5 Things the LGBTQ+ Community Needs to Know About Cancer Prevention, Finding the Right Doctor, and Overcoming Shame

LGBTQ+ Community Face Increased Cancer Risk, Prioritize Your Health

• Members of the LGBTQ+ community face elevated cancer risks, according to a new study by the American Cancer Society in the realm of increased smoking, alcohol consumption, and obesity.
• The LGBTQ+ community faces added societal stressors, including lack of acceptance and discrimination, which may contribute to increasing smoking, drinking, and obesity, all of which are known cancer risk factors.
• LGBTQ+ patients may face added stigma even from healthcare providers who lack adequate training on how to address health risks specific to this group, including addressing health screenings for men, women, and transgender people.
• The human papillomavirus (HPV) is a group of more than 200 related viruses, some of which are spread through vaginal, anal, or oral sex. Gay and bisexual men are at increased risk for anal cancer. The HPV vaccine Gardasil is recommended to reduce health risks.
• LGBTQ+ patients are encouraged to be their biggest healthcare advocates. If your current doctor does not feel trustworthy to your needs, find another to ensure you receive the best care and screenings possible.

The lived experience for people who identify as LGBTQ+ (lesbian, gay, bisexual, transgender, queer) can be a stressful experience. While some days can be marginally pleasant, others can be volatile depending on various factors such as gender, racial ethnicity, geographic location, religion, culture, socioeconomic status, and more. However, among this group, the cancer risk is elevated according to a new study published in the medical journal “Cancer” by the American Cancer Society. The researchers behind the study say that members of the LGBTQ+ community “experience discrimination and minority stress that may lead to elevated cancer risk.”

The study also concluded that LGBTQ+ individuals are “more likely to smoke cigarettes,” which is a known cancer risk factor. It also says obesity and heavier alcohol consumption compared to people who identify as heterosexual are more prevalent. Obesity and excessive alcohol are also cancer risk factors. SurvivorNet sat down with a colorectal surgeon at Cedars-Sinai Medical Center , Dr. Zuri Murrell , to address several key items members of the LGBTQ+ community need to know about cancer prevention and how to cope with stigma while seeking care.

Reduce Smoking and Drinking

As the American Cancer Society’s study addressed, the LGBTQ+ community can face immense societal stress that impacts their health. Dr. Murrell furthers the point made by researchers on the stressors felt by this group, which makes up 7.6% of U.S. adults according to polling from Gallup. “I do think in this particular community, there are a lot of stressors that are found because of acceptance, which can impact their healthcare choices and treatment,” Dr. Murrell tells SurvivorNet. “It’s not that being part of that community causes you to innately want to drink or smoke, but it’s how you’re treated in this society. So that’s something that is very important and why we kind of have to consider all these things,” Dr. Murrell continued. The Centers for Disease Control and Prevention (CDC) says cigarette smoking is linked to about 80 to 90 percent of lung cancer deaths, and people who smoke cigarettes are 15 to 30 times more likely to get lung cancer or die from lung cancer than people who don’t smoke. Additionally, second-hand smoke can cause lung cancer. WATCH: Does smoking marijuana pose health risks? While an occasional alcoholic beverage may be harmless, excessive drinking can damage the liver, an organ vital for regulating blood chemistry. Drinking heavily regularly is considered one of the most significant risk factors for liver cancer. “The effects of alcohol, along with the effects of metabolic diseases like obesity and diabetes, is definitely the driving factor for liver cancer in the United States,” notes Dr. Ariel Jaffe , a board-certified internist, gastroenterologist, and hepatologist and assistant professor at the Yale School of Medicine.

