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Breast Cancer Mortality’s Association with Sexual Orientation

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Abstract

Our objective is to test disparities in breast cancer mortality by sexual orientation. Using an ecological approach that links SEER breast cancer mortality data with Census 2000 data, we test the hypothesis of higher breast cancer mortality in areas with more presumed lesbians. From the Census 2000 data on female same-sex partnered households, we derive a measure of sexual minority women density (SMWD) for each of the 215 counties covered by SEER 12. We test the association of SMWD with breast cancer mortality using multivariable Poisson regression models that control for age, race, and socioeconomic status. We confirm our hypothesis as we find a significant positive association between SMWD and breast cancer mortality. This relationship remains significant even after controlling for other factors, known to have an association with mortality, such as poverty or race. This ecological approach compensates for the absence of cancer surveillance by sexual orientation. The results suggest a disparity in breast cancer mortality due to sexual orientation. The causes for this disparity need to be identified by future studies.

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References

  • Akaike, H. (1981). Likelihood of a model and information criteria. Journal of Econometrics, 16(1), 3–14.

    Article  Google Scholar 

  • American Cancer Society. (2012). Cancer treatment and survivorship facts & figures: 2012–2013. Atlanta, GA: American Cancer Society (ACS).

    Google Scholar 

  • Boehmer, U., Clark, M., Glickman, M., Timm, A., Sullivan, M., Bradford, J., et al. (2010). Using cancer registry data for recruitment of sexual minority women: successes and limitations. Journal of Women's Health, 19(7), 1289–1297.

    Article  PubMed  Google Scholar 

  • Boehmer, U., Miao, X., & Ozonoff, A. (2011a). Cancer survivorship and sexual orientation. Cancer, 107(16), 3796–3804.

    Article  Google Scholar 

  • Boehmer, U., Ozonoff, A., & Miao, X. (2011b). An ecological analysis of colorectal cancer incidence and mortality: differences by sexual orientation. BMC Cancer, 11(1), 400.

    Article  PubMed  Google Scholar 

  • Boehmer, U., Ozonoff, A., & Timm, A. (2011c). County-level association of sexual minority density with breast cancer incidence: results from an ecological study. Sexuality Research and Social Policy, 8(2), 139–145.

    Article  Google Scholar 

  • Boehmer, U., Ozonoff, A., & Miao, X. (2012). An ecological approach to examine lung cancer disparities due to sexual orientation. Public Health, 126(7), 605–612.

    Article  PubMed  Google Scholar 

  • Bowen, D. J., & Boehmer, U. (2007). The lack of cancer surveillance data on sexual minorities and strategies for change. Cancer Causes & Control, 18(4), 343–349.

    Article  Google Scholar 

  • Cameron, A. C., & Trivedi, P. (1998). Regression analysis of count data. Cambridge, UK: Cambridge University Press.

    Book  Google Scholar 

  • American Cancer Society. (2009). Cancer facts & figures: 2009. Atlanta, GA: American Cancer Society (ACS).

    Google Scholar 

  • Carpenter, C., & Gates, G. J. (2008). Gay and lesbian partnership: evidence from California. Demography, 45(3), 573–590.

    Article  PubMed  Google Scholar 

  • Centers for Disease Control and Prevention (2008) United States Cancer Statistics, 1999–2005 Mortality Archive Request. United States Department of Health and Human Services, CDC. http://wonder.cdc.gov/CancerMort-v2005.html. Accessed 29 October 2010

  • Cochran, S. D., Keenan, C., Schober, C., & Mays, V. (2000). Estimates of alcohol use and clinical treatment needs among homosexually active men and women in the U.S. population. Journal of Consulting and Clinical Psychology, 68(6), 1062–1071.

    Article  PubMed  Google Scholar 

  • Cochran, S. D., & Mays, V. (2011). Sexual orientation and mortality among US men aged 17 to 59 years: results from the National Health and Nutrition Examination Survey III. American Journal of Public Health, 101(6), 1133–1138.

    Article  PubMed  Google Scholar 

  • Cochran, S. D., & Mays, V. M. (2000). Lifetime prevalence of suicide symptoms and affective disorders among men reporting same-sex sexual partners: results from NHANES III. American Journal of Public Health, 90(4), 573–578.

    Article  PubMed  Google Scholar 

  • Cochran, S. D., & Mays, V. M. (2012). Risk of breast cancer mortality among women cohabiting with same sex partners: findings from the National Health Interview Survey, 1997–2003. Journal of Women's Health, 21(5), 528–533.

    Article  PubMed  Google Scholar 

  • Cochran, S. D., Mays, V. M., Bowen, D., Gage, S., Bybee, D., Roberts, S. J., et al. (2001). Cancer-related risk indicators and preventive screening behaviors among lesbians and bisexual women. American Journal of Public Health, 91(4), 591–597.

    Article  PubMed  Google Scholar 

  • Dibble, S. L., Roberts, S. A., & Nussey, B. (2004). Comparing breast cancer risk between lesbians and their heterosexual sisters. Women's Health Issues, 14(2), 60–68.

    PubMed  Google Scholar 

  • Eschbach, K., Mahnken, J. D., & Goodwin, J. S. (2005). Neighborhood composition and incidence of cancer among Hispanics in the United States. Cancer, 103(5), 1036–1044.

    Article  PubMed  Google Scholar 

  • Frisch, M., & Bronnum-Hansen, H. (2009). Mortality among men and women in same-sex marriage: a national cohort study of 8333 Danes. American Journal of Public Health, 99(1), 133–137.

