PO.CL09.04 · 临床研究
LGBTQ+癌症患者中的烟草、尼古丁、大麻和酒精使用：一家NCI指定综合癌症中心的真实世界分析
Tobacco, nicotine, cannabis, and alcohol use among LGBTQ+ patients with cancer: Real-world analysis at an NCI-Designated Comprehensive Cancer Center
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摘要 Abstract
中文摘要
背景：既往研究已描述了在患有癌症的性与性别少数（SGM）个体中升高的物质使用模式，如烟草和酒精使用。然而，这些发现局限于特定癌症和研究设计（例如基于人群的调查）。真实世界数据可以揭示SGM癌症患者物质使用行为的重要洞见，以满足患者需求并提供量身定制的癌症护理。在本研究中，我们对物质使用（烟草、尼古丁、大麻和酒精）与SGM状态之间的关联进行了真实世界分析。
方法：本研究纳入了110,072例在Moffitt癌症中心（佛罗里达州坦帕）初次就诊时完成标准治疗电子患者问卷（EPQ）的癌症患者。EPQ采集患者报告的人口学信息（包括性取向和性别认同[SOGI]）、病史、家族癌症史、生活方式因素、补充和替代医学的使用以及生活质量。使用SOGI条目识别SGM和非SGM患者。结局变量包括（1）既往和当前的烟草和尼古丁产品使用，（2）近期酒精使用，以及（3）近期物质和非医学指征处方药物使用。采用Pearson卡方检验；以p<0.05确定显著性。
结果：约3.1%的人群自我认定为SGM。与非SGM患者相比，SGM报告了更高的当前吸烟率（14.8% vs 10.7%；p<.001）、醒后即吸第一支烟（5分钟内：5.6% vs 4.7%；6-30分钟：13.1 vs 10.8%，p<.001）、当前烟斗吸食（0.2% vs 0.1%，p<.001）、当前和既往电子烟使用（分别为4.0% vs 1.7%和9.6% vs 4.3%，p<.001）、过去一年饮酒（p<.001）、饮酒日饮酒杯数更多（p<.001）以及过去3个月大麻使用（4.7% vs 2.1%）连同镇静剂和兴奋剂使用（p<.001）。然而，SGM报告了更低的既往烟斗使用（2.0%和2.8%，p<.001）、既往和当前雪茄（p<.01）、既往和当前无烟烟草（p<.001）以及每月超过9天饮酒（p<.01）。
讨论：这些数据表明，与非SGM癌症患者相比，SGM癌症患者呈现出更高的烟草、尼古丁、大麻和酒精使用。这些结果通过阐明异质性癌症类型中SGM癌症患者的物质使用模式，补充了现有文献。有必要进一步研究SGM患者亚组中的物质使用模式以及系统性评估和早期干预的潜在需求。
查看英文原文 English abstract
Background: Prior studies have described patterns of substance use, such as tobacco and alcohol use, that are elevated among sexual and gender minority (SGM) individuals with cancer. However, the findings have been limited to specific cancers and study designs (e.g., population-based survey). Real-world data can reveal important insights into the substance use behaviors among SGM cancer patients to meet the patients' needs and provide tailored cancer care. In this study, we conducted a real-world analysis on the association between substance use (tobacco, nicotine, cannabis, and alcohol) by SGM status.
Methods: This study included 110,072 cancer patients who completed a standard-of-care electronic patient questionnaire (EPQ) during their initial visit at the Moffitt Cancer Center (Tampa, FL). The EPQ captures patient-reported information on demographics (including sexual orientation and gender identity [SOGI]), medical history, family cancer history, lifestyle factors, use of complementary and alternative medicine, and quality of life. SGM and non-SGM patients were identified using the SOGI items. The outcome variables included (1) past and current tobacco and nicotine product use, (2) recent alcohol use, and (3) recent substance and non-medically indicated prescription medication use. Pearson's Chi-Square test was utilized; significance was determined by p <0.05.
Results: Approximately 3.1% of the population self-identified as an SGM. Compared to non-SGM patients, SGMs reported higher rates of current cigarette smoking (14.8% vs 10.7%; p <.001), smoking their first cigarette after waking up (within 5 minutes: 5.6% vs 4.7%; 6-30 minutes: 13.1 vs. 10.8%, p <.001), current pipe smoking (0.2% vs 0.1%, p <.001), current and former electronic cigarette use (4.0% vs 1.7% and 9.6% vs 4.3%, respectively, p <.001), alcohol use in the past year ( p <.001), more number of drinks on the days of alcohol use ( p <.001), and past 3-months cannabis use (4.7% vs 2.1%) along with sedatives and stimulants use ( p <.001). However, SGM reported lower use of ever pipe (2.0% and 2.8%, p <.001), ever and current cigar ( p <.01), ever and current smokeless tobacco ( p <.001), and alcohol more than 9 days per month ( p <.01).
Discussion: These data suggest that SGM cancer patients, compared to non-SGM cancer patients, present with higher use of tobacco, nicotine, cannabis, and alcohol. These results add to the existing literature by elucidating patterns of substance use among SGM cancer patients with heterogeneous cancer types. Further research is warranted on the patterns of substance use among subgroups of SGM patients and the potential need for systematic assessment and early intervention.
利益披露 Disclosure
M. Yang, None..
S. A. Zamani, None..
M. B. Schabath, None.