Department of Pediatrics, Duke University School of Medicine, Durham, North Carolina, USA.
Department of Nursing, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Cancer. 2024 Feb 15;130(4):553-562. doi: 10.1002/cncr.35015. Epub 2023 Dec 4.
In the general population, individuals with minoritized sexual orientation and gender identity have a higher burden of chronic health conditions than heterosexual individuals. However, the extent to which sexual orientation is associated with excess burden of chronic conditions in adolescent and young adult cancer survivors (AYACS) is unknown.
Lesbian, gay, and bisexual (LGB) AYACSs, LGB individuals without a history of cancer, and heterosexual AYACSs were identified by self-reported data from the cross-sectional National Health Interview Survey (2013-2020). Socioeconomic factors and the prevalence of chronic health conditions were compared between groups using χ tests. Logistic regression methods were used to determine the odds of chronic conditions by socioeconomic factors within and between survivor and comparison groups.
One hundred seventy LGB cancer survivors, 1700 LGB individuals without a history of cancer, and 1700 heterosexual cancer survivors were included. Compared with heterosexual survivors, LGB survivors were less likely to be married (p = .001) and more likely to have never been married (p < .001). LGB survivors were more likely to have incomes between 100% and 200% of the federal poverty level than LGB individuals without a history of cancer (p = .012) and heterosexual survivors (p = .021) and were less likely to report incomes >200% the federal poverty level. LGB survivors had higher odds of chronic health conditions than LGB individuals without a history of cancer (odds ratio, 2.45; p < .001) and heterosexual survivors (odds ratio, 2.16; p = .003).
LGB AYACSs are at increased risk of having chronic health conditions compared with both LGB individuals without a history of cancer and heterosexual AYACSs.
在普通人群中，性少数群体和跨性别者的慢性健康状况负担比异性恋者更高。然而，性取向与青少年和年轻成年癌症幸存者（AYACS）的慢性疾病负担之间的关联程度尚不清楚。
通过横断面全国健康访谈调查（2013-2020 年）的自我报告数据，确定了同性恋、双性恋和跨性别（LGB）AYACS、没有癌症病史的 LGB 个体以及异性恋 AYACS。使用 χ 检验比较组间社会经济因素和慢性健康状况的流行率。使用逻辑回归方法确定幸存者和对照组内部和组间社会经济因素与慢性疾病的关联。
纳入了 170 名 LGB 癌症幸存者、1700 名没有癌症病史的 LGB 个体和 1700 名异性恋癌症幸存者。与异性恋幸存者相比，LGB 幸存者结婚的可能性较小（p=0.001），从未结婚的可能性较大（p<0.001）。与没有癌症病史的 LGB 个体（p=0.012）和异性恋幸存者（p=0.021）相比，LGB 幸存者的收入更有可能处于联邦贫困线的 100%至 200%之间，而报告收入高于联邦贫困线 200%的可能性较小。与没有癌症病史的 LGB 个体（比值比，2.45；p<0.001）和异性恋幸存者（比值比，2.16；p=0.003）相比，LGB 幸存者患有慢性健康状况的几率更高。
与没有癌症病史的 LGB 个体和异性恋 AYACS 相比，LGB AYACS 患有慢性健康状况的风险更高。
