Cross-sectional study of psychosocial well-being among lesbian, gay, bisexual, and heterosexual gynecologic cancer survivors.


Journal

Cancer reports (Hoboken, N.J.)
ISSN: 2573-8348
Titre abrégé: Cancer Rep (Hoboken)
Pays: United States
ID NLM: 101747728

Informations de publication

Date de publication:
02 2022
Historique:
revised: 17 05 2021
received: 05 03 2021
accepted: 18 05 2021
pubmed: 1 6 2021
medline: 29 3 2022
entrez: 31 5 2021
Statut: ppublish

Résumé

Delays in care and increased risk for mental health diagnoses put individuals identifying as a sexual minority with cancer at risk for decreased quality of life. To assess psychosocial health among sexual minority gynecologic cancer survivors, we compared self-reported quality of life and psychosocial measures between individuals diagnosed with gynecologic cancers identifying as lesbian/gay/bisexual (LGB) and heterosexual. English-speaking adults with gynecologic cancers were invited to participate in an ongoing cohort survey study. Quality of life and psychosocial measures included the Functional Assessment of Cancer Therapy-General, Distress Thermometer (distress), Patient Health Questionnaire-8 (depression), General Anxiety Disorder-7 (anxiety), and Post-traumatic Stress Disorder Checklist for DSM-5 (post-traumatic stress disorder; PTSD). Measures were compared by self-reported sexual orientation (heterosexual vs. LGB) using descriptive statistics (frequencies and means) and linear and logistic regression models, adjusting for college education. Of 814 patients invited, 457 enrolled (56.1%) and 401 (92.6%) completed the survey and provided information on their sexuality. All but one self-identified as cisgender women and 22 (5.5%) as LGB. LGB participants were more likely to have completed college (68.2% vs. 40.1%, p = .009) but were otherwise similar across demographic and clinical characteristics. Quality of life and distress scores were similar between groups. LGB participants, compared to heterosexual, reported higher rates of depression (31.8% vs. 10.6%, adjusted odds ratio [OR] = 4.1 [95% confidence interval [CI]: 1.6-11.0], p = .004), anxiety (25.0% vs. 7.1%, adjusted OR = 5.4 [95% CI: 1.7-16.7], p= .004), and PTSD (13.6% vs. 3.5%, adjusted OR = 4.2 [95% CI: 1.1-16.3], p = .04). LGB participants reported poorer emotional health following a gynecologic cancer diagnosis than heterosexual participants. Our data suggest this population may need additional resources and support during and after their cancer diagnosis. Future work is needed to identify additional risk factors and the underlying sources of these disparities in order to improve patient care and wellness in this population.

Sections du résumé

BACKGROUND
Delays in care and increased risk for mental health diagnoses put individuals identifying as a sexual minority with cancer at risk for decreased quality of life.
AIM
To assess psychosocial health among sexual minority gynecologic cancer survivors, we compared self-reported quality of life and psychosocial measures between individuals diagnosed with gynecologic cancers identifying as lesbian/gay/bisexual (LGB) and heterosexual.
METHODS AND RESULTS
English-speaking adults with gynecologic cancers were invited to participate in an ongoing cohort survey study. Quality of life and psychosocial measures included the Functional Assessment of Cancer Therapy-General, Distress Thermometer (distress), Patient Health Questionnaire-8 (depression), General Anxiety Disorder-7 (anxiety), and Post-traumatic Stress Disorder Checklist for DSM-5 (post-traumatic stress disorder; PTSD). Measures were compared by self-reported sexual orientation (heterosexual vs. LGB) using descriptive statistics (frequencies and means) and linear and logistic regression models, adjusting for college education. Of 814 patients invited, 457 enrolled (56.1%) and 401 (92.6%) completed the survey and provided information on their sexuality. All but one self-identified as cisgender women and 22 (5.5%) as LGB. LGB participants were more likely to have completed college (68.2% vs. 40.1%, p = .009) but were otherwise similar across demographic and clinical characteristics. Quality of life and distress scores were similar between groups. LGB participants, compared to heterosexual, reported higher rates of depression (31.8% vs. 10.6%, adjusted odds ratio [OR] = 4.1 [95% confidence interval [CI]: 1.6-11.0], p = .004), anxiety (25.0% vs. 7.1%, adjusted OR = 5.4 [95% CI: 1.7-16.7], p= .004), and PTSD (13.6% vs. 3.5%, adjusted OR = 4.2 [95% CI: 1.1-16.3], p = .04).
CONCLUSION
LGB participants reported poorer emotional health following a gynecologic cancer diagnosis than heterosexual participants. Our data suggest this population may need additional resources and support during and after their cancer diagnosis. Future work is needed to identify additional risk factors and the underlying sources of these disparities in order to improve patient care and wellness in this population.

