Abstract A133: Assessing functional disability status across sexual orientations among cancer survivors in the US

Abstract Background: Cancer survivors often experience long-term health problems and possess unique healthcare needs. Disability can add another layer of adverse effects during survivorship care. Few cancer survivorship studies have paid attention to disability in sexual and gender minority populations. This study aimed to assess whether there are differences in functional disability across sexual orientations among cancer survivors in the US. Methods: We analyzed data from the 2023 National Health Interview Survey (NHIS) that used multistage probability sampling to interview US adults aged ≥18 years. This study was limited to adults who had a history of cancer, reported sex assigned at birth (note: NHIS does not collect data on gender identity), and self-identified as straight/heterosexual, gay/lesbian, or bisexual/other. Per NHIS, any functional disability (yes/no) was defined by the Washington Group Composite Disability Indicator, which measures the self-reported difficulty level in 6 functional domains: vision, hearing, mobility, communication, cognition, and self-care. Weighted percentages were compared using Rao-Scott chi-squared tests. Weighted logistic regression was performed to estimate adjusted odds ratios (aOR), controlling for demographic and socioeconomic factors. All analyses accounted for complex survey design and weights. Results: The unweighted sample size was 3,762, representing a weighted sample of 25,002,435 cancer survivors in the US. The mean age was 66 years; 54.8% were female; 96.3% identified as straight/heterosexual, 1.9% as bisexual/other, and 1.8% as gay/lesbian. Overall, 17.3% (95% CI, 16.0-18.6%) had any functional disability. Female survivors had greater odds of having any functional disability than males (18.5% vs 15.8%; aOR, 1.38; 95% CI, 1.08-1.77). The percentage of functional disability was higher for survivors who identified as gay/lesbian (22.1% [95% CI, 8.6-35.6%]) or bisexual/other (33.0% [95% CI, 19.0-47.0%]) than those who identified as straight/heterosexual (17.0% [95% CI, 15.7-18.4%]) (P=0.021). After covariate adjustment, survivors who identified as gay/lesbian had greater odds of having any functional disability than those identified as straight/heterosexual (aOR, 2.41; 95% CI, 1.05-5.53). Bisexual/other survivors had greater odds of having any functional disability than straight/heterosexual survivors (aOR, 2.25; 95% CI, 0.89-5.68), though this difference was not statistically significant. Furthermore, Asian race, being married, and better self-rated general health were associated with lower odds of having any functional disability. Conclusions: In this US population-based sample, functional disability was more prevalent among cancer survivors who were female and those who identified as sexual minorities. Our findings highlight the potential need for survivorship programs to address the compounding burden of cancer survivorship and functional disability in survivors who are socially vulnerable while improving the functional health of the growing and aging population of cancer survivors. Citation Format: Jincong Q. Freeman, Kent Schechter, Xinyi Li, Victoria Umutoni, Jeffrey A. Wilhite, Long C. Nguyen, Yong Gun Lee. Assessing functional disability status across sexual orientations among cancer survivors in the US [abstract]. In: Proceedings of the 18th AACR Conference on the Science of Cancer Health Disparities; 2025 Sep 18-21; Baltimore, MD. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2025;34(9 Suppl):Abstract nr A133.