Satisfaction with care, general health, and mental health among sexual and gender minority cancer survivors: Results of the OUT National Cancer Survey

Cancer. 2024 Apr 15;130(8):1292-1302. doi: 10.1002/cncr.35164. Epub 2023 Dec 20.

Abstract

Background: Few studies have attempted to characterize the cancer care experiences and outcomes of sexual and gender minority (SGM) patients with cancer, despite indications that this population experiences disparities across the cancer continuum. The current study used descriptive and exploratory methods to assess factors related to SGM cancer patients' satisfaction with cancer care and self-reported physical and mental health.

Methods: The authors designed a cross-sectional self-report online survey and recruited 3750 SGM cancer patient participants (mixed cancers; 85.6% White; 57% gay, 24% lesbian, 6.7% bisexual, and 6.2% transgender/gender nonbinary) using social media posts, partner organizations, and paid advertisements. They analyzed data using descriptive approaches and exploratory multivariate logistic regression models.

Results: Overall, 70.6% of participants reported feeling satisfied with the cancer care they received, 70% rated their physical health as very good or excellent, and 46% reported experiencing less than 5 days of poor mental health in the last month. In models including all participants, complete cases, and Black, Indigenous, and people of color (BIPOC), satisfaction with care was consistently associated with receiving treatment in an SGM welcoming environment. Physical health was consistently associated with having strong social support after cancer. Mental health was consistently associated with feeling safe disclosing SGM identities.

Conclusions: SGM cancer patients treated in SGM-welcoming environments were over six times more likely to be satisfied with the care they received than those treated in nonwelcoming environments; this and other modifiable factors could be the target of further study and intervention.

Keywords: cancer; gender identity; health disparities; sexual and gender minorities; sexual orientation.

MeSH terms

  • Cancer Survivors*
  • Cross-Sectional Studies
  • Female
  • Health Status
  • Humans
  • Mental Health
  • Neoplasms* / epidemiology
  • Neoplasms* / therapy
  • Personal Satisfaction
  • Sexual Behavior / psychology
  • Sexual and Gender Minorities*