Department of Nursing, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN, USA.
Support Care Cancer. 2024 Aug 12;32(9):585. doi: 10.1007/s00520-024-08778-8.
Survivors of adolescent and young adult (AYA) cancer face significant psychological distress and encounter barriers accessing mental health care. However, limited research exists on psychological health among lesbian, gay, and bisexual (LGB) survivors of AYA cancer, particularly in comparison with heterosexual survivors and LGB individuals without a history of cancer.
Using the National Health Interview Survey (2013-2018), we identified LGB survivors of AYA cancer, LGB individuals without a history of cancer, and heterosexual survivors of AYA cancer. Sociodemographic, chronic health conditions, modifiable factors (such as smoking and alcohol use), and psychological outcomes were assessed using chi-square tests. Logistic regression models, adjusted for survey weights, evaluated the odds of psychological distress by cancer status after accounting for covariates. Interactions between variables and cancer status were explored.
The study comprised 145 LGB survivors, 1450 LGB individuals without a history of cancer, and 1450 heterosexual survivors. Compared to heterosexual survivors, LGB survivors were more likely to report severe distress (aOR = 2.26, p = 0.021) and had higher odds of reporting a mental health care visit (aOR = 1.98, p = 0.003). Odds of severe distress (aOR = 1.36, p = 0.36) and reporting a mental health care visit (aOR = 1.27, p = 0.29) were similar between LGB survivors and LGB individuals without a history of cancer. While 47.8% of LGB survivors reported moderate/severe distress, only 29.7% reported a mental health care visit.
A history of cancer during the AYA years is associated higher odds of severe psychological distress among LGB survivors compared to heterosexual survivors. However, many LGB survivors with psychological distress have not accessed mental health care.
青少年和年轻成人（AYA）癌症幸存者面临严重的心理困扰，并在获得心理健康护理方面遇到障碍。然而，针对 LGB AYA 癌症幸存者的心理健康研究有限，尤其是与异性恋幸存者和没有癌症病史的 LGB 个体相比。
我们使用国家健康访谈调查（2013-2018 年），确定了 LGB AYA 癌症幸存者、没有癌症病史的 LGB 个体以及 AYA 癌症的异性恋幸存者。使用卡方检验评估社会人口统计学、慢性健康状况、可改变因素（如吸烟和饮酒）以及心理结果。调整了调查权重后，使用逻辑回归模型评估了考虑协变量后癌症状态对心理困扰的几率。探讨了变量与癌症状态之间的相互作用。
该研究包括 145 名 LGB 幸存者、1450 名没有癌症病史的 LGB 个体和 1450 名异性恋幸存者。与异性恋幸存者相比，LGB 幸存者更有可能报告严重困扰（OR=2.26，p=0.021），并且更有可能寻求心理健康护理（OR=1.98，p=0.003）。严重困扰的几率（OR=1.36，p=0.36）和寻求心理健康护理的几率（OR=1.27，p=0.29）在 LGB 幸存者和没有癌症病史的 LGB 个体之间相似。虽然 47.8%的 LGB 幸存者报告中度/重度困扰，但只有 29.7%的人寻求了心理健康护理。
在 AYA 期间患有癌症与 LGB 幸存者相比，异性恋幸存者发生严重心理困扰的几率更高。然而，许多有心理困扰的 LGB 幸存者尚未获得心理健康护理。
