title: Disparities in psychological distress impacting lesbian, gay, bisexual and transgender cancer survivors.
abstract: OBJECTIVE
  Recent studies have highlighted disparities in cancer diagnosis between lesbian, gay, bisexual and transgender (LGBT) and heterosexual adults. Studies have yet to examine disparities between LGBT and heterosexual cancer survivors in prevalence of psychological distress.
  
  
  METHODS
  Data for the current study were drawn from the LIVESTRONG dataset, a US national survey that sampled 207 LGBT and 4899 heterosexual cancer survivors (all cancer types, 63.5% women, mean age 49) in 2010. Symptoms of psychological distress were assessed with dichotomous yes/no items in three symptom clusters (depression related to cancer, difficulties with social relationships post-cancer, fatigue/energy problems). We selected a sample of 621 heterosexual survivors matched by propensity score to the 207 LGBT survivors and assessed disparities in count of symptoms using Poisson regression. We also performed subgroup analyses by self-reported sex.
  
  
  RESULTS
  Relative to heterosexuals, LGBT cancer survivors reported a higher number of depression and relationship difficulty symptoms. Exploratory analyses revealed that disparities in number of symptoms were visible between gay, bisexual, and transgender versus heterosexual men but not between lesbian, bisexual, and transgender versus heterosexual women.
  
  
  CONCLUSIONS
  This study highlights several disparities in psychological distress that exist between LGBT and heterosexual survivors. A need remains for interventions tailored to LGBT survivors and for studies examining disparities within subgroups of LGBT survivors.
authors: University of Rochester Medical Center, Cancer Control Unit, Rochester, NY, USA.
authors: Charles
authors: C
authors: Kamen
authors: University of Rochester Medical Center, Cancer Control Unit, Rochester, NY, USA.
authors: Karen M
authors: KM
authors: Mustian
authors: University of Rochester Medical Center, Department of Public Health Sciences, Rochester, NY, USA.
authors: Ann
authors: A
authors: Dozier
authors: School of Public Health, University of Washington, Seattle, WA, USA.
authors: Deborah J
authors: DJ
authors: Bowen
authors: University of Rochester Medical Center, Department of Public Health Sciences, Rochester, NY, USA.
authors: Yue
authors: Y
authors: Li
mesh_terms: D000328:Adult; D001727:Bisexuality / Q000523:psychology / Q000706:statistics & numerical data; D005260:Female; D054624:Health Status Disparities; D006306:Health Surveys; D020010:Heterosexuality / Q000523:psychology / Q000706:statistics & numerical data; D018452:Homosexuality, Female / Q000523:psychology / Q000706:statistics & numerical data; D018451:Homosexuality, Male / Q000523:psychology / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology* / Q000628:therapy; D019529:Sexuality / Q000523:psychology* / Q000706:statistics & numerical data; D013315:Stress, Psychological / Q000453:epidemiology*; D017741:Survivors / Q000523:psychology* / Q000706:statistics & numerical data; D063106:Transgender Persons / Q000523:psychology / Q000706:statistics & numerical data; D014481:United States / Q000453:epidemiology
keywords: health disparities; psychological distress; sexuality; survivors
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