Abstract:
Sexual minorities (SM) have higher chronic physiologic stress as indicated by allostatic load (AL), which may be explained in part by consistent experiences of discriminatory practices. This is one of the first studies to examine the joint effects of SM status and AL on the association with long-term risk for cancer death. Retrospective analyses were conducted on 12,470 participants using National Health and Nutrition Examination Survey (NHANES) from years 2001 through 2010 linked with the National Death Index through December 31, 2019. Cox proportional hazards models estimated adjusted hazard ratios (aHRs) of cancer deaths between groups of SM (those reporting as gay, lesbian, bisexual, or having same-sex sexual partners) status and AL. SM adults living with high AL (n = 326) had a 2-fold increased risk of cancer death (aHR: 2.55, 95% CI: 1.40-4.65) when compared to straight/heterosexual adults living with low AL (n = 6674). Among those living with high AL, SM (n = 326) had a 2-fold increased risk of cancer death (aHR: 2.26, 95% CI: 1.33-3.84) when compared to straight/heterosexual adults with high AL (n = 4957). SM with high AL have an increased risk of cancer mortality. These findings highlight important implications for promoting a focused agenda on cancer prevention with strategies that reduce chronic stress for SM adults.
摘要:
性少数(SM)具有较高的慢性生理应激,如同种异体负荷(AL)所示,这可以部分解释为歧视性做法的一贯经验。这是首批研究SM状态和AL对癌症死亡长期风险的联合影响的研究之一。使用2001年至2010年的国家健康和营养检查调查(NHANES)对12,470名参与者进行了回顾性分析,该调查与2019年12月31日的国家死亡指数相关。Cox比例风险模型估计SM组之间癌症死亡的调整风险比(aHRs)(那些报告为同性恋,拉拉,双性恋,或有同性性伴侣)身份和AL。与低AL的直性/异性恋成年人(n=6674)相比,高AL的SM成年人(n=326)的癌症死亡风险增加了2倍(aHR:2.55,95%CI:1.40-4.65)。在那些生活在高AL中的人中,与高AL的直性/异性恋成年人(n=4957)相比,SM(n=326)的癌症死亡风险增加了2倍(aHR:2.26,95%CI:1.33-3.84)。具有高AL的SM具有增加的癌症死亡风险。这些发现强调了对促进癌症预防的重点议程以及减少SM成人慢性压力的策略的重要意义。