Abstract
OBJECTIVES: This study examined whether lesbians are at increased risk for certain cancers as a result of an accumulation of behavioral risk factors and difficulties in accessing health care. METHODS: Prevalence estimates of behavioral risk factors (nulliparity, obesity, smoking, and alcohol use), cancer screening behaviors, and self-reported breast cancer histories derived from 7 independently conducted surveys of lesbians/bisexual women (n = 11,876) were compared with national estimates for women. RESULTS: In comparison with adjusted estimates for the US female population, lesbians/bisexual women exhibited greater prevalence rates of obesity, alcohol use, and tobacco use and lower rates of parity and birth control pill use. These women were also less likely to have health insurance coverage or to have had a recent pelvic examination or mammogram. Self-reported histories of breast cancer, however, did not differ from adjusted US female population estimates. CONCLUSIONS: Lesbians and bisexual women differ from heterosexual women in patterns of health risk. These women would be expected to be at especially greater risk for chronic diseases linked to smoking and obesity.
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- Bradford J., Ryan C., Rothblum E. D. National Lesbian Health Care Survey: implications for mental health care. J Consult Clin Psychol. 1994 Apr;62(2):228–242. doi: 10.1037//0022-006x.62.2.228. [DOI] [PubMed] [Google Scholar]
- Broeders M. J., Verbeek A. L. Breast cancer epidemiology and risk factors. Q J Nucl Med. 1997 Sep;41(3):179–188. [PubMed] [Google Scholar]
- Carroll N. M. Optimal gynecologic and obstetric care for lesbians. Obstet Gynecol. 1999 Apr;93(4):611–613. [PubMed] [Google Scholar]
- Cochran S. D., Keenan C., Schober C., Mays V. M. Estimates of alcohol use and clinical treatment needs among homosexually active men and women in the U.S. population. J Consult Clin Psychol. 2000 Dec;68(6):1062–1071. doi: 10.1037//0022-006x.68.6.1062. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Cochran S. D., Mays V. M. Depressive distress among homosexually active African American men and women. Am J Psychiatry. 1994 Apr;151(4):524–529. doi: 10.1176/ajp.151.4.524. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Cochran S. D., Mays V. M. Relation between psychiatric syndromes and behaviorally defined sexual orientation in a sample of the US population. Am J Epidemiol. 2000 Mar 1;151(5):516–523. doi: 10.1093/oxfordjournals.aje.a010238. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Deevey S. Older lesbian women. An invisible minority. J Gerontol Nurs. 1990 May;16(5):35–39. doi: 10.3928/0098-9134-19900501-09. [DOI] [PubMed] [Google Scholar]
- Ferris D. G., Batish S., Wright T. C., Cushing C., Scott E. H. A neglected lesbian health concern: cervical neoplasia. J Fam Pract. 1996 Dec;43(6):581–584. [PubMed] [Google Scholar]
- Hill H. A., Austin H. Nutrition and endometrial cancer. Cancer Causes Control. 1996 Jan;7(1):19–32. doi: 10.1007/BF00115635. [DOI] [PubMed] [Google Scholar]
- Kohlmeier L., Mendez M. Controversies surrounding diet and breast cancer. Proc Nutr Soc. 1997 Mar;56(1B):369–382. doi: 10.1079/pns19970039. [DOI] [PubMed] [Google Scholar]
- La Vecchia C., Tavani A., Franceschi S., Parazzini F. Oral contraceptives and cancer. A review of the evidence. Drug Saf. 1996 Apr;14(4):260–272. doi: 10.2165/00002018-199614040-00006. [DOI] [PubMed] [Google Scholar]
