0
No votes yet

Risk Factors for Ovarian Cancer: Lesbian and Heterosexual Women

Suzanne L. Dibble
Stephanie A. Roberts
Patricia A. Robertson
Steven M. Paul
ONF 2002, 29(1), E1-E7 DOI: 10.1188/02.ONF.E1-E7

Purpose/Objectives: To compare the distribution of risk factors for developing ovarian cancer in lesbian and heterosexual women.

Design: Secondary analysis of a retrospective medical record review.

Setting: Urban health clinic with special outreach to lesbians.

Sample: Typical participant (N = 1,019) was 42.9 years old and white (70%). Most were without health insurance, and 99% were poor (< $15,780 annual income). The majority (58%, n = 586) described themselves as heterosexual; 42% (n = 433) said they were lesbian.

Methods: Data were collected from medical records and analyzed using analysis of covariance and logistic regression techniques.

Main Research Variables: Ovarian cancer risk factors (parity, exogenous hormone use, smoking, body mass index [BMI], and tubal ligation/hysterectomy).

Findings: Lesbians had a higher BMI; heterosexual women had higher rates of current smoking and a higher incidence of the protective factors of pregnancy, children, miscarriages, abortions, and use of birth control pills.

Conclusions: The results of this study indicate that lesbians may have an increased risk for developing ovarian cancer. A study designed specifically to explore the risk factors of lesbian and heterosexual women for developing ovarian cancer must be undertaken to confirm these findings.

Implications for Nursing Practice: Differences in risk levels may exist for lesbians; therefore, healthcare providers must become comfortable asking questions about sexual orientation and behavior.

References 

American Cancer Society, California Division, & Public Health Institute, California Cancer Registry. (1999). <i>California: Cancer facts and figures</i>, <i>1999</i>. Oakland, CA: American Cancer Society.

American Lung Association, Epidemiology and Statistics Unit. (1999). <i>Trends in cigarette smoking.</i> Atlanta: Author.

Bachu, A. (1995). Fertility of American women. <i>U.S. Bureau of Census, current population reports</i> (Report No. 20-482). Washington DC: U.S. Government Printing Office.

Bailey, J.M., Pillard, R.C., Neale, M.C., & Agyci, Y. (1993). Heritable factors influence sexual orientation in women. <i>Archives of General Psychiatry</i>, <i>50</i>, 217-233.

Becker, B.L., & Robison, J. (1996). <i>Synopsis: Houston area health care needs assessment for lesbian, gay, bisexual, and transgender women.</i> Presented at the National Lesbian/Gay Health Association Conference, July 1996, Seattle, WA.

Berchuck, A., Carney, M.E., & Futreal, P.A. (1999). Genetic susceptibility testing and prophylactic oophorectomy. <i>European Journal of Obstetrics, Gynecology, and Reproductive Biology</i>, <i>82</i>, 159-164.

Bradford, J., Ryan, C., & Rothblum, E.D. (1994). National lesbian health care survey: Implication for mental health care. <i>Journal of Consulting Clinical Psychology</i>, <i>62</i>, 228-242.

Cochran, S.D., & Mays, V.M. (2000). Relation between psychiatric syndromes and behaviorally defined sexual orientation in a sample of the U.S. population. <i>American Journal of Epidemiology</i>, <i>151</i>, 516-523.

Denenberg, R. (1995). Report on lesbian health. <i>Women's Health International</i>, <i>5</i>(2), 81-91.

Eliason, M., Donelan, C., & Randal, C. (1992). Lesbian stereotypes. <i>Health Care for Women International</i>, <i>13</i>, 131-144.

Engeland, A., Andersen, A., Haldorsen, T., & Tretli, S. (1996). Smoking habits and risk of cancers other than lung cancer; 28 years' follow-up of 26,000 Norwegian men and women. <i>Cancer Causes and Control</i>, <i>7</i>, 497-506.

Greenlee, R.T., Hill-Harmon, M.B., Murray T., & Thun, M. (2001). Cancer statistics, 2001. <i>CA: A Cancer Journal for Clinicians</i>, <i>51</i>, 15-36.

Hankinson, S.E, Colditz, G.A, Hunter, D.J., Willett, W.C., Stampfer, M.J., Rosner, B., Hannekens, C.H., & Speizer, F.E. (1995). A prospective study of reproductive factors and risk of epithelial ovarian cancer. <i>Cancer</i>, <i>76</i>, 284-290.

Harlow, B.L., Cramer, D.W., Baron, J.A., Titus-Ernstoff, L., & Greenberg, E.R. (1998). Psychotropic medication use and risk of epithelial ovarian cancer. <i>Cancer Epidemiology, Biomarkers, and Prevention</i>, <i>7</i>, 697-702.

