Exploring the Relationship between Self-Rated Health and Unmet Cancer Needs among Sexual and Gender Minority Adolescents and Young Adults with Cancer.

Nina Francis-Levin, Lauren V Ghazal, Jess Francis-Levin, Bradley Zebrack, Meiyan Chen, Anao Zhang
Author Information
  1. Nina Francis-Levin: Division of Endocrinology, Metabolism & Diabetes, Michigan Medicine, University of Michigan, Ann Arbor, MI 48109, USA.
  2. Lauren V Ghazal: School of Nursing, University of Rochester, Rochester, NY 14642, USA. ORCID
  3. Jess Francis-Levin: Institute for Social Research, University of Michigan, Ann Arbor, MI 48104, USA.
  4. Bradley Zebrack: School of Social Work, University of Michigan, Ann Arbor, MI 48109, USA. ORCID
  5. Meiyan Chen: School of Social Work, University of Michigan, Ann Arbor, MI 48109, USA.
  6. Anao Zhang: School of Social Work, University of Michigan, Ann Arbor, MI 48109, USA. ORCID

Abstract

This study evaluates the unmet needs of sexual and gender minority (SGM) adolescent and young adult (AYA) cancer survivors by comparing SGM AYA self-rated health (SRH) scores to their non-SGM (i.e., cisgender/heterosexual) counterparts. The Cancer Needs Questionnaire-Young People (CNQ-YP) and self-rated health measures were used to assess unmet needs in AYAs aged 15-39 who had been diagnosed with cancer in the previous ten years ( = 342). Participants were recruited from a National Cancer Institute (NCI) Comprehensive Cancer Center registry using the modified Dillman's method. Self-reported sexual orientation and gender identity (SO/GI) data were collected. Independent -tests were used to test between-group differences in unmet needs and Pearson's chi-square test was used to determine the difference in SRH scores between SGM and non-SGM AYA cancer survivors. SGM AYA cancer survivors reported greater mean needs than their non-SGM counterparts across all six domains and reported significantly greater needs in the domains of Feelings and Relationships, (314) = -2.111, = 0.036, Information and Activities, (314) = -2.594, = 0.009, and Education, (207) = -3.289, < 0.001. SGM versus non-SGM SRH scores were significantly different, indicating that a higher percentage of SGM AYAs reported poor/fair health compared to those who were non-SGM. Unmet life and activities needs were negatively associated with AYA cancer survivors' SRH, whereas unmet work needs were positively associated with AYA cancer survivors' SRH. An AYA's gender identity (SGM versus non-SGM) was not a moderator. SGM AYAs are an understudied group within an already vulnerable patient population. Unmet psychosocial needs related to one's feelings and relationships, and information and activity needs merit further research to develop tailored interventions that reflect the experiences of SGM AYAs.

