LGBTQ+ Patients More Likely to Decline Oncologist-Recommended Treatments

By Tamara Thomas - May 30, 2023

LGBTQ+ patients have a higher risk of breast cancer recurrence and are more likely to decline their oncologist’s recommended course of treatment, according to research published in JAMA Oncology.

Erik Eckhert and colleagues studied ninety-two LGBTQ+ patients and ninety-two matched cisgender heterosexual patients, all diagnosed with breast cancer in a single healthcare system between January 2008 and January 2022. The median age at diagnosis was 49 years, and most patients in both groups had private insurance.

About eighty percent (74) of the LGBTQ+ patients were cisgender lesbians. Thirteen percent (12) were cisgender bisexuals (13%). The other participants, about four percent, include a few transgender men, including four heterosexual, one gay, and one asexual.

The study found that LGBTQ+ patients took longer to get diagnosed with breast cancer than cisgender heterosexual patients. Specifically, the median time from symptom onset to diagnosis was sixty-four days for LGBTQ+ patients and thirty-four days for cisgender heterosexual patients. However, once diagnosed, both groups received similar treatment with no differences in surgery, radiation, or chemotherapy.

Interestingly, LGBTQ+ patients were more likely to decline recommended treatments from their oncologist and instead use alternative medicine. According to the study, thirty-eight percent of LGBTQ+ patients declined treatment, while only twenty percent of cisgender heterosexual patients did the same.

The study also found that the recurrence rate was higher in LGBTQ+ patients, with a three-fold higher risk than in cisgender heterosexual patients. Specifically, the recurrence rate was 32.2% in LGBTQ+ patients compared to 13.3% in cisgender heterosexual patients. 

Furthermore, the local recurrence rate was also higher in LGBTQ+ patients, with 17.3% compared to 2.5% in cisgender heterosexual patients.

The researchers recommend conducting more prospective and population-based studies to investigate these differences. The aim is to use the results to develop healthcare interventions and improve the quality of care for LGBTQ+ patients with breast cancer.


Source: Cancer Therapy Advisor

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