​Publication highlights critical issues concerning cancer prevention, treatment, and care.

In a first-of-its-kind study, the American Cancer Society on May 31 released “Cancer in People who Identify as Lesbian, Gay, Bisexual, Transgender, Queer or Gender-nonconforming (LGBTQ+)”. The article provides the latest statistics on the prevalence of cancer screening and modifiable risk factors in LGBTQ+ populations, as well as a review of literature on cancer occurrence and obstacles to cancer prevention and treatment. These important findings are published in the journal Cancer, alongside its consumer-friendly companion, Cancer Facts & Figures 2024 Special Section: Cancer in People Who Identify as Lesbian, Gay, Bisexual, Transgender, Queer, or Gender-nonconforming, to coincide with the start of Pride month in June.

Perhaps the greatest health disparity faced by LGBTQ+ communities is the presumption-of-care gap, which is the fear that a provider will refuse care due to gender identity or sexual orientation. The concern is especially valid for the 20% of this population who reside in the nine states where it is legal to refuse care to LGBTQ+ individuals due to “conscience clauses” that allow healthcare providers, staff, and insurers to deny care and services based on personal and religious beliefs.

“One of the biggest take-aways from our report is that LGBTQ+ people are probably at higher risk for cancer, yet experience multiple barriers to high-quality healthcare access like discrimination and shortfalls in provider knowledge of their unique medical needs,” said Rebecca Siegel, senior scientific director, cancer surveillance, at the American Cancer Society and senior author of the study. “Everyone deserves an equal opportunity to prevent and detect cancer early, which is why it’s so important to remove these roadblocks for this population.”

LGBTQ+ individuals in the United States have elevated prevalence of smoking, excess body weight, and other factors that increase cancer risk. “Minority stress” is a likely contributor to behaviors like smoking that increase cancer risk according to other studies. Although these findings suggest cancer disparities, cancer incidence and mortality for this population are not available because sexual orientation and gender identity are not routinely collected in healthcare settings, despite the community’s willingness to report this information.

“We are very proud of this report,” said Tyler Kratzer, associate scientist II, cancer surveillance research at the American Cancer Society and lead author of the study. "It is meant to facilitate critical conversations around the need to improve the routine collection of sexual orientation and gender identity data at all levels of healthcare.”

Read more about cancer risk factors for LGBTQ+ people, the approach that researchers took, and other key findings of the report.

“All people should have a fair and just opportunity to live a longer, healthier life free from cancer,” said Lisa A. Lacasse, president of ACS’ advocacy affiliate, the American Cancer Society Cancer Action Network. “As part of our mission to advocate for public policies that reduce the cancer burden for everyone, ACS CAN urges policymakers and lawmakers to prioritize policies that address the serious challenges and barriers to comprehensive access to health care that LGBTQ+ people experience. Importantly, passing laws that facilitate and increase the appropriate collection of sexual orientation and gender identity data is crucial to better understanding cancer disparities and to ultimately improving health outcomes.

Other ACS researchers participating in the report include Dr. Ahmedin Jemal, Jessica Star, Dr. Farhad Islami, Dr. Priti Bandi, and Angela Giaquinto.

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