Health Behaviors and Self-Reported Health Among Cancer Survivors by Sexual Orientation

Purpose: Health behaviors and self-reported health are important for understanding cancer survivor health. However, there is a paucity of published research about how cancer survivors' health behaviors and self-rated health vary by sexual orientation. This study examined cancer survivors' health behaviors and self-reported health by sexual orientation. Methods: This study used data from the National Health and Nutrition Examination Survey (NHANES) from 2001-2010. Self-reported health and cancer-related health behaviors were compared by sexual orientation. Propensity score adjustment was used to account for differences in age, race, education, gender and health insurance status. Results: Of the 602 survivors eligible for the study, 4.3% identified as sexual minorities. Sexual minorities were 2.6 times more likely to report a history of illicit drug use (adjusted odds ratio [aOR] = 2.4, 95% confidence interval [CI]: 1.04, 5.35), and 60% less likely to report their current health status as good (aOR= 0.40, 95% CI: 0.18, 0.89), compared to heterosexual cancer survivors. These disparities persisted even after adjustment for sociodemographic characteristics. Conclusion: Our findings suggest that sexual minority cancer survivors may be at greater risk for poorer outcomes after cancer than other survivors. A possible explanation for the observed differences involves minority stress. Future research should test stress as an explanation for these differences. However, using population-methods to achieve this goal requires larger samples of lesbian, gay, and bisexual (LGB) cancer survivors.