Exploring the Relationship between Self-Rated Health and Unmet Cancer Needs among Sexual and Gender Minority Adolescents and Young Adults with Cancer

Author:

Francis-Levin Nina1,Ghazal Lauren V.2ORCID,Francis-Levin Jess3,Zebrack Bradley4ORCID,Chen Meiyan4,Zhang Anao4ORCID

Affiliation:

1. Division of Endocrinology, Metabolism & Diabetes, Michigan Medicine, University of Michigan, Ann Arbor, MI 48109, USA

2. School of Nursing, University of Rochester, Rochester, NY 14642, USA

3. Institute for Social Research, University of Michigan, Ann Arbor, MI 48104, USA

4. School of Social Work, University of Michigan, Ann Arbor, MI 48109, USA

Abstract

This study evaluates the unmet needs of sexual and gender minority (SGM) adolescent and young adult (AYA) cancer survivors by comparing SGM AYA self-rated health (SRH) scores to their non-SGM (i.e., cisgender/heterosexual) counterparts. The Cancer Needs Questionnaire—Young People (CNQ-YP) and self-rated health measures were used to assess unmet needs in AYAs aged 15–39 who had been diagnosed with cancer in the previous ten years (n = 342). Participants were recruited from a National Cancer Institute (NCI) Comprehensive Cancer Center registry using the modified Dillman’s method. Self-reported sexual orientation and gender identity (SO/GI) data were collected. Independent t-tests were used to test between-group differences in unmet needs and Pearson’s chi-square test was used to determine the difference in SRH scores between SGM and non-SGM AYA cancer survivors. SGM AYA cancer survivors reported greater mean needs than their non-SGM counterparts across all six domains and reported significantly greater needs in the domains of Feelings and Relationships, t(314) = −2.111, p = 0.036, Information and Activities, t(314) = −2.594, p = 0.009, and Education, t(207) = −3.289, p < 0.001. SGM versus non-SGM SRH scores were significantly different, indicating that a higher percentage of SGM AYAs reported poor/fair health compared to those who were non-SGM. Unmet life and activities needs were negatively associated with AYA cancer survivors’ SRH, whereas unmet work needs were positively associated with AYA cancer survivors’ SRH. An AYA’s gender identity (SGM versus non-SGM) was not a moderator. SGM AYAs are an understudied group within an already vulnerable patient population. Unmet psychosocial needs related to one’s feelings and relationships, and information and activity needs merit further research to develop tailored interventions that reflect the experiences of SGM AYAs.

Funder

National Cancer Institute

National Institutes of Health

University of Michigan Vivian A. and James L. Curtis School of Social Work Center for Health Equity Research and Training, Signature Programs Initiatives

Publisher

MDPI AG

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