Abstract C021: Characteristics of malignancy in lesbian, gay, bisexual, and transgender/transsexual (LGBT) population
Authors: Al-Shbool Ghassan , Farid Saira , Nassar Ahmad , Kim Chul 
Published: September 2020

Background: LGBT people account for 4.5% of adult population in U.S. and face multiple challenges across different aspects of life. Although malignancy is the second most common cause of death in the U.S., only few studies that analyzed the characteristics of malignancies in the LGBT community exist. We aim to provide an overview of malignancy affecting LGBT patients. Methods: A retrospective chart review of LGBT patients with a diagnosis of malignancy treated at Medstar Health Hospitals was performed. Natural language processing with strings was utilized to retrieve patient charts with ICD-9 and ICD-10 codes for LGBT status and cancer. Results: A total of sixty-one patients (pts) were identified; (5 lesbian female, 49 gay male, 6 female transgenders and 1 male transgender). The median age was 49 (range: 19-79). 30 pts (49%) were Caucasian, 26 (43%) were African American and 5 (8%) were Hispanic. Among the female transgender patients, 3 received hormonal therapy for gender change and no patient underwent surgery to change the biological gender. 18 pts had human immunodeficiency virus (HIV) infection, 1 pt hepatitis B virus (HBV), 2 pts hepatitis C virus (HCV), 8 pts HIV/HCV, 2 pts HIV/HBV, and 1 pt HIV/HBV/HCV. Among the patients with HIV infection (n=29), 26 (90%) were receiving anti-retroviral treatment at last follow-up. 27 (44%) pts were active smokers, 10 (16%) pts former smokers and 24 (40%) never smoker. 27 (44%) reported a history of substance abuse with 9 (15%) pts with active substance abuse and 25 (41%) never used it. Employment status was employed (n=32), unemployed (n=20), retired (n=6), and not available (n=3). Tumor types included anal squamous cell carcinoma (anal SCC; n=15), Non-Hodgkin lymphoma (NHL; n=12), non-small-cell lung cancer (NSCLC; n=9), colorectal cancer (CRC; n=7), Kaposi sarcoma (n=4), brain cancer (n=3), breast carcinoma, small-cell lung cancer and pancreatic cancer (2 each), prostate carcinoma, testicular carcinoma, head and neck cancer, Hodgkin lymphoma and mesothelioma (1 each). Among the HIV-infected patients, tumor types include [NHL n=8, anal SCC n=6, NSCLC n=4, CRC n=4, Kaposi sarcoma n=3, head and neck cancer =1, prostate cancer n=1, pancreatic cancer n=1, Hodgkin lymphoma n=1]. Among the anal SCC group (n=15), 6 pts had human papilloma (HPV)-associated cancer, while 1 pt had non-HPV associated cancer and HPV status was not available in 8 pts. Conclusion: LGBT people with cancer have a high incidence of chronic viral infection and appear to have distinct patterns of malignancy compared to those in the general population. Larger studies are needed to verify the findings and to understand unique challenges facing the LGBT population.

Citation Format: Ghassan Al-Shbool, Saira Farid, Ahmad Nassar, Chul Kim. Characteristics of malignancy in lesbian, gay, bisexual, and transgender/transsexual (LGBT) population [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr C021.