Cancer Prevention, Control & Population Health Program, Department of Medicine, Augusta University, Augusta, GA 30912, USA.
Institute of Preventive and Public Health, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA.
Int J Environ Res Public Health. 2023 Jun 13;20(12):6120. doi: 10.3390/ijerph20126120.
Sexual minorities (SM) have higher chronic physiologic stress as indicated by allostatic load (AL), which may be explained in part by consistent experiences of discriminatory practices. This is one of the first studies to examine the joint effects of SM status and AL on the association with long-term risk for cancer death. Retrospective analyses were conducted on 12,470 participants using National Health and Nutrition Examination Survey (NHANES) from years 2001 through 2010 linked with the National Death Index through December 31, 2019. Cox proportional hazards models estimated adjusted hazard ratios (aHRs) of cancer deaths between groups of SM (those reporting as gay, lesbian, bisexual, or having same-sex sexual partners) status and AL. SM adults living with high AL ( = 326) had a 2-fold increased risk of cancer death (aHR: 2.55, 95% CI: 1.40-4.65) when compared to straight/heterosexual adults living with low AL ( = 6674). Among those living with high AL, SM ( = 326) had a 2-fold increased risk of cancer death (aHR: 2.26, 95% CI: 1.33-3.84) when compared to straight/heterosexual adults with high AL ( = 4957). SM with high AL have an increased risk of cancer mortality. These findings highlight important implications for promoting a focused agenda on cancer prevention with strategies that reduce chronic stress for SM adults.
性少数群体 (SM) 的身体压力持续存在，表现为全身性适应不良负荷 (AL) 较高，这在一定程度上可以解释为他们持续经历歧视性做法。这是第一项研究性少数群体状态和 AL 对癌症死亡长期风险关联的联合影响的研究之一。使用国家健康和营养检查调查 (NHANES) 对 2001 年至 2010 年期间的 12470 名参与者进行了回顾性分析，并通过与国家死亡指数的链接，将这些数据延长至 2019 年 12 月 31 日。Cox 比例风险模型估计了性少数群体 (SM) 状态和 AL 之间癌症死亡的调整后的风险比 (aHR)。与低 AL（ = 6674）的直/异性恋成年人相比，高 AL（ = 326）的 SM 成年人患癌症死亡的风险增加了两倍（aHR：2.55，95%CI：1.40-4.65）。在那些患有高 AL 的人中，SM（ = 326）的癌症死亡风险增加了两倍（aHR：2.26，95%CI：1.33-3.84），而高 AL 的直/异性恋成年人的风险增加了两倍（ = 4957）。患有高 AL 的 SM 患癌症死亡的风险增加。这些发现强调了为 SM 成年人减少慢性压力的癌症预防策略提供重点议程的重要意义。
