LGBTQ* and Cancer

Nearly two million Americans are diagnosed with cancer each year. ¹ Research shows that up to 50% of cancer cases and about 50% of cancer deaths are preventable. Routine cancer screening can detect cancer early, even if you have no signs or symptoms. When cancer is detected early, it increases your chance of survival. LGBTQ* individuals have a higher risk of certain cancers and may be less likely to get screened for cancer. ¹ Systemic inequalities and discrimination create barriers to care, socioeconomic disparities, and behavioral health disparities.

Cancer Disparities in the LGBTQ* Community: Cancer Prevention, Screening, and Care

• LGBTQ* individuals:
  • Have a higher risk of getting cancer than those who identify as heterosexual or cisgender. ¹
  • Have specific risk factors and face additional barriers to accessing health care.
  • Are less likely to be up to date on cancer screenings. ²
  • Are less likely to have health insurance and more likely to delay health care. ³
  • Report lower satisfaction with cancer treatment and higher rates of feeling discriminated against in healthcare settings. ²
• Regardless of sexual orientation, people whose healthcare providers knew their sexual orientation were more likely to have been encouraged to get cancer screening compared to people whose providers didn’t know their sexual orientation. ³
• Gay and Bisexual men have a higher risk for anal cancer, especially if they are HIV positive. HIV-positive individuals have a higher risk for HPV infections and HPV cancers. ⁴
• Lesbian and bisexual women have higher rates of breast cancer. ¹
• Lesbian women are less likely than heterosexual women to be recommended for cancer prevention care such as HPV vaccination and Pap tests by their providers. When provided with a Pap test, lesbian women had higher rates of abnormal Pap results compared with heterosexual women. ³
• Transgender individuals with a cervix have 10x higher rates of inadequate Pap screening, including abnormal and inconclusive results. ⁶
• Pap tests for transgender individuals are often rejected or thrown out by the lab because they think it’s a mistake because of “wrong” gender. ⁶
• Smoking rates are higher among LGBTQ* individuals. Nearly 1 in 6 (16.1%) LGB adults smoke cigarettes, compared with nearly 1 in 8 (12.3%) of heterosexual adults. Cigarette smoking is also higher among transgender adults (35.5%) than among cisgender adults. ⁷
• Gay and bisexual men have higher rates of skin cancer, and higher rates of tanning bed use, compared with heterosexual men. ⁸ Indoor tanning beds are a known carcinogen and increase skin cancer risk.
• Not much is known about breast cancer risk disparities in the transgender population due to a lack of research. Hormone use can contribute to risk, and top-surgery does not eliminate all breast tissue. Therefore, each patient should talk with their health care provider about their breast cancer screening options. ^{9, 10}

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Sources:

1. American Cancer Society. (2023). Lesbian, Gay, Bisexual, Transgender, Queer [LGBTQ*] People and Cancer Fact Sheet for Healthcare Professionals.
2. American Cancer Society. (2019). Study: Oncologists Want More Education About LGBTQ Issues.
3. American Cancer Society. (2022). More Information About Cancer in LGBTQ People May Help Improve Prevention, Diagnosis, and Treatment.
4. National LGBT Cancer Network. (2009). Anal Cancer, HIV, and Gay/Bisexual Men.
5. American Cancer Society. (2021). Cancer Care for Transgender and Gender Nonconforming People.  
6. University of California, San Francisco, Transgender Care Program. (2016). Screening for Cervical Cancer in Transgender Men.
7. Centers for Disease Control and Prevention [CDC]. (2023). Tips from Former Smokes®: Lesbian, Gay, Bisexual, Transgender, and Queer [LGBTQ*] People.
8. National LGBT Cancer Network. (2023). Melanoma and the LGBTQ* Community.
9. Susan G. Komen® organization. 
10. Radiological Society of North America.