Cancer disparities by age: a focus on sexual and gender minorities

The purpose of this study is to examine the age at which sexual and gender minorities are diagnosed with cancer relative to heterosexual cisgender individuals.

We use population-based representative Behavioral Risk Factor Surveillance Survey data with self-reported sexual orientation, gender identity, cancer diagnoses, and the age at diagnosis. We determined the mean age at diagnosis and used logistic regression modeling to obtain odds ratios, reporting significant differences defined as p < 0.05. Separately, we adjusted for race/ethnicity and corrected for underlying differences in the age of survey respondents.

Compared to heterosexual cisgender populations, sexual and gender minorities are diagnosed about 4-11 years earlier, with bisexual women and transgender individuals reporting the youngest age, 43.9 and 52.1 years, respectively. When focusing on select cancer types, lesbian and bisexual women are diagnosed earlier with breast, melanoma, other skin cancers, and leukemia & lymphoma. Gay and bisexual men are diagnosed earlier with colorectal cancers, and transgender individuals earlier with breast, prostate, melanoma, and other skin cancers compared to heterosexual men and women.

These findings suggest that sexual and gender minorities experience earlier onset of cancer and many of these age differences remained even after adjustments were made. These findings need to be confirmed in oncology settings that have cancer incidence and sexual orientation and gender identity data and call for greater attention to sexual and gender minorities in cancer research.