Racial/Ethnic Issues and LGBT Cancer Survivors
Individuals at the intersection of race/ethnicity and sexual minority status may be at elevated risk for poor outcomes across the cancer care continuum due to the combined impact of poor adherence to cancer screening, barriers to adequate health care services and engagement in cancer-promoting health risk behaviors. Researchers Alicia K. Matthews, Natalie Ross, Meenhye Lee and Frances Aranda (Cancer and the LGBT Community pp. 261-272 Springer) define sexual minorities as members of our LGBT community. Minorities of color are people that are not white (i.e. African American, Latinas, Asians, etc.).
Knowledge about sexual minorities of color remains limited We do not have enough information to tell us the full story about racial/ethnic minorities within the LGBT cancer community. To conduct research, you have to have a large enough sample size of participants to come up with statistically sound conclusions. Our history of distrust and discrimination negatively impacts the recruitment numbers for these studies. Historically, these communities have not trusted researchers, mostly white researchers looking at communities of color. They have also experienced discrimination within the health care system. When we don’t have enough people participating in research studies, it becomes hard to identify the full spectrum of needs and issues for racial/ethnic and sexual minorities within the cancer care continuum.
The intersection where belonging to two distinct identity groups – one based on race/ethnicity and the other based on sexual orientation and/or gender identity – may create some commonalities because of shared experiences of oppression and discrimination.
The unique needs and experiences of LGBT people of color within the cancer continuum demand a unique care. People who are are members of more than one minority group, such as LGBT people of color, present low numbers of preventative care, high rates of cancer, and low rates of survivorship. Belonging to more than one distinct group of identity makes understanding treatment outcomes and choice making more difficult.
Cancer screening behaviors may directly contribute to elevated risk for late-stage diagnosis and poor cancer outcomes.
Race/ethnic minorities and members of the LGBT community are more likely to not seek out preventative screenings that are necessary for early detection. If we aren’t getting these preventative and early screenings to detect cancer early, then it means that by the time that we get to the doctor, our cancer has progressed significantly. For instance, anal Pap screening is a preventative detection test that is often not discussed with male patients, but men tend to show a high interest in the test when they do find out about it. African American men show likelihood to decline the test so this might be why we see high rates of HPV-related anal cancers in African American LGBT men. Members of minority groups that intersect are also less likely to follow up with a doctor after screenings.