Harrison, A.E., & Silenzio, V.M. (1996). Comprehensive care of lesbian and gay patients and families. <i>Primary Care</i>, <i>23</i>, 31-46.

Herzog, D.B., Newman, K.L., Yeh, C.J., & Warshaw, M. (1992). Body image satisfaction in homosexual and heterosexual women. <i>International Journal of Eating Disorders</i>, <i>11</i>, 391-396.

Johnson, S.R., Smith, E.M., & Guenther, S.M. (1987). Comparison of gynecologic healthcare problems between lesbians and bisexual women: A survey of 2,345 women. <i>Journal of Reproductive Medicine</i>, <i>32</i>, 805-811.

Kuczmarski, R.J. (1992). Prevalence of overweight and weight gain in the United States. <i>American Journal of Clinical Nutrition</i>, <i>55</i>(Suppl. 2), 495S-502S.

Laumann, E.O., Gagnon, J.H., Michael, R.T., & Michaels, S. (1994). <i>The social organization of sexuality: Sexual practices in the United States.</i> Chicago: University of Chicago Press.

Micozzi, M.S., & Harris, T.M. (1990). Age variations in the relation of body mass indices to estimates of body fat and muscle mass. <i>American Journal of Physical Anthropology</i>, <i>81</i>, 375-379.

National Cancer Institute. (2001). <i>Surveillance, epidemiology, and end results: CanQues.</i> Bethesda, MD: Author. Retrieved November 30, 2001 from the World Wide Web: <a target="_blank" href='http://canques.seer.cancer.gov'>http://canques.seer.cancer.gov</a>

National Heart, Blood, and Lung Institute. (2000). <i>Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults</i> (NIH Publication #98-4083). Washington, DC: Author.

O'Hanlan, K.A. (1995). Lesbian health and homophobia: Perspectives for the treating obstetrician/gynecologist. <i>Current Problems in Obstetrics, Gynecology, and Fertility</i>, <i>18</i>(4), 96-133.

Patton, C.L., Millard, P.S., Kessenich, C.R., Storn, D., Kinnicutt, E., & Rosen, C.J. (1998). Screening calcaneal ultrasound and risk factors for osteoporosis among lesbians and heterosexual women. <i>Journal of Women's Health</i>, <i>7</i>, 909-915.

Purdie, D., Green, A., Bain, C., Siskind, V., Ward, B., Hacker, N., Quinn, M., Wright, G., Russell, P., & Susil, B. (1995). Reproductive and other factors and risk of epithelial ovarian cancer: An Australian case-control study. <i>International Journal of Cancer</i>, <i>62</i>, 678-684.

Rankow, E.J. (1995). Breast and cervical cancer among lesbians. <i>Women's Health International</i>, <i>5</i>, 123-129.

Riman, T., Persson, I., & Nilsson, S. (1998). Hormonal aspects of epithelial ovarian cancer: Review of epidemiological evidence. <i>Clinical Endocrinology</i>, <i>49</i>, 695-707.

Roberts, S.A., Dibble, S.L., Scanlon, J., Paul, S., & Davids, H.R. (1998). Differences in risk factors for breast cancer: Lesbians and heterosexual women. <i>Journal of the Gay and Lesbian Medical Association</i>, <i>2</i>, 93-101.

Skinner, W.F., & Otis, M.D. (1996). Drug and alcohol use among lesbian and gay people in a southern U.S. sample: Epidemiological, comparative, and methodological findings from the Trilogy Project. <i>Journal of Homosexuality</i>, <i>30</i>(3), 59-91.

Solarz, A.L. (Ed.). (1999). <i>Lesbian health: Current assessment and directions for the future.</i> Washington DC: National Academy Press.

U.S. Federal Register. (1997). <i>Annual update of the Department of Health and Human Services poverty guidelines</i>, <i>62</i>, 10856-10859.

Westhoff, C. (1996). Ovarian cancer. <i>Annual Review of Public Health</i>, <i>17</i>, 85-96.

White, J., & Levinson, W. (1995). Lesbian health care: What a primary care physician needs to know. <i>Western Journal of Medicine</i>, <i>162</i>, 463-466.

Whittemore, A.S. (1994). Characteristics relating to ovarian cancer risk: Implications for prevention and detection. <i>Gynecologic Oncology</i>, <i>55</i>(Suppl. 3, Pt 2), S15-S19.

Wong, C., Hempling, R.E., Piver, M.S., Natarajan, N., & Mettlin, C.J. (1996). Perineal talc exposure and subsequent epithelial ovarian cancer: A case-control study. <i>Obstetrics and Gynecology</i>, <i>93</i>, 372-376.