    Article  PubMed  Google Scholar 

  • Gates, G. J. (2006). Same-sex couples and the gay, lesbian, bisexual population: new estimates from the American Community Survey. Los Angeles, CA: The Williams Institute on Sexual Orientation Law and Public Policy UCLA School of Law.

    Google Scholar 

  • Gumpertz, M. L., Pickle, L. W., Miller, B. A., & Bell, B. S. (2006). Geographic patterns of advanced breast cancer in Los Angeles: associations with biological and sociodemographic factors (United States). Cancer Causes & Control, 17(3), 325–339.

    Article  Google Scholar 

  • Haynes, S. (1994). Risk of breast cancer among lesbians. Paper presented at the Cancer and Cancer Risk among Lesbians. WA: Fred Hutchinson Cancer Research Center Seattle.

    Google Scholar 

  • Herek, G., Norton, A., Allen, T., & Sims, C. (2010). Demographic, psychological, and social characteristics of self-identified lesbian, gay, and bisexual adults in a US probability sample. Sexuality Research and Social Policy, 7(3), 176–200.

    Article  PubMed  Google Scholar 

  • Horner, M., Ries, L., Krapcho, M., Neyman, N., Aminou, R., Howlader, N., et al. (2009). SEER Cancer Statistics Review, 1975–2006. Bethesda, MD: National Cancer Institute.

    Google Scholar 

  • Kavanaugh-Lynch, M. H. E., White, E., Daling, J. R., & Bowen, D. J. (2002). Correlates of lesbian sexual orientation and the risk of breast cancer. Journal of the Gay and Lesbian Medical Association, 6(3–4), 91–95.

    Article  Google Scholar 

  • Krieger, N., Chen, J. T., Waterman, P. D., Rehkopf, D. H., & Subramanian, S. V. (2005). Painting a truer picture of US socioeconomic and racial/ethnic health inequalities: the Public Health Disparities Geocoding Project. American Journal of Public Health, 95(2), 312–323.

    Article  PubMed  Google Scholar 

  • McTiernan, A., Kuniyuki, A., Yasui, Y., Bowen, D., Burke, W., Culver, J. B., et al. (2001). Comparisons of two breast cancer risk estimates in women with a family history of breast cancer. Cancer Epidemioliology, Biomarkers, & Prevention, 10(4), 333–338.

    Google Scholar 

  • Partridge, E., & Fouad, M. (2010). Community-driven approaches for reducing health disparities in cancer. Journal of the American Medical Association, 303(11), 1090–1091.

    Article  PubMed  Google Scholar 

  • Reynolds, P., Hurley, S. E., Quach, A. T., Rosen, H., Von Behren, J., Hertz, A., et al. (2005). Regional variations in breast cancer incidence among California women, 1988–1997. Cancer Causes & Control, 16(2), 139–150.

    Article  Google Scholar 

  • Roelfs, D. J., Shor, E., Kalish, R., & Yogev, T. (2011). The rising relative risk of mortality for singles: meta-analysis and meta-regression. American Journal of Epidemiology, 174(4), 379–389.

    Article  PubMed  Google Scholar 

  • Schootman, M., Jeffe, D. B., Lian, M., Gillanders, W. E., & Aft, R. (2009). The role of poverty rate and racial distribution in the geographic clustering of breast cancer survival among older women: a geographic and multilevel analysis. American Journal of Epidemiology, 169(5), 554–561.

    Article  PubMed  Google Scholar 

  • Simmons, T., & O’Connell, M. (2003). Married-couple and unmarried-partner households: 2000. Census 2000 special reports. Washington, DC: US Department of Commerce Economics and Statistics Administration. US Census Bureau.

    Google Scholar 

  • Singh, G., Miller, B., Hankey, B., & Edwards, B. (2003). Area socioeconomic variations in U.S. cancer incidence, mortality, stage, treatment, and survival, 1975–1999 (monograph). Bethesda, MD: National Cancer Institute.

    Google Scholar 

  • The President's Cancer Panel. (2007). Promoting healthy lifestyles: policy, program, and personal recommendations for reducing cancer risk. Annual report 2006–2007. Bethesda, MD: US Department of Health and Human Services.

    Google Scholar 

  • Tian, N., Goovaerts, P., Zhan, F. B., & Wilson, J. G. (2010). Identification of racial disparities in breast cancer mortality: does scale matter? International Journal of Health Geogr, 9, 35.

    Article  Google Scholar 

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Acknowledgments

This work was supported by the Susan G. Komen for the Cure Foundation (DISP0707511).

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Authors and Affiliations

  1. Department of Community Health Sciences, School of Public Health, Boston University, 801 Massachusetts Avenue, Crosstown Center, Boston, MA, 02118, USA

    Ulrike Boehmer

  2. Children’s Hospital Boston, 300 Longwood Ave, Boston, MA, 02115, USA

    AI Ozonoff

  3. School of Public Health, Boston University, 801 Massachusetts Avenue, Crosstown Center, Boston, MA, 02118, USA

    Xiaopeng Miao

Authors
  1. Ulrike Boehmer
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  2. AI Ozonoff
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  3. Xiaopeng Miao
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Correspondence to Ulrike Boehmer.

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Boehmer, U., Ozonoff, A. & Miao, X. Breast Cancer Mortality’s Association with Sexual Orientation. Sex Res Soc Policy 10, 279–284 (2013). https://doi.org/10.1007/s13178-013-0126-5

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  • DOI: https://doi.org/10.1007/s13178-013-0126-5

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