggest that the observed differences in cancer incidence and mortality among various population groups are the result of a complex interplay of genetic, environmental and social factors,” said the Institute on Health Disparities Research of the United States. cancer.

Other circumstances such as distrust in the healthcare system due to discrimination are related to healthcare inequalities. Behavioral factors such as alcohol use are attributed, in part, to the effect of marginalization and the unequal and biased treatment they receive on mental and emotional health.

Additionally, lower rates of access to health insurance and a lower likelihood of seeking health care and undergoing early diagnosis tests have been identified due to lack of health sensitivity and bias (in this case, bias against a person because of their sexual orientation and gender identity). Regarding cancer statistics in the LGBTQ+ population specific to Puerto Rico, Dr. Edna Mora, director of the Comprehensive Cancer Center’s Research Biobank, indicated that they are not available.

Regarding the Behavioral Risk Factor Surveillance System (BRFSS), a professor in the Department of Surgery at the Medical Sciences Campus also said that the questionnaires include a section for gathering information on sexual orientation and gender identity. This is important to obtain accurate data to develop an effective and comprehensive action plan for the processes of reducing and eradicating health inequalities.

“In 2013, the CDC [Centros para el Control y la Prevención de Enfermedades] developed an application form for the BRFSS, in order to collect data on sexual orientation and gender identity (SO/GI). The CDC began giving states the option to add this form to their BRFSS questionnaires in 2014, and it is currently one of 25 optional forms that states decide on Medicare and Medicaid services each year.

However, As Mora pointed out, the BRFSS survey of adults in Puerto Rico does not include the sexual orientation and gender identity module. Thus, deficiencies in data collection perpetuate stigmatizing and invisible practices. The expert argued that this has an impact, in turn, on public policies aimed at addressing health disparities and how people access preventive and screening tests, and called for inclusion. Referring to the importance of sexual orientation and gender identity questions in epidemiological surveys and in the health system, the National Institute of Health Minorities and Health Disparities (NIMHD) points out that it has caused a significant lack of inclusion of the LGBTQ+ population in clinical trials and intervention studies. “Developing ways to improve access to quality cancer care, from access to smoking cessation programs and recommended cancer screening tests to timely treatment, remains one of the toughest challenges facing the cancer research community ”, says the NIMHD.