- Lauver D. R., Karon S. L., Egan J., Jacobson M., Nugent J., Settersten L., Shaw V. Understanding lesbians' mammography utilization. Womens Health Issues. 1999 Sep-Oct;9(5):264–274. doi: 10.1016/s1049-3867(99)00024-9. [DOI] [PubMed] [Google Scholar]
- Longnecker M. P. Alcohol consumption and risk of cancer in humans: an overview. Alcohol. 1995 Mar-Apr;12(2):87–96. doi: 10.1016/0741-8329(94)00088-3. [DOI] [PubMed] [Google Scholar]
- McKirnan D. J., Peterson P. L. Alcohol and drug use among homosexual men and women: epidemiology and population characteristics. Addict Behav. 1989;14(5):545–553. doi: 10.1016/0306-4603(89)90075-0. [DOI] [PubMed] [Google Scholar]
- Mettler F. A., Upton A. C., Kelsey C. A., Ashby R. N., Rosenberg R. D., Linver M. N. Benefits versus risks from mammography: a critical reassessment. Cancer. 1996 Mar 1;77(5):903–909. [PubMed] [Google Scholar]
- Miller A. B. An epidemiological perspective on cancer screening. Clin Biochem. 1995 Feb;28(1):41–48. doi: 10.1016/0009-9120(94)00069-8. [DOI] [PubMed] [Google Scholar]
- Price J. H., Easton A. N., Telljohann S. K., Wallace P. B. Perceptions of cervical cancer and Pap smear screening behavior by women's sexual orientation. J Community Health. 1996 Apr;21(2):89–105. doi: 10.1007/BF01682301. [DOI] [PubMed] [Google Scholar]
- Rankow E. J., Tessaro I. Cervical cancer risk and Papanicolaou screening in a sample of lesbian and bisexual women. J Fam Pract. 1998 Aug;47(2):139–143. [PubMed] [Google Scholar]
- Roberts S. J., Sorensen L. Health related behaviors and cancer screening of lesbians: results from the Boston Lesbian Health Project. Women Health. 1999;28(4):1–12. doi: 10.1300/J013v28n04_01. [DOI] [PubMed] [Google Scholar]
- Shopland D. R. Tobacco use and its contribution to early cancer mortality with a special emphasis on cigarette smoking. Environ Health Perspect. 1995 Nov;103 (Suppl 8):131–142. doi: 10.1289/ehp.95103s8131. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Siegel P. Z., Waller M. N., Frazier E. L., Mariolis P. Behavioral Risk Factor Surveillance System: summary of data for 1991. MMWR CDC Surveill Summ. 1993 Aug 27;42(4):23–30. [PubMed] [Google Scholar]
- Sorensen L., Roberts S. J. Lesbian uses of and satisfaction with mental health services: results from Boston Lesbian Health Project. J Homosex. 1997;33(1):35–49. doi: 10.1300/J082v33n01_03. [DOI] [PubMed] [Google Scholar]
- Stevens P. E., Hall J. M. Stigma, health beliefs and experiences with health care in lesbian women. Image J Nurs Sch. 1988 Summer;20(2):69–73. doi: 10.1111/j.1547-5069.1988.tb00033.x. [DOI] [PubMed] [Google Scholar]
- Trippet S. E., Bain J. Physical health problems and concerns of lesbians. Women Health. 1993;20(2):59–70. doi: 10.1300/J013v20n02_05. [DOI] [PubMed] [Google Scholar]
- Trippet S. E., Bain J. Reasons American lesbians fail to seek traditional health care. Health Care Women Int. 1992 Apr-Jun;13(2):145–153. doi: 10.1080/07399339209515987. [DOI] [PubMed] [Google Scholar]
- Welch S., Howden-Chapman P., Collings S. C. Survey of drug and alcohol use by lesbian women in New Zealand. Addict Behav. 1998 Jul-Aug;23(4):543–548. doi: 10.1016/s0306-4603(98)00036-7. [DOI] [PubMed] [Google Scholar]
- White J. C., Dull V. T. Health risk factors and health-seeking behavior in lesbians. J Womens Health. 1997 Feb;6(1):103–112. doi: 10.1089/jwh.1997.6.103. [DOI] [PubMed] [Google Scholar]