Email updates

Keep up to date with the latest news and content from BMC Cancer and BioMed Central.

Open Access Research article

An ecological analysis of colorectal cancer incidence and mortality: Differences by sexual orientation

Ulrike Boehmer1*, Al Ozonoff2 and Xiaopeng Miao3

Author Affiliations

1 Department of Community Health Sciences, Boston University School of Public Health, 801 Massachusetts Avenue, Boston, MA 02118, USA

2 Clinical Research Program, Children's Hospital Boston, 300 Longwood Avenue, Boston, MA 02215, USA

3 Department of Biostatistics, Boston University School of Public Health, 801 Massachusetts Avenue, Boston, MA 02118, USA

For all author emails, please log on.

BMC Cancer 2011, 11:400  doi:10.1186/1471-2407-11-400

Published: 21 September 2011

Abstract

Background

Some have suggested gays and lesbians may carry a greater burden of colorectal cancer. To date, individual sexual orientation data are not available in cancer surveillance registries. This prevents an assessment of differences in colorectal cancer incidence and mortality by sexual orientation, using individual-level data.

Methods

We use an ecological approach to examine differences in colorectal cancer incidence and mortality by county-level sexual orientation data. From the Surveillance, Epidemiology and End Results (SEER) Program we obtain population-based surveillance data on colorectal cancer incidence and mortality from 1996 to 2004. We use Census 2000 data on same-sex partnered households, a proxy of sexual orientation, to derive county-level sexual orientation data. Using multiple regression models, we examined the county-level association of sexual minority density with colorectal cancer incidence and mortality.

Results

After controlling for race and SES, we identify a significant positive association between greater density of sexual minority men and women and colorectal cancer incidence. With respect to colorectal cancer mortality, we identify a positive association with density of sexual minority men, but not women.

Conclusions

In the absence of surveillance data on sexual minority individuals, ecological analyses provide estimates of associations at the aggregate level, thereby providing crucial information for follow-up studies.