LGBTQ+ 癌症幸存者的慢性健康状况、残疾以及身体和认知障碍。
Chronic Health Conditions, Disability, and Physical and Cognitive Limitations among LGBTQ+ Cancer Survivors.
机构信息
Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
出版信息
Cancer Epidemiol Biomarkers Prev. 2024 Nov 1;33(11):1405-1413. doi: 10.1158/1055-9965.EPI-24-0166.
BACKGROUND
Cancer survivors are at high risk for chronic health conditions and physical and cognitive limitations. However, few studies have explored these outcomes among Lesbian, Gay, Bisexual, Transgender, Queer, Plus (LGBTQ+) survivors.
METHODS
We used pooled, weighted Behavioral Risk Factor Surveillance System data from 23 states that completed two specific modules at least once from 2020 to 2022. We calculated age-adjusted prevalence for heart disease, asthma, chronic obstructive pulmonary disease, depressive disorders, myocardial infarction, kidney disease, stroke, diabetes, hearing disability, vision disability, cognitive limitations, and difficulty walking, dressing, and running errands in LGBTQ+, lesbian, gay, or bisexual, transgender or gender nonconforming (TGNC), and non-LGBTQ+ cancer survivors. Four multivariable logistic regression models controlling for different factors were run for each outcome.
RESULTS
Of 40,990 cancer survivors, 1,715 were LGBTQ+. LGBTQ+ survivors had significantly higher age-adjusted prevalence of all outcomes. The prevalence of all outcomes was the highest among TGNC survivors, except for depressive disorders and cognitive limitations. LGBTQ+ survivors had higher odds of reporting asthma [adjusted OR (aOR): 1.5; 95% confidence interval (CI), 1.2-1.9], depressive disorders (aOR: 1.9; 95% CI, 1.6-2.4), kidney disease (aOR: 1.5; 95% CI, 1.1-2.1), stroke (aOR: 1.7; 95% CI, 1.3-2.3), diabetes (aOR: 1.3; 95% CI, 1.0-1.6), vision disability (aOR: 1.6; 95% CI, 1.2-2.2), cognitive limitations (aOR: 2.3; 95% CI, 1.8-2.9), difficulty walking (aOR: 1.7; 95% CI, 1.3-2.0), dressing (aOR: 2.0; 95% CI, 1.5-2.7), and running errands (aOR: 1.6; 95% CI, 1.3-2.1). In TGNC models, TGNC cancer survivors had increased odds of most outcomes in comparison to cisgender survivors.
CONCLUSIONS
LGBTQ+ cancer survivors have an elevated burden of all chronic health conditions, disabilities, and limitations assessed. TGNC cancer survivors experience even higher burden of the same outcomes.
IMPACT
Findings highlight substantial disparities regarding the health of LGBTQ+ cancer survivors. See related In the Spotlight, p. 1395.
背景
癌症幸存者存在罹患慢性健康状况以及身体和认知障碍的高风险。然而，很少有研究探讨过 LGBTQ+（女同性恋、男同性恋、双性恋、跨性别、酷儿、无性恋等）幸存者的这些后果。
方法
我们使用了来自 23 个州的经加权和年龄调整的 pooled，加权的行为风险因素监测系统数据，这些州在 2020 年至 2022 年期间至少完成了两次特定模块。我们计算了 LGBTQ+、女同性恋、男同性恋或双性恋、跨性别或性别不一致（TGNC）以及非 LGBTQ+癌症幸存者中心脏病、哮喘、慢性阻塞性肺疾病、抑郁障碍、心肌梗死、肾病、中风、糖尿病、听力障碍、视力障碍、认知障碍以及行走、穿衣和跑腿困难的年龄调整患病率。对于每种结局，我们都运行了四个控制不同因素的多变量逻辑回归模型。
结果
在 40990 名癌症幸存者中，有 1715 名是 LGBTQ+。LGBTQ+幸存者的所有结局的年龄调整患病率均显著更高。除抑郁障碍和认知障碍外，所有结局的患病率在 TGNC 幸存者中最高。LGBTQ+幸存者报告哮喘（调整后的比值比（aOR）：1.5；95%置信区间（CI），1.2-1.9）、抑郁障碍（aOR：1.9；95%CI，1.6-2.4）、肾病（aOR：1.5；95%CI，1.1-2.1）、中风（aOR：1.7；95%CI，1.3-2.3）、糖尿病（aOR：1.3；95%CI，1.0-1.6）、视力障碍（aOR：1.6；95%CI，1.2-2.2）、认知障碍（aOR：2.3；95%CI，1.8-2.9）、行走困难（aOR：1.7；95%CI，1.3-2.0）、穿衣困难（aOR：2.0；95%CI，1.5-2.7）和跑腿困难（aOR：1.6；95%CI，1.3-2.1）的几率更高。在 TGNC 模型中，与顺性别幸存者相比，TGNC 癌症幸存者的大多数结局的几率更高。
结论
LGBTQ+癌症幸存者的所有慢性健康状况、残疾和受限评估的负担都加重了。TGNC 癌症幸存者经历了更高的同样结局负担。
影响
研究结果突显了 LGBTQ+癌症幸存者健康方面的显著差异。请参见相关的特写文章，第 1395 页。
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