Identifiants

pubmed: 34057316
doi: 10.1002/cnr2.1461
pmc: PMC8842686
doi:

Types de publication

Journal Article Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't Research Support, U.S. Gov't, Non-P.H.S.

Langues

eng

Sous-ensembles de citation

IM

Pagination

e1461

Subventions

Organisme : U.S. Department of Defense
ID : OC180392 W81XWH-19-1-0013
Organisme : NCI NIH HHS
ID : P30 CA077598
Pays : United States
Organisme : NCATS NIH HHS
ID : UL1 TR002494
Pays : United States
Organisme : NCI NIH HHS
ID : P30 CA77598
Pays : United States
Organisme : Masonic Cancer Center, University of Minnesota
Organisme : NCI NIH HHS
ID : T32 CA163184
Pays : United States

Informations de copyright

© 2021 The Authors. Cancer Reports published by Wiley Periodicals LLC.

Références

J Clin Oncol. 2001 Mar 15;19(6):1809-17
pubmed: 11251013
Arch Fam Med. 2000 Sep-Oct;9(9):843-53
pubmed: 11031391
CA Cancer J Clin. 2015 Sep-Oct;65(5):384-400
pubmed: 26186412
Psychol Bull. 2003 Sep;129(5):674-697
pubmed: 12956539
Semin Oncol Nurs. 2018 Feb;34(1):60-71
pubmed: 29306523
BMC Med Educ. 2019 Aug 30;19(1):325
pubmed: 31470837
Obstet Gynecol Clin North Am. 2017 Mar;44(1):71-80
pubmed: 28160894
BJOG. 2017 Feb;124(3):381-392
pubmed: 27862853
J Geriatr Oncol. 2020 Jun;11(5):820-827
pubmed: 31668948
Cancer Rep (Hoboken). 2022 Feb;5(2):e1461
pubmed: 34057316
Cancer. 2011 Aug 15;117(16):3796-804
pubmed: 21557209
Patient Educ Couns. 2016 Oct;99(10):1676-84
pubmed: 27161166
J Gen Intern Med. 2001 Sep;16(9):606-13
pubmed: 11556941
LGBT Health. 2019 Aug/Sep;6(6):271-288
pubmed: 31314662
BMC Med Educ. 2020 May 6;20(1):138
pubmed: 32375760
LGBT Health. 2021 Jan;8(1):68-78
pubmed: 33325783
Clin Obstet Gynecol. 2018 Dec;61(4):663-673
pubmed: 30285974
Arch Intern Med. 2006 May 22;166(10):1092-7
pubmed: 16717171
LGBT Health. 2019 Feb/Mar;6(2):77-86
pubmed: 30720385
Am J Public Health. 2006 Jun;96(6):1111-8
pubmed: 16670230
CA Cancer J Clin. 2020 Jan;70(1):7-30
pubmed: 31912902
Sex Med. 2017 Sep;5(3):e175-e183
pubmed: 28823314
Am J Public Health. 2010 Dec;100(12):2433-41
pubmed: 20395586
LGBT Health. 2019 May/Jun;6(4):184-191
pubmed: 31066610
J Trauma Stress. 2015 Dec;28(6):489-98
pubmed: 26606250
BMC Psychiatry. 2008 Aug 18;8:70
pubmed: 18706118
Support Care Cancer. 2019 Jul;27(7):2525-2532
pubmed: 30411237
J Clin Oncol. 2017 Jul 1;35(19):2203-2208
pubmed: 28368670
J Clin Oncol. 2014 May 20;32(15):1605-19
pubmed: 24733793
J Am Coll Radiol. 2019 Apr;16(4 Pt B):607-620
pubmed: 30947895
Am J Orthopsychiatry. 2014 Nov;84(6):653-63
