Lesbians and cancer: an overlooked health disparity.
OBJECTIVE
To evaluate the breast, cervical, ovarian, lung, and colorectal cancer literatures using a novel application of the cancer disparities grid to identify disparities along domains of the cancer continuum focusing on lesbians as a minority population.


METHODS
Computerized databases were searched for articles published from 1981 to present. Cumulative search results identified 51 articles related to lesbians and disparities, which were classified by domain.


RESULTS
The majority of articles identified were related to breast and cervical cancer screening. Barriers to adequate screening for both cancers include personal factors, poor patient-provider communication, and health care system factors. Tailored risk counseling has been successful in increasing lesbian's mammography and Pap screening. Ovarian, lung, and colorectal cancer have been virtually unexplored in this population. An "Adjustment to Illness/Quality of Life" domain was added to capture literature on psychosocial aspects of cancer.


CONCLUSIONS
This review revealed a lack of research for specific cancers and for specific aspects of the cancer continuum. The limited number of studies identified focused on issues related to screening/prevention in cervical and breast cancers, with almost no attention to incidence, etiology, diagnosis, treatment, survival, morbidity, or mortality. We present implications for social and public health policy, research, and prevention.
Brown
Jessica P
JP
Department of Epidemiology and Preventive Medicine, University of Maryland School of Medicine, Baltimore, MD 21201, USA. jpbrown@epi.umaryland.edu
Tracy
J Kathleen
JK
D001943:Breast Neoplasms / Q000517:prevention & control; D005260:Female; D018452:Homosexuality, Female; D006801:Humans; D008403:Mass Screening; D009369:Neoplasms / Q000517:prevention & control*; D002583:Uterine Cervical Neoplasms / Q000517:prevention & control