What question did this study set out to answer?

This study aims to investigate differences in fatigue and mental health between sexual and gender minority cancer survivors and cisgender-heterosexual cancer survivors.

July 10, 2026Open Access

Comparative analysis of fatigue and mental health in sexual and gender minority cancer survivors

Key Points

This study aims to investigate differences in fatigue and mental health between sexual and gender minority cancer survivors and cisgender-heterosexual cancer survivors.
Analyzed survey data from 36,684 cancer survivors collected by the NIH's All of Us Research Program.
Utilized multivariable logistic regression to compare outcomes between SGM and cisgender-heterosexual survivors.
Assessed factors including sexual orientation, gender, race, ethnicity, and history of mental health issues.
SGM survivors represent 6.6% of respondents and have higher odds of high fatigue (OR = 1.33, 95% CI[1.17, 1.51], p < .001).
Experienced greater odds of poor mental health compared to cisgender-heterosexual survivors (OR = 1.85, 95% CI [1.64, 2.03], p < .001).
Post-adjustment for anxiety and depression, SGM survivors still reported lower mental health ratings than their cisgender counterparts.

Abstract

PURPOSE: This study aims to compare self-reported fatigue and mental health in sexual and gender minority (SGM) cancer survivors and cisgender-heterosexual cancer survivors. METHODS: Using data from the National Institutes of Health's All of Us Research Program, survey responses from 36,684 respondents with a history of cancer were analyzed. Information collected from respondents included sexual orientation, gender, race, ethnicity, age at first cancer, history of anxiety or depression, and history of fatigue-related diagnoses. Outcomes included surveys assessing fatigue and mental health. SGM individuals were compared with majority groups using multivariable logistic regression. RESULTS: SGM survivors represented 6.6% of the sample. SGM survivors had increased odds of high fatigue than cisgender-heterosexual survivors (OR = 1.33, 95% CI1.17, 1.51, p < .001). SGM survivors also experienced higher odds of self-reported poor mental health when compared with cisgender-heterosexual survivors (OR = 1.85, 95% CI 1.64, 2.03, p < .001). After controlling for anxiety, depression, and fatigue, SGM cancer survivors had higher odds of self-rated poor or fair mental health compared to cisgender-heterosexual cancer survivors. CONCLUSIONS: Fatigue and mental health are worse among SGM cancer survivors compared to cisgender-heterosexual survivors. Future interventional studies are needed to mitigate the unique fatigue and mental health needs of this population. IMPLICATIONS: Given the higher burden of fatigue among SGM cancer survivors, cancer care providers should screen for and address fatigue and mental health needs of SGM individuals impacted by cancer before, during, and after treatment to minimize the impact on their daily life. Outcomes for SGM survivors could be improved by routine sexual orientation and gender identity data collection in oncology settings and cancer databases, by education for