PO.PS01.09 · 人群科学
COVID-19对寻求乳腺癌筛查和治疗的性少数女性的影响：OUT全国癌症调查数据分析
The impact of COVID-19 on sexual minority women seeking breast cancer screenings and treatment: An analysis of the OUT national cancer survey data
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摘要 Abstract
中文摘要
乳腺癌是美国乃至全球最常被诊断的女性癌症。通过筛查早期检出乳腺癌已被充分证实可降低死亡率。尽管获益显著，与性多数女性（即异性恋女性）相比，性少数女性（如女同性恋者和双性恋女性）接受乳腺癌筛查的可能性显著更低，一生中接受乳腺X线摄影筛查的患病率更低，且接受及时筛查的比例更低。筛查利用率低的一些原因包括对医疗照护的负面看法、感知严重性较低、缺乏医疗保险、照护费用，以及对医疗提供者中异性恋主义和恐同的感知。性少数女性乳腺癌筛查的犹豫因文化特异性风险因素而加剧，这些因素使许多性少数女性面临更高的乳腺癌风险。已识别的、性少数女性更易暴露的风险因素包括：烟草使用和吸烟、较高的饮酒量、药物使用、肥胖、体力活动水平低、较不可能接受常规预防性筛查、较不可能拥有保险覆盖、对医疗互动满意度较低、心理困扰发生率较高（可能因恐惧恐同和偏见所致），以及未生育或不生育后代。即使在暂时转向与医疗从业者进行远程医疗（在线、虚拟）预约期间，COVID-19时期的犹豫和延误仍有所增加。本研究利用National LGBT Cancer Network的OUT全国癌症调查数据，分析了面临乳腺癌诊断的性少数女性的经历。该数据集是首个针对LGBTQ+人群癌症诊断的大型全国性样本。调查项目包括人口学信息、关于癌症治疗和社会支持的行为问题，以及寻求照护的结构性和社会心理障碍或促进因素。共有2,700名受访者完成了National LGBT Cancer Network调查。在这2,700名受访者中，503人曾被诊断为乳腺癌。本研究的样本包括这503名受访者中的490名（出生时为）女性，其中359人为女同性恋或男同性恋，62人为双性恋。研究结果凸显了在社会隔离、乐观与悲观程度、医生或医疗诊所是否延误癌症筛查、远程医疗的经历和满意度，以及COVID-19的其他影响等方面的经历。
查看英文原文 English abstract
Breast cancer is the most frequently diagnosed female cancer in the U.S. and now globally. Early detection of breast cancer through screening is well established to reduce mortality. Despite the substantial benefits, sexual minority women (e.g., lesbians and bisexual women) are significantly less likely to access breast cancer screenings, have lower lifetime prevalence of screening mammography, and undergo less timely screening as compared to sexual majority women (i.e., heterosexual women). Some reasons for the low utilization of screenings include negative beliefs about care, lower perceived severity, lack of health insurance, costs of care, and perceptions of heterosexism and homophobia among providers. Hesitancy in breast cancer screenings for sexual minority women is compounded by culturally-specific risk factors that place many sexual minority women at higher risk for breast cancer. Risk factors identified as those sexual minority women are more subject to include: tobacco use and smoking, higher alcohol consumption, drug use, obesity, low levels of physical activity, less likely to undergo routine preventive screenings, less likely to have insurance coverage, less satisfaction with medical interactions, higher rates of psychological distress (likely due to the fear of homophobia and bias), and nulliparity or not bearing offspring. Hesitancy and delays were increased during the COVID-19 era even with the temporary transition to telehealth (online, virtual) appointments with healthcare practioners. Using data from the National LGBT Cancer Network's OUT National Cancer Survey, this study analyzes the experiences of sexual minority women who faced breast cancer diagnoses. This dataset is the first large, nationwide sample to target LGBTQ+ populations regarding their cancer diagnoses. Survey items included demographics, behavioral questions about cancer treatment and social support, and structural and psychosocial barriers to or facilitators of seeking care. A total of 2,700 respondents completed the National LGBT Cancer Network survey. Of those 2,700 respondents, 503 had had breast cancer diagnoses. The sample for this study included the 490 females (since birth), 359 were lesbian or gay and 62 were bisexual, of those 503 respondents. Findings highlight experiences with social isolation, levels of optimism versus pessimism, whether doctors or medical clinics delayed cancer screenings, experiences and satisfaction with telemedicine, and other impacts of COVID-19.
利益披露 Disclosure
K. Tredway, None..
M. S. Camp, None..
V. Stearns, None.