Abstract 4911: Cancer disparities based on seven years of sexual orientation and gender identity collection at an NCI-Designated Comprehensive Cancer Center

Abstract Background: Sexual and gender minority (SGM) populations are underserved and minoritized. To aid in identifying real world cancer disparities among SGM patients, in 2016 our institution began collecting sexual orientation and gender identity (SOGI) on all patients. Leveraging these valuable data, this study analyzed differences between SGM and non-SGM cancer patients for clinical characteristics and quality-of-life (QoL). Methods: Data were acquired on >118, 000 patients who completed the standard-of-care Electronic Patient Questionnaire which collects self-reported SOGI. Patients were categorized as SGM or non-SGM based on SOGI. Clinical covariates were obtained from cancer registry for a subset of 51, 189 patients. Descriptive statistics and survival analyses were used. Results: ∼3.2% of patients self-identified as SGM. Cancer diagnoses: Breast cancer was the most common diagnosis in SGM and non-SGM patients, followed by melanoma, hematologic, prostate, and lung cancers. Notably, SGM patients exhibited higher-than-expected rates of anorectal (6.8% vs. 0.7%, p<0.001) and uterine cancers (5.4% vs. 3.6%, p<0.001) compared to non-SGM patients. Age: Among the cancers analyzed, the mean age at diagnosis was significantly (p<0.001) lower for SGM compared to non-SGM: breast (54.8 vs. 60.5), melanoma (57.8 vs. 65.5), hematologic (62.0 vs. 67.1), prostate (65.4 vs. 68.1), lung (63.4 vs. 68.9), anorectal (55.1 vs. 64.4), and uterine (55.1 vs. 63.6). Stage: Among anorectal cancers, SGM were more likely to be diagnosed carcinoma in situ compared to non-SGM (45.8% vs. 4.8%, p < 0.001). For uterine cancers, SGM were more frequently diagnosed at stage II compared to non-SGM patients (18.2% vs. 4.8%, p = 0.008). No significant differences were observed for breast, lung, and hematologic cancers. Survival: Cancer site specific analysis revealed no significant differences. QOL: Concerns about barriers to seeking care were significantly higher (p<0.001) among SGM patients with breast (27.0% vs. 15.3%), lung (14.3% vs. 27.2%), and anorectal (35.9% vs. 15.5%) cancers. SGM patients with prostate cancer showed statistically significant lower social support (8.0% vs. 2.9%, p<0.001) and higher rates of living alone (28.4% vs. 10.8%, p<0.001), with similarly higher rates of living alone among SGM patients with anorectal cancer (33.9% vs. 16.3%, p=0.007). Worse mental health was reported by SGM patients with breast, hematologic, melanoma, prostate, uterine cancers (p<0.001), and SGM breast cancer patients had lower physical health scores (47.2% vs. 45.3%, p=0.042). Conclusions: SGM patients were diagnosed at younger age, diagnosed at higher rates of some cancer types, experienced elevated psychosocial challenges, reported worse mental health, and higher barriers to obtaining care. These findings highlight the value of SOGI data in advancing health equity in oncology. Citation Format: Shahrzad A. Zamani, Jaileene Pérez-Morales, Min-Jeong Yang, Matthew B. Schabath. Cancer disparities based on seven years of sexual orientation and gender identity collection at an NCI-Designated Comprehensive Cancer Center [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 4911.