| Abstract: | Objectives. We examined sexual-orientation disparities in frequent engagement in cancer-related risk indicators of tobacco, alcohol, diet and physical activity, ultraviolet radiation, and sexually transmitted infections (STIs).Methods. We used longitudinal data from the national Growing Up Today Study (1999–2010). Of the analytic sample (n = 9958), 1.8% were lesbian or gay (LG), 1.6% bisexual (BI), 12.1% mostly heterosexual (MH), and 84.5% completely heterosexual (CH).Results. More sexual minorities (LGs, BIs, and MHs) than CHs frequently engaged in multiple cancer-related risk behaviors (33%, 29%, 28%, and 19%, respectively). Sexual-minority young women, especially BI and MH, more frequently engaged over time in substance use and diet and physical activity risk than CH women. More young gay than CH men frequently engaged over time in vomiting for weight control (odds ratio OR] = 3.2; 95% confidence interval CI] = 1.1, 9.4), being physically inactive (OR = 1.7; 95% CI = 1.2, 2.4), and using tanning booths (OR = 4.7; 95% CI = 3.0, 7.4), and had a higher prevalence of ever having an STI (OR = 3.5; 95% CI = 2.0, 6.4). Individual analyses were generally comparable to the group-level analyses.Conclusions. Young sexual minorities are at risk for cancer through frequent exposure to cancer-related risk behaviors over time. Long-term, longitudinal studies and surveillance data are essential and warranted to track frequent engagement in the risk behaviors and cancer-related morbidity and mortality.A 2011 report by the Institute of Medicine highlighted the absence of national data on cancer incidence and prevalence for sexual minorities (lesbians, gays, and bisexuals) and transgender individuals.1 The lack of data is surprising because cancer remains the second-leading cause of mortality in the United States, responsible for approximately 1 in 4 deaths.2 Furthermore, behaviors that increase the risk of cancer are more prevalent among sexual minorities. Despite the fact that cancer-related risk behaviors may become habitual over time through behaviorally reinforcing contingencies and neurobiological reward circuits, little is known about the extent to which sexual minorities engage in the behaviors over time. Frequent engagement in the behaviors over time would increase risk for cancer, as would the potential additive or synergistic effects resulting from clustering of the behaviors.Although the prevalence of engaging (yes or no) in risk behaviors among sexual minorities has been studied in literatures that are relatively independent of each other, rarely has the risk of many such behaviors for cancer been noticed. Such awareness and documentation are necessary to argue for the surveillance of cancer morbidity and mortality that the Institute of Medicine1 found lacking. We used a large national cohort of young people to document sexual-orientation disparities in frequent engagement over time in cancer-related risk behaviors at the group and individual levels of analysis. |
