Abstract 1916: Cancer disparities among sexual and gender minority patients at a National Cancer Institute-Designated Comprehensive Cancer Center
Authors: Zamani Shahrzad A. , Perez-Morales Jaileene , Miller Jarred D. , Schabath Matthew B. 
Published: April 2023

Background: Over the last several decades there have been concerted efforts to reduce health disparities among intersecting underserved populations including racial and ethnic, social class, disability, and geographic location. However, there have been limited efforts to identify and address cancer disparities by sexual orientation and gender identity (SOGI). We sought to identify differences in demographics, risk factors, clinical characteristics, and outcomes between sexual and gender minority (SGM) and non-SGM cancer patients.

Methods: Analysis include over 70,000 cancer patients at the Moffitt Cancer Center (Tampa, FL) who completed our Electronic Patient Questionnaire (EPQ) at their initial appointment. Moffitt’s EPQ is a standard-of-care (SOC) questionnaire instrument used to collect self-reported demographics, prior medical history, history of cancer, utilization of cancer screening services, and lifestyle risk factors. The SOGI items in the demographics section were used to categorize persons as a SGM or non-SGM. Cancer registry data were used to obtain clinical covariates on the patients that completed the EPQ.

Results: SGM patients represented 2.3% of the patient population. The mean age of SGM patients was significantly lower (mean=56) compared to non-SGM patients (mean=62.3, p= &lt;0.001). There was a higher prevalence of racial (10.1% vs 9.4%, p= &lt;0.001) and ethnic (11.5% vs 8.8%, p= &lt;0.001) minorities among SGM vs non-SGM patients. SGM patients were significantly more likely to be single (32.8% vs 10.3%, p= &lt;0.001). For modifiable risk factors, there were significantly more current smokers among SGM vs non-SGM patients (5.4% vs 3.1%, p= &lt;0.001) and SGM patients reported higher number of pack-years smoked (mean=22.5 vs mean=22.5, p= 0.007). SGM patients reported higher rates alcohol consumption, especially significantly higher rates of more than 5 drinks per day (8.1% vs 6.2%, p= &lt;0.001). SGM patients reported significantly higher rates of depression (35.1% vs 19.8%, p= &lt;0.001). SGM patients also reported less utilization in all forms of exercise such as moderate to vigorous physical activity or walking). SGM patients reported lower utilizing of fecal occult blood test (26.6% vs 32.3%, p= 0.026) and sigmoidoscopy/colonoscopy (75.1% vs 89.8%, p= &lt;0.001) for colorectal cancer screening compared to non-SGM patients. SGM patients had slightly higher rates of cancer diagnoses for GI, Endocrine, Sarcoma, GYN and associated with overall inferior survival (p= 0.001).

Discussion: The Moffitt Cancer Center began collecting SOGI information as SOC information on all new patients since 2016. In just 5 years of data collection, our institution has identified numerous real-world disparities among SGMs patients. These findings will be critical to develop tailored interventions to improve equality care across the cancer care continuum for SGM populations.

Citation Format: Shahrzad A. Zamani, Jaileene Perez-Morales, Jarred D. Miller, Matthew B. Schabath. Cancer disparities among sexual and gender minority patients at a National Cancer Institute-Designated Comprehensive Cancer Center [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 1916.