pubmed: 25545433
Rural Remote Health. 2017 Jan-Mar;17(1):3875
pubmed: 28248528
Am J Public Health. 2001 Apr;91(4):591-7
pubmed: 11291371
Ann Plast Surg. 1992 Jan;28(1):26-8
pubmed: 1642402
Am J Public Health. 2001 Jun;91(6):947-52
pubmed: 11392939
JCO Oncol Pract. 2020 Aug;16(8):e649-e659
pubmed: 32091952
Cancer. 2019 Apr 15;125(8):1313-1318
pubmed: 30561776
Am J Public Health. 2014 Feb;104(2):e68-73
pubmed: 24328650
J Clin Oncol. 1993 Mar;11(3):570-9
pubmed: 8445433
Cancer. 2019 Dec 15;125(24):4371-4379
pubmed: 31593319
Am J Clin Oncol. 2001 Dec;24(6):591-6
pubmed: 11801761
J Clin Oncol. 2019 Mar 1;37(7):547-558
pubmed: 30650044
J Adolesc Young Adult Oncol. 2021 Apr;10(2):148-155
pubmed: 32730111
J Immigr Minor Health. 2019 Jun;21(3):540-548
pubmed: 29946865
J Affect Disord. 2009 Apr;114(1-3):163-73
pubmed: 18752852
Psychiatry Investig. 2019 Apr;16(4):300-305
pubmed: 31042692
LGBT Health. 2015 Aug 26;3(1):65-73
pubmed: 26789396
Neurobiol Aging. 2012 Jul;33(7):1129-37
pubmed: 21122949
Semin Oncol Nurs. 2018 Feb;34(1):99-115
pubmed: 29329960
Lancet. 2016 Jul 23;388(10042):390-400
pubmed: 27323925
Cancer. 2019 Sep 1;125(17):3079-3085
pubmed: 31106409

Auteurs

Alexandra Schefter (A)

Department of Obstetrics, Division of Gynecologic Oncology, Gynecology and Women's Health, University of Minnesota, Minneapolis, Minnesota, USA.

Lauren Thomaier (L)

Department of Obstetrics, Division of Gynecologic Oncology, Gynecology and Women's Health, University of Minnesota, Minneapolis, Minnesota, USA.

Patricia Jewett (P)

Department of Medicine, Division of Hematology and Oncology, University of Minnesota, Minneapolis, Minnesota, USA.

Katherine Brown (K)

Department of Obstetrics, Division of Gynecologic Oncology, Gynecology and Women's Health, University of Minnesota, Minneapolis, Minnesota, USA.

Ashley E Stenzel (AE)

Program in Health Disparities Research, Department of Family Medicine & Community Health, University of Minnesota Medical School, Minneapolis, Minnesota, USA.

Anne Blaes (A)

Department of Medicine, Division of Hematology and Oncology, University of Minnesota, Minneapolis, Minnesota, USA.

Deanna Teoh (D)

Department of Obstetrics, Division of Gynecologic Oncology, Gynecology and Women's Health, University of Minnesota, Minneapolis, Minnesota, USA.

Rachel I Vogel (RI)

Department of Obstetrics, Division of Gynecologic Oncology, Gynecology and Women's Health, University of Minnesota, Minneapolis, Minnesota, USA.

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