Lung Cancer in the LGBTQIA+ Community

Lung cancer is the leading cause of cancer death in the United States, responsible for one in five cancer deaths. However, some people have a higher risk of lung cancer than others.

Lung cancer risk in LGBTQIA+ people is higher than in straight people, and LGBTQIA+ people are more likely to be diagnosed at a later, less curable stage of lung cancer. However, several behaviors can reduce that risk.

LGBTQIA+ Lung Cancer Facts

Lung cancer is the second most common cancer, besides skin cancer, in the United States. Only prostate cancer in men and breast cancer in women occur more often. But lung cancer kills more people than colon, breast, and prostate cancers combined.

The American Cancer Society estimates more than 238,000 new cases of lung cancer and 127,000 deaths from lung cancer occur each year. Fortunately, lung cancer rates and deaths have been decreasing in recent years.

LGBTQIA+ people have a higher risk of lung cancer than straight people, research has found. The main reason for these lung cancer disparities is higher rates of smoking in LGBTQIA+ people. Also, LGBTQIA+ people are more likely to be eligible for lung cancer screening but less likely to get screenings.

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LGBTQIA+ Lung Cancer Risk Factors

The number one risk factor for lung cancer is smoking. About 8 or 9 out of every 10 deaths from lung cancer resulted from smoking, according to the Centers for Disease Control and Prevention (CDC). Other tobacco use, including cigars, pipes, and chewable tobacco, also increases the risk of lung cancer.

Secondhand smoke is another risk factor for lung cancer. Secondhand smoke is exposure to smoke from other people’s cigarettes, cigars, or pipes.

The second biggest risk factor for lung cancer is radon. Radon is a gas that occurs naturally in the environment, but you cannot see, taste, or smell it. If radon builds up inside a home or office, people can breathe in large amounts of it over time.

The CDC estimates that about 1 in 15 homes has high radon levels. Radon leads to about 21,000 deaths from lung cancer each year. More than one in 10 lung cancer deaths due to radon occurred in people who never smoked.

Other lung cancer risk factors include:

Smoking Among LGBTQIA+ People

Higher smoking rates among LGBTQIA+ people are a major reason for higher LGBTQIA+ lung cancer risk. Smoking is more common among LGBTQIA+ people largely due to stress from oppression, discrimination, and social stigma.

LGBTQIA+ people experience much more prejudice, bigotry, and discrimination than straight people. LGBTQIA+ people are also less likely to have a strong support network because of isolation or negative reactions to their identity. These experiences increase the risk of mental health issues and substance use in LGBTQIA+ individuals.

Smoking, drinking alcohol, and other substance use are unhealthy coping mechanisms for many people living with stress from homophobia and transphobia. An estimated 1 in 5 LGBTQIA+ adults smokes cigarettes, compared to 1 in 7 straight adults, according to the American Lung Association. Further, more than twice as many LGBTQIA+ youth smoke cigarettes than straight youth.

LGBTQIA+ people can also find it more difficult to quit smoking than straight people. They have less access to good health care, and they are more likely to have negative experiences with health care. LGBTQIA+ people may not seek help with quitting smoking because they fear disrespect or discrimination from health care providers.

Research has shown that LGBTQIA+ people are also less aware of the options for quitting smoking. For example, LGBTQIA+ people are less likely to call a smoking quitline than straight people, according to the CDC. They are also less likely than straight people to use counseling or medication to quit smoking.

Lower LGBTQIA+ Lung Cancer Screening Rates

LGBTQIA+ people also have a higher risk of being diagnosed with a later, less curable stage of lung cancer because they are less likely to get lung cancer screenings. A 2019 study found that LGBTQIA+ people eligible for lung cancer screening were three times less likely to get the screening. One likely reason for LGBTQIA+ disparities in lung cancer screenings is having less access to health care.

Barriers to health care for LGBTQIA+ people include:

  • Discrimination, social stigma, and poor treatment from medical staff.
  • Lack of knowledge among health care providers regarding how to treat LGBTQIA+ people effectively. In one study from 2017, only half of providers correctly answered questions about LGBTQIA+ health.
  • Less likely to have health insurance.
  • Lower employment rates, making it harder to get health insurance or pay for health care.
  • More likely to delay health care, often due to fear of discrimination and poor treatment. For example, a national survey in 2020 found that 15% of LGBTQIA+ people postponed or avoided medical treatment because they feared mistreatment.

Screening for Lung Cancer

A screening test is a way to look for cancer before a person shows symptoms. Screening for lung cancer can help find lung cancer in its early stages. Finding cancer sooner can lead to earlier treatment, which increases a person’s chances of surviving.

The U.S. Preventive Services Task Force and American Cancer Society recommend lung cancer screening for people who meet these criteria:

  • Between 50 and 80 years old.
  • Currently smoking or quit smoking within the past 15 years.
  • Have at least a “20 pack-year” history of smoking. One pack-year is smoking one pack of cigarettes per day for a year. Having 20-pack years could mean one pack a day for 20 years or two packs a day for 10 years.

The most effective lung cancer screening is a scan called low-dose computed tomography (LDCT). LDCT lowers the risk of dying from lung cancer in people who smoke or previously smoked. It involves using a low dose of radiation to take images of inside the body in a spiral pattern.

The main risk of lung cancer screening is a false positive result. This means the screening suggests you might have cancer when you actually don’t. A false positive can lead to unnecessary or invasive procedures, such as a biopsy.

Reducing LGBTQIA+ Lung Cancer Risk and Improving Lung Cancer Survival

The number one way LGBTQIA+ people can reduce their risk of lung cancer is not to smoke or to quit smoking. For those who have smoked, making sure that every body has accessed and knowledge of LDCT, can save lives.

Pennsylvania residents can also get help quitting by signing up for the state’s PA Quit program. Another option for Pennsylvania LGTBQIA+ residents is the Bradbury-Sullivan LGBT Community Center’s LGBTQ+ Tobacco-Free program.

They can also reduce risk by:

  • Avoiding all products with tobacco, including vaping.
  • Avoiding chemicals that increase lung cancer risk.
  • Avoiding secondhand smoke.
  • Checking their home and workplace for radon exposure.
  • Eating a healthy diet full of fruits, vegetables, whole grains, and lean proteins.
  • Exercising regularly.

About UPMC Hillman Cancer Center

When you are facing cancer, you need the best care possible. UPMC Hillman Cancer Center provides world-class cancer care, from diagnosis to treatment, to help you in your cancer battle. We are the only comprehensive cancer center in our region, as designated by the National Cancer Institute. We have more than 70 locations throughout Pennsylvania, Ohio, and New York, with more than 200 oncologists – making it easier for you to find world-class care close to home. Our internationally renowned research team is striving to find new advances in prevention, detection, and treatment. Most of all, we are here for you. Our patient-first approach aims to provide you and your loved ones the care and support you need. To find a provider near you, visit our website.