Associations Between Sexual Orientation and Overall and Site-Specific Diagnosis of Cancer: Evidence From Two National Patient Surveys in England

Saunders, Catherine L. and Meads, Catherine and Abel, Gary A. and Lyratzopoulos, Georgios (2017) Associations Between Sexual Orientation and Overall and Site-Specific Diagnosis of Cancer: Evidence From Two National Patient Surveys in England. Journal of Clinical Oncology, 35 (32). pp. 3654-3661. ISSN 0732-183X

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Official URL: 10.1200/JCO.2017.72.5465


Purpose To address gaps in evidence on the risk of cancer in people from sexual minorities. Patients and Methods We used data from 796,594 population-based English General Practice Patient Survey responders to explore the prevalence of self-reported diagnoses of cancer in the last 5 years among sexual minorities compared with heterosexual women and men. We analyzed data from 249,010 hospital- based English Cancer Patient Experience Survey responders with sexual orientation as a binary outcome, and International Classi fi cation of Diseases, Tenth, Revision, diagnosis as covariate — 38 different common and rarer cancers, with breast and prostate cancer as baseline categories for women and men, respectively — to examine whether people from sexual minorities are over- or under-represented among different cancer sites. For both analyses, we used logistic regression, strati fi ed by sex and adjusted for age. Results A diagnosis of cancer in the past 5 years was more commonly reported by male General Practice Patient Survey responders who endorsed gay or bisexual orientation compared with heterosexual men (odds ratio [OR], 1.31; 95% CI, 1.15 to 1.49; P , .001) without evidence of a difference between lesbian or bisexual compared with heterosexual women (OR, 1.14; 95% CI, 0.94 to 1.37; P = .19). For most common and rarer cancer sites (30 of 33 in women, 28 of 32 in men), the odds of speci fi c cancer site diagnosis among Cancer Patient Experience Survey respondents seemed to be in- dependent of sexual orientation; however, there were notable differences in infection-related (HIV and human papillomavirus [HPV]) cancers. Gay or bisexual men were over-represented among men with Kaposi ’ s sarcoma (OR, 48.2; 95% CI, 22.0 to 105.6), anal (OR, 15.5; 95% CI, 11.0 to 21.9), and penile cancer (OR, 1.8; 95% CI, 0.9 to 3.7). Lesbian or bisexual women were over-represented among women with oropharyngeal cancer (OR, 3.2; 95% CI, 1.7 to 6.0). Conclusion Large-scale evidence indicates that the distribution of cancer sites does not vary substantially by sexual orientation, with the exception of some HPV- and HIV-associated cancers. These fi ndings highlight the importance of HPV vaccination in heterosexual and sexual minority populations.

Item Type: Journal Article
Faculty: ARCHIVED Faculty of Medical Science (until September 2018)
Depositing User: Ian Walker
Date Deposited: 26 Jan 2018 10:09
Last Modified: 26 Jan 2018 10:10

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