Table 1.

Summary of Articles Included in Scoping Review

Author	Year published	Recruitment method	Study details (study design; study name; and data collection year if applicable)	Populations and sample size	Cancer focus	Key findings
Arena et al.23	2007	Convenience sampling by nationwide distribution of fliers at women's networks and community resource centers. Matched with Miami-based hospitals.	Case–control study	N = 78 Previously treated for breast cancer n = 39 Lesbian women n = 39 Heterosexual women	Breast cancer treatment	● Lesbians more likely to report having stressful thoughts regarding cancer compared with heterosexuals ● Heterosexual women were more concerned about body image and sexual issues ● No difference in the overall amount of available social support, although lesbians used more emotional support from friends than heterosexuals.
Austin et al.26	2012	Single mailing sent out to registered nurses between the ages of 25–42 to 14 most populous U.S. states. Those who responded to initial questionnaire were enrolled in the cohort	Quantitative prospective cohort study; Nurses' Health Study II; 1989–2005	N = 116,430 Women aged 25–42 in 14 most populous U.S. states; data collected 1989–2005; 1.5% African American (n = 5,145), 94% White (n = 334,519)	Breast cancer screening	● Receipt of mammogram in the last 2 years was slightly higher in heterosexuals ● Fewer than half of eligible participants received colorectal screening and did not differ based on sexual orientation ● No difference by race/ethnicity except for African American women and colorectal screening (30% more compared with White women)
Boehmer et al.32	2005a	Community-based purposeful sampling and snowball sampling	Qualitative study; individual interviews	N = 30 SMW with breast cancer n = 23 of whom had support providers	Breast cancer coping	● SMW's level of disclosure impacts the level of distress reported by support providers.
Boehmer et al.51	2005b	Community-based purposeful sampling and snowball sampling	Quantitative cross-sectional study	N = 64 SMW with breast cancer.	Breast cancer coping	● Positive association between “fighting spirit” and social support as well as a negative association between “fighting spirit” and distress. ● Lesbians had lower distress than bisexual women or women who partnered with other women.
Boehmer et al.50	2007	Community-based and snowball sampling	Qualitative study; individual semistructured interviews	N = 27 n = 15 SMW n = 12 of SMW support partners.	Breast cancer treatment defined as mastectomy and reconstructive surgery	● Decision to do reconstructive surgery dealt with body image and value system shaped by sexual minority identity. ● Women who did reconstruction had regrets and difficulties while those who did not transitioned better into recovery.
Clavelle et al.28	2015	Retrospective review of all mammography patients at community health center in	Modeling study; quantitative retrospective cohort study; 2013–2014	N = 423 Women n = 162 SMW n = 13 SMW Black n = 38 Hetero Black	Breast cancer screening	● SMW were more likely to be nulliparous (risk factor for breast cancer) and overall had higher lifetime Gail scores than hetero women ● SMW had lower prevalence of birth control pills
		Northeast United States				● No differences in mammogram screening between hetero and sexual minority
Cochran et al.13	2001	n/a	Quantitative cross-sectional meta-analysis from 1987 to 1996: Boston Lesbian Health Project, National Lesbian and Bisesual Women's Health Survey, Michigan Lesbian Health Survey, Massachusetts Lesbian Health Needs Assessment, Houston Lesbian Health Initiative, North Carolina Women's Health Access Survey, and Oregon Lesbian Health Survey	N = 11,876 SMW	Breast cancer screening	● Greater prevalence of behavioral risk factors for breast and gynecological cancers among lesbian and bisexual women compared with the general female population. ● Lesbians and bisexual women are more likely to be obese than other women, less likely to give birth, less likely to use oral contraceptives, less likely to undergo routine screening procedures (mammograms and gynecological examinations) influenced by negative experiences with health care practitioners and mistrust of health care community.
DeHart34	2008	Convenience sampling in Southern Cities (Columbia, SC; Louisville, KY; Wilmington, NC).	Modeling study; quantitative cross-sectional study	N = 173 Exclusively homosexual women n = 9 Black homosexual women	Breast cancer screening	● Women perceived heterosexism and homophobia from providers to influence the amount of discussion they had with providers, such that it significantly contributed to women's use of self-examinations and limited health care provider visits.
Grindel et al.29	2006	Community-based sampling and snowball sampling	Quantitative cross-sectional study; Boston Lesbian Health Project II	N = 1,139 Lesbians n = 46 Black women	Breast cancer screening	● Majority of women did not smoke, had diets high in fruits and vegetables, low in fat and moderate in alcohol. ● Most women had mammograms and PAP smears as recommended; however, they did not adhere to self-breast examination guidelines. ● Older age, high income, nonsmoking status, and self-breast examination were positively associated with having mammogram.
Jabson and Bowen25	2014	Convenience sampling of 211 breast cancer survivors via online through breast cancer groups	Quantitative cross-sectional study	N = 211 Breast cancer n = 68 SMW n = 143 Heterosexual women	Breast cancer treatment	● The average perception of stress is 8.2 and standard deviation of 1.4 out of a total of 16 possible points. ● When stratified by sexual orientation, heterosexual breast cancer survivors reported less perceived stress (M = 8.10, s = 1.50) than sexual minority breast cancer survivors (M = 8.54, s = 1.30). ● Sexual orientation was significantly associated with perceived stress (B = −0.15, p = 0.03).
Matthews et al.2	2013	Convenience sample of lesbians and heterosexual women with a diagnosis of breast cancer in the last 5 years	Qualitative study focus groups	n = 13 Lesbians n = 28 Heterosexual women n = 11 Black heterosexual n = 1 Black Lesbian	Satisfaction of breast cancer treatment from physicians	● Lesbians had higher stress levels associated with diagnosis, lower satisfaction with care from physicians during treatment, and lower satisfaction with availability of emotional support.
McElroy et al.3	2015	Random sampling by landline or cell phone for Missouri Counties.	Quantitative cross-sectional study; Missouri County-Level Study; January through December 2011	N = 29,847 Heterosexual women n = 114 Lesbian women	Breast cancer screening	● No significant differences in cancer screenings between sexual minority and heterosexual women or time since recommended cancer screenings. ● Lesbians had higher educational attainment; lesbian (but no bisexual) women were more likely to report smoking and to be obese.
Rankow et al.33	1998	Convenience sampling via outreaching at pride events, lesbian bars, bookstores, churches, etc.	Mixed-methods cross-sectional study	N = 591 SMW n = 112 Black n = 409 White	Breast cancer screening	● Mammography is associated with majority sociodemographic characteristics such as older age, being White, having insurance, and higher incomes. ● Women with higher education (p = <0.0001) and incomes (p = 0.02) were more likely to report breast self-examination. ● The most frequently reported barriers to mammography were costs (24%), lack of feeling at risk (21%), no health insurance (18%), and radiation concerns (18%).
Roberts et al.35	2004	Quota sampling	Quantitative cross-sectional study; 1987	N = 1139 Lesbian women n = 46 Black women	Breast cancer screening and treatment	● Lesbians in this sample were more likely to be “out” to their provider compared with lesbians in the past (10 years before) ● Older women were more likely to be “out” to provider than younger women. ● Screening for pap smears and breast cancer is still lower than expected. ● High rates of drinking (for whole sample) and smoking (among younger women) still persist in this sample.

n/a, not applicable; PAP, Papanicolaou; SMW, sexual minority women.