Sexual Orientation Disparities in Cancer-Related Risk Behaviors of Tobacco,Alcohol, Sexual Behaviors,and Diet and Physical Activity: Pooled Youth Risk Behavior Surveys

Objectives. We examined sexual orientation disparities in cancer-related risk behaviors among adolescents.Methods. We pooled data from the 2005 and 2007 Youth Risk Behavior Surveys. We classified youths with any same-sex orientation as sexual minority and the remainder as heterosexual. We compared the groups on risk behaviors and stratified by gender, age (< 15 years and > 14 years), and race/ethnicity.Results. Sexual minorities (7.6% of the sample) reported more risk behaviors than heterosexuals for all 12 behaviors (mean = 5.3 vs 3.8; P < .001) and for each risk behavior: odds ratios (ORs) ranged from 1.3 (95% confidence interval [CI] = 1.2, 1.4) to 4.0 (95% CI = 3.6, 4.7), except for a diet low in fruit and vegetables (OR = 0.7; 95% CI = 0.5, 0.8). We found sexual orientation disparities in analyses by gender, followed by age, and then race/ethnicity; they persisted in analyses by gender, age, and race/ethnicity, although findings were nuanced.Conclusions. Data on cancer risk, morbidity, and mortality by sexual orientation are needed to track the potential but unknown burden of cancer among sexual minorities.A 2011 Institute of Medicine report detailed the lack of national data to estimate cancer incidence and prevalence among lesbian, gay, bisexual, and transgender individuals,1 representing little progress since a 1999 report from the Institute on the health of lesbians that highlighted the absence of cancer data for that group.2 The persistent lack of national surveillance data on cancer among sexual minorities is a significant public health omission. Cancer remains the second most common cause of mortality in the United States, accounting for nearly 1 of every 4 deaths.3 Behaviors that increase the risk for cancer are elevated among sexual minorities, are likely to be apparent at young ages, and may become habitual over the life span by means of behavioral reinforcement and neurobiological reward circuits.