Key messages
- In patients belonging to gender minorities and sexual orientation, breast cancer diagnosis, treatments and outcomes are reduced and different compared to heterosexual/cisgender patients.
In a case-control study, published in JAMA oncology, 92 patients belonging to different gender or sexual minorities (sex and gender minority, SGM) were compared with as many heterosexual and cisgender patients, considering some factors such as: the year of diagnosis of breast cancer, the tumor stage, age, status of estrogen receptors and ERBB2.What emerges in the SGM group is a delay in diagnosis, a higher recurrence rate and a rejection of therapies recommended by oncologists, an analysis that however requires further validation. In fact, neither in the oncological registers nor in the medical records are precise data regarding sexual orientation or gender identity reported.
The demographic and clinical characteristics and quality of treatment used for the comparison of the patient groups under consideration were examined according to several parameters. For example, the lack of screening, the presence of adequate genetic counseling, the choice of mastectomy vs lumpectomy, antiestrogen therapy for at least 5 years for estrogen receptor positivity, the time from diagnosis to the first treatment and the time from the end of treatment to the first relapse and many others were considered. What emerged was that patients in the SGM group showed inequalities in one or more of these parameters.
The research, carried out by , involved a total of 184 patients in whom the average age at diagnosis of cancer was 49 years.In the SGM group, a delay from symptom onset to histological diagnosis was observed (median time to diagnosis, 34 vs 64 days). Patients from these minorities were also more likely to refuse treatments recommended by oncologists (35 [38%] vs 18 [20%]), and were more likely to develop relapses (multivariable adjusted hazard ratio, 3.07; 95% CI, 1.56-6.03; P = .001).
The study highlights a gap between heterosexual/cisgender and non-heterosexual patients, both in the diagnosis and treatment and health care of breast cancer, but larger and more in-depth studies are needed.
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Source — https://www.univadis.it/viewarticle/tumore-al-seno-disparit%25C3%25A0-di-assistenza-pazienti-2023a10002qi