Kamen Charles, Mustian Karen M, Dozier Ann, Bowen Deborah J, Li Yue
University of Rochester Medical Center, Cancer Control Unit, Rochester, NY, USA.
University of Rochester Medical Center, Department of Public Health Sciences, Rochester, NY, USA.
Psychooncology. 2015 Nov;24(11):1384-91. doi: 10.1002/pon.3746. Epub 2015 Jan 28.
Recent studies have highlighted disparities in cancer diagnosis between lesbian, gay, bisexual and transgender (LGBT) and heterosexual adults. Studies have yet to examine disparities between LGBT and heterosexual cancer survivors in prevalence of psychological distress.
Data for the current study were drawn from the LIVESTRONG dataset, a US national survey that sampled 207 LGBT and 4899 heterosexual cancer survivors (all cancer types, 63.5% women, mean age 49) in 2010. Symptoms of psychological distress were assessed with dichotomous yes/no items in three symptom clusters (depression related to cancer, difficulties with social relationships post-cancer, fatigue/energy problems). We selected a sample of 621 heterosexual survivors matched by propensity score to the 207 LGBT survivors and assessed disparities in count of symptoms using Poisson regression. We also performed subgroup analyses by self-reported sex.
Relative to heterosexuals, LGBT cancer survivors reported a higher number of depression and relationship difficulty symptoms. Exploratory analyses revealed that disparities in number of symptoms were visible between gay, bisexual, and transgender versus heterosexual men but not between lesbian, bisexual, and transgender versus heterosexual women.
This study highlights several disparities in psychological distress that exist between LGBT and heterosexual survivors. A need remains for interventions tailored to LGBT survivors and for studies examining disparities within subgroups of LGBT survivors.
近期研究突显了女同性恋、男同性恋、双性恋和跨性别者（LGBT）与异性恋成年人在癌症诊断方面的差异。但尚未有研究考察LGBT癌症幸存者与异性恋癌症幸存者在心理困扰患病率上的差异。
本研究的数据取自“坚强生活”数据集，这是一项2010年在美国开展的全国性调查，样本包括207名LGBT癌症幸存者和4899名异性恋癌症幸存者（涵盖所有癌症类型，63.5%为女性，平均年龄49岁）。心理困扰症状通过三个症状群中的二分法“是/否”项目进行评估（与癌症相关的抑郁、癌症后社会关系方面的困难、疲劳/精力问题）。我们选取了621名通过倾向得分与207名LGBT幸存者匹配的异性恋幸存者样本，并使用泊松回归评估症状数量上的差异。我们还按自我报告的性别进行了亚组分析。
与异性恋者相比，LGBT癌症幸存者报告的抑郁和关系困难症状数量更多。探索性分析显示，男同性恋、双性恋和跨性别者与异性恋男性在症状数量上存在差异，但女同性恋、双性恋和跨性别者与异性恋女性之间不存在差异。
本研究突显了LGBT幸存者与异性恋幸存者在心理困扰方面存在的若干差异。仍需要针对LGBT幸存者的干预措施，以及考察LGBT幸存者亚组内差异的研究。