Get the HPV Vaccine as Gay & Bisexual Men Are More at Risk for Anal Cancer

The human papillomavirus (HPV), the National Cancer Institute says , is "a group of more than 200 related viruses, some of which are spread through vaginal, anal, or oral sex." Dr. Murrell points to HPV as a notable cancer risk factor, particularly among gay and bisexual men. “Anal cancer is higher in the gay male and bisexual male population, especially among men who are HIV positive and are anal receptive,” Dr. Murrell said. Anal cancer is a rare tumor that's most often linked to human papillomavirus (HPV), according to the National Institutes of Health. “The biggest thing to do, and hopefully this will be a thing of the past, is making sure everybody gets the Gardasil shot,” Dr. Murrell advises. WATCH: Debunking the myths about HPV. The HPV vaccine is recommended to protect against HPV and HPV-related cancers. Gardasil 9 is an HPV vaccine that offers protection against “nine HPV types: the two low-risk HPV types that cause most genital warts, plus seven high-risk HPV types that cause most HPV-related cancer,” according to the National Cancer Institute. The vaccine creates an immune response to HPV 16, the primary cause of 92% of head and neck cancers. Once children are vaccinated, they cannot be infected with that strain. For parents, the HPV vaccine enables them to protect their children from developing cancer in the future. According to the CDC, the HPV vaccine is recommended for all male and female preteens 11 to 12 years old, and it is given in two doses between six and 12 months. WATCH: The HPV Vaccine Is Completely Safe The series of shots can also start as young as 9. The CDC also notes that teens and young adults through age 26 who didn’t start or finish the HPV vaccine series also need the vaccine. Additionally, people with weakened immune systems or teens and young adults who started the series between 15 and 26 should get three doses instead of two. Although adults up to age 45 can still receive the vaccine, it’s not recommended for everyone older than 26. Still, a person older than 26 could choose to get vaccinated after talking to their doctor about possible benefits, despite it being less effective in this age range, as more people have already been exposed to HPV by this point. RELATED: Gay Men Get More Skin Cancer– The Perils of Tanning Bed Culture

Find a Doctor You Trust and Can Speak Openly About Your Healthcare

Although the healthcare profession should be free of bias and discrimination, the reality is that is not always the case. Some within the LGBTQ+ community are reluctant to seek care when they need it out of fear their doctor will shun them. Dr. Murrell believes healthcare providers must better understand the LGBTQ+ community. He notes that with more education, LGBTQ+ patients can grow to trust their doctors more. “[Trust] is something that influences healthcare choices,” Dr. Murrell said. “It’s like, I’m going to have to go through this explanation again. I’m going to have to see somebody’s face, and they may give me a look. It almost becomes chicken, and the egg, in terms of doctors, can be like, ‘You guys don’t get checked out.’ Well, it’s like I’m not getting checked because of how you make me feel,” Dr. Murrell explained. Dr. Murrell says many physicians are trained on heterosexual white males. He says training becomes less stringent among communities of color and even less for marginalized groups like the LGBTQ+ community. “I don’t fault the patients…I fault us as physicians” when limited trust exists between LGBTQ+ patients and the medical community. Limited trust may be even more apparent among the transgender community. The American Cancer Society’s study notes that transgender people are less likely to be screened for cervical, colorectal, and prostate cancer. Dr. Murrell believes a contributing factor could be doctors not believing a transgender man does not need all the cancer and regular health screenings a biological woman would and vice-versa. He says prompting patients with appropriate screenings and asking the right questions can improve screening rates among the transgender community. “If you don’t feel like you can trust your doctor, you need to find another one,” Dr. Murrell advises. RELATED: 5 Things to Do if You Have Trust Issues with Your Oncologist; Building Trust with Care Providers

Be Your Biggest Advocate

Piggybacking on the value of the doctor-patient relationship being built on trust and mutual respect, Dr. Murrell believes that if doctors are not as accepting, educated, or understanding of LGBTQ+ patient issues, it’s incumbent on the patient to lead the way. WATCH: Be Pushy, Be Your Own Advocate, Don’t Settle “Be your own healthcare advocate. What does that mean? It means finding a doctor who you trust, and he or she trusts you, and you’re working on a plan together,” Dr. Murrell advises. You know your body better than anyone else. When you see a doctor for a problem, don't hesitate to ensure that your question is fully answered and that you are comfortable with the plan moving forward.

Stay Current With Your Screenings

Staying on top of your cancer and health screenings is helpful advice for any community, especially one that may be at an elevated risk for cancer. “I could be broad with it: no smoking, decrease your drinking, make sure you get all your screening tests, etc.,” Dr. Murrell advised. Notable cancer screenings among biological women include annual mammograms that screen for breast cancer. The U.S. Preventive Services Task Force recommends women begin screening for breast cancer at age 40. Among biological men, prostate cancer screening, according to the American Cancer Society, should begin at age 50 for men at average risk. Men at high risk or have a close relative diagnosed with prostate cancer should consider annual screenings in their 30s.