Disparities in health-related quality of life among lesbian, gay, and bisexual cancer survivors

Abstract

Objective

This study compared health-related quality of life (HRQOL) among lesbian, gay, and bisexual (LGB) cancer survivors and their heterosexual counterparts in a US population-based sample of cancer survivors.

Methods

The study utilized data from the All of Us research program. LGB survivors (n = 885) were matched for age, gender identity, marital status, income, education, and cancer site with heterosexual survivors (n = 885) using 1:1 propensity matching. Physical, mental, and social HRQOL were assessed with items from the Patient-Reported Outcomes Measurement Information System (PROMIS).

Results

Relative to heterosexuals, LGB cancer survivors reported lower HRQOL in mental and social domains, but not in physical HRQOL. Older age was associated with higher HRQOL across domains. LGB survivors identifying as Black/African American were more likely to experience lower social HRQOL than White survivors.

Conclusions

This study highlights several disparities in HRQOL that exist between LGB and heterosexual cancer survivors.

Keywords:

• cancer
• distress
• health-related quality of life
• propensity matching
• sexual minority

Acknowledgments

The All of Us Research Program is supported by the National Institutes of Health, Office of the Director: Regional Medical Centers: 1 OT2 OD026549; 1 OT2 OD026554; 1 OT2 OD026557; 1 OT2 OD026556; 1 OT2 OD026550; 1 OT2 OD 026552; 1 OT2 OD026553; 1 OT2 OD026548; 1 OT2 OD026551; 1 OT2 OD026555; IAA #: AOD 16037; Federally Qualified Health Centers: HHSN 263201600085U; Data and Research Center: 5 U2C OD023196; Biobank: 1 U24 OD023121; The Participant Center: U24 OD023176; Participant Technology Systems Center: 1 U24 OD023163; Communications and Engagement: 3 OT2 OD023205; 3 OT2 OD023206; and Community Partners: 1 OT2 OD025277; 3 OT2 OD025315; 1 OT2 OD025337; 1 OT2 OD025276. In addition, the All of Us Research Program would not be possible without the partnership of its participants. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. We thank the UCI All of Us team for their support.

Disclosure statement

The authors declare no conflicts of interest.

Patient consent statement

Participants provided written informed consent at enrollment in the study.

Ethical approval statement

All study procedures were reviewed and approved by the NIH All of Us Institutional Review Board (see 10.1056/NEJMsr1809937). Secondary analyses of deidentified data in the current study are not required to undergo a separate IRB review as there is no direct participant contact and all potentially identifying information has been removed from available data from the Researcher Workbench.

Additional information

Funding

The authors received financial support from the University of California, Irvine Genetic Epidemiology Research Institute and the UCI Office of Data and Information Technology.