Specific segments of the population bear a greater cancer burden than the general population. It has been hypothesized that sexual minorities are among the population groups likely to experience cancer disparities. However, in the absence of reliable population-based data that include sexual orientation, this hypothesis has yet to be tested. This secondary data analysis will link two data sources, SEER and the US Census, to assess if sexual minorities are unequally affected by cancer. Using a county-level proxy for sexual orientation, we will test the hypothesis that geographic areas in which sexual minorities (defined as same-sex partnered households) are concentrated have higher lung and colorectal cancer incidence, more advanced stage at diagnosis, and greater cancer mortality compared to areas with few sexual minority women. A secondary goal is to consider the economic structure of the geographic areas in which sexual minorities live so that any disparities in the cancer burden are appropriately attributed. We have four specific aims to identify lung and colorectal cancer disparities: 1. Examine the relationship of lung cancer incidence to the percentage of sexual minority populations (defined as female or male same-sex partnered households) in a geographic area and examine the relationship of colorectal cancer incidence to the percentage of SMW. 2. Determine the rate of late stage lung cancer diagnoses to the percentage of sexual minority populations in a geographic area and determine the rate of late stage colorectal cancer diagnoses to the percentage of SMW. 3. Compare lung cancer mortality as a function of percentage of sexual minority populations in a geographic area and compare colorectal cancer mortality as a function of percentage of SMW in a geographic area. 4. Compare lung cancer incidence, stage of diagnosis, and mortality in the geographic areas where sexual minority populations are concentrated as a function of per capita income in these areas and compare colorectal cancer incidence, stage of diagnosis, and mortality in the geographic areas where SMW are concentrated as a function of per capita income in these areas.
Results from this study will show whether sexual minorities are a vulnerable population for lung and colorectal cancers. If this innovative data use is successful, it can be replicated for other population groups that are not well described in existing cancer surveillance databases. Ultimately, this epidemiological approach to cancer disparities is a necessary first step on which we expect to build with follow-up research focused on understanding and eliminating disparities linked to sexual orientation.
| Boehmer, U; Ozonoff, A; Miao, X (2012) An ecological approach to examine lung cancer disparities due to sexual orientation. Public Health 126:605-12 |
| Boehmer, Ulrike; Ozonoff, Al; Miao, Xiaopeng (2011) An ecological analysis of colorectal cancer incidence and mortality: differences by sexual orientation. BMC Cancer 11:400 |