Keywords

References

  1. Lancet Oncol. 2022 Jan;23(1):2-3 [PMID: 34871552]
  2. Ann Behav Med. 2022 Jun 29;56(6):573-591 [PMID: 34228052]
  3. LGBT Health. 2014 Mar;1(1):50-7 [PMID: 26789509]
  4. Support Care Cancer. 2023 May 11;31(6):332 [PMID: 37166532]
  5. Oncol Nurs Forum. 2015 Jan;42(1):44-51 [PMID: 25542320]
  6. Fertil Steril. 2020 Jan;113(1):149-157.e2 [PMID: 31727413]
  7. Support Care Cancer. 2012 May;20(5):991-1010 [PMID: 21533810]
  8. SSM Popul Health. 2019 Nov 29;10:100525 [PMID: 31872041]
  9. Curr Oncol Rep. 2018 Sep 13;20(11):85 [PMID: 30209629]
  10. J Psychosoc Oncol. 2018 Jul-Aug;36(4):393-405 [PMID: 29791273]
  11. CA Cancer J Clin. 2015 Sep-Oct;65(5):384-400 [PMID: 26186412]
  12. BMC Geriatr. 2020 Mar 30;20(1):120 [PMID: 32228464]
  13. Front Public Health. 2013 May 20;1:15 [PMID: 24350184]
  14. Cancer. 2021 Sep 1;127(17):3223-3231 [PMID: 33974717]
  15. Public Health Rep. 2020 Nov/Dec;135(6):721-727 [PMID: 33026972]
  16. Cancer. 2012 Oct 1;118(19):4884-91 [PMID: 22688896]
  17. Cancers (Basel). 2022 Sep 22;14(19): [PMID: 36230516]
  18. BMC Cancer. 2021 Jan 5;21(1):17 [PMID: 33402126]
  19. LGBT Health. 2018 Apr;5(3):203-211 [PMID: 29641317]
  20. Psychooncology. 2018 Feb;27(2):532-538 [PMID: 28778113]
  21. Am Soc Clin Oncol Educ Book. 2020 Mar;40:1-15 [PMID: 32324424]
  22. JAMA Intern Med. 2017 Aug 1;177(8):1210-1212 [PMID: 28558100]
  23. Transl Androl Urol. 2020 Mar;9(Suppl 2):S215-S226 [PMID: 32257862]
  24. Int J Environ Res Public Health. 2018 Jun 01;15(6): [PMID: 29857580]
  25. Semin Oncol Nurs. 2021 Dec;37(6):151227 [PMID: 34753639]
  26. Psychol Med. 2022 Apr;52(5):824-833 [PMID: 32571438]
  27. Fertil Steril. 2021 Apr;115(4):1029-1034 [PMID: 33276964]
  28. Cancer Med. 2021 Oct;10(20):7339-7346 [PMID: 34586755]
  29. J Gerontol. 1991 Mar;46(2):S55-65 [PMID: 1997583]
  30. J Clin Oncol. 2017 Jul 1;35(19):2203-2208 [PMID: 28368670]
  31. LGBT Health. 2014 Jun;1(2):86-92 [PMID: 26789618]
  32. Bioethics. 2021 Mar;35(3):270-276 [PMID: 33205395]
  33. J Natl Compr Canc Netw. 2017 Nov;15(11):1305-1308 [PMID: 29118223]
  34. Oncologist. 2022 Feb 3;27(1):e45-e52 [PMID: 35305105]
  35. J Clin Med. 2021 Apr 22;10(9): [PMID: 33922382]
  36. JCO Oncol Pract. 2022 Aug;18(8):e1297-e1305 [PMID: 35605183]
  37. Cancers (Basel). 2021 Sep 28;13(19): [PMID: 34638332]
  38. J Cancer Surviv. 2019 Aug;13(4):611-619 [PMID: 31273638]
  39. Int J Environ Res Public Health. 2020 Oct 08;17(19): [PMID: 33050069]
  40. Sci Rep. 2021 Mar 17;11(1):6139 [PMID: 33731775]
  41. SSM Popul Health. 2019 Jan 23;7:100364 [PMID: 30723772]
  42. Syst Rev. 2021 Jun 21;10(1):183 [PMID: 34154645]
  43. J Cancer Surviv. 2017 Dec;11(6):751-764 [PMID: 28357785]
  44. Psychooncology. 2015 Nov;24(11):1384-91 [PMID: 25630987]
  45. Front Oncol. 2022 Jun 24;12:918016 [PMID: 35814403]
  46. Asia Pac J Oncol Nurs. 2021 Mar 09;8(3):314-321 [PMID: 33850965]
  47. Cancer. 2022 Jul 1;128(13):2405-2419 [PMID: 35435238]
  48. Cancer. 2019 Dec 15;125(24):4371-4379 [PMID: 31593319]
  49. Can Fam Physician. 1986 Nov;32:2366-8 [PMID: 21267217]
  50. J Clin Oncol. 2012 Apr 10;30(11):1221-6 [PMID: 22412147]
  51. J Adolesc Health. 2020 Oct;67(4):583-589 [PMID: 32359942]
  52. Sci Rep. 2020 Mar 17;10(1):4886 [PMID: 32184429]
  53. Pediatr Blood Cancer. 2019 Aug;66(8):e27789 [PMID: 31058418]
  54. CA Cancer J Clin. 2020 Nov;70(6):443-459 [PMID: 32940362]
  55. J Natl Compr Canc Netw. 2014 Jan;12(1):34-45 [PMID: 24453291]
  56. Health Qual Life Outcomes. 2012 Jan 30;10:13 [PMID: 22284545]
  57. Soc Psychiatry Psychiatr Epidemiol. 2022 Oct;57(10):1979-1986 [PMID: 35507033]
  58. J Natl Cancer Inst Monogr. 2021 Sep 3;2021(57):15-17 [PMID: 34478507]
  59. Ann LGBTQ Public Popul Health. 2022 Jun;3(2):111-128 [PMID: 38078047]
  60. PLoS One. 2021 Feb 23;16(2):e0246883 [PMID: 33621230]
  61. CA Cancer J Clin. 2021 May;71(3):250-263 [PMID: 33283888]
  62. J Am Board Fam Med. 2010 May-Jun;23(3):306-14 [PMID: 20453176]
  63. J Racial Ethn Health Disparities. 2022 Apr;9(2):462-477 [PMID: 33544329]
  64. J Clin Oncol. 2002 May 15;20(10):2514-9 [PMID: 12011130]
  65. Workplace Health Saf. 2021 Nov;69(11):506-516 [PMID: 34039084]
  66. J Cancer Surviv. 2022 Aug;16(4):844-852 [PMID: 34633638]

Grants

  1. R01 AG067506/NIA NIH HHS
  2. T32 CA236621/NCI NIH HHS
  3. T32 DK007245/NIDDK NIH HHS
  4. T32 DK007245/NCI NIH HHS

MeSH Term

Humans
Male
Female
Adolescent
Young Adult
Gender Identity
Sexual Behavior
Surveys and Questionnaires
Cancer Survivors
Neoplasms
Sexual and Gender Minorities

Word Cloud

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