Abstract C110: Sexual health concerns and confidence among sexual minority cancer survivors: Gender differences in a national survivorship survey

Abstract

Sexual health outcomes among LGBTQ+ cancer survivors remain understudied. This study investigated whether LGBTQ+ identification is associated with sexual concerns during or after cancer treatment and whether there are differences by gender. Data came from the 2025 Cancer Nation State of Survivorship Survey, a weighted, cross-sectional survey of adult U.S. cancer survivors recruited via non-probability online panels and quota sampling (N=1,959; mean age 58.9 years; 61% women; 78% White, 10% Black, 8% Hispanic, 5% other/multiracial; household income 30% <$50,000, 34% ≥$100,000; breast cancer [23%], multiple cancers [24%], genitourinary [17%]). LGBTQ+ respondents (n=133) were compared with non-LGBTQ+ respondents (n=1,826). Analyses were stratified by gender. The primary outcome was self-reported sexual concerns (e.g., intimacy issues, loss of desire, painful intercourse, vaginal dryness, erectile dysfunction) during or after treatment. Weighted logistic regression was adjusted for race/ethnicity, age at diagnosis, time since diagnosis, and cancer type, plus household income in the overall model. A secondary outcome assessed confidence regarding the sexual health effect of treatment among survivors who had completed treatment, dichotomized as confident vs. not. A sensitivity analysis further restricted the LGBTQ+ group to cisgender gay/lesbian respondents (n=51). Generative AI (Claude, Anthropic) was used to check statistical code and cross-check computed values. LGBTQ+ survivors had higher adjusted odds of sexual concerns than non-LGBTQ+ survivors (42% vs. 31%; adjusted OR=1.69, 95% CI 1.13–2.53, p=0.011), driven by differences among men. LGBTQ+ men had nearly three-fold higher odds than non-LGBTQ+ men (47% vs. 32%; OR=2.94, 95% CI 1.55–5.57, p=0.001). There was no difference among women (36% vs. 31%; OR=0.93, 95% CI 0.54–1.58, p=0.78). Restricting the analysis to cisgender gay men increased the odds (OR=3.51, 95% CI 1.56–7.89, p=0.002), confirming robustness. Household income ≥$100,000 was independently associated with higher odds of sexual concerns (OR=1.41, 95% CI 1.11–1.81, p=0.006). Findings were robust to adjustment for treatment type (OR=1.68). No differences were observed for confidence understanding treatment's sexual health impact (all p>0.35). Sexual minority men, but not women, cancer survivors had significantly greater odds of sexual concerns during or after cancer treatment, independent of demographic, clinical, and socioeconomic factors. These findings identify an underrecognized disparity and support tailored sexual health assessment for sexual minority male cancer survivors. Findings should be interpreted in light of the non-probability sampling design. Cancer Nation (formerly National Coalition for Cancer Survivorship) is the author of the State of Survivorship data set. Generative AI (Claude, Anthropic) was used for grammar and language editing of this abstract text; all analyses, interpretations, and conclusions are those of the authors. Cristobal Calvillo, Jaimi Allen, S. Alexandra. Marshall, Mark L. Williams, Benjamin C. Amick III. Sexual health concerns and confidence among sexual minority cancer survivors: Gender differences in a national survivorship survey [abstract]. In: Proceedings of the 19th AACR Conference on the Science of Cancer Health Disparities; 2026 Oct 18-21; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2026;35(10 Suppl):Abstract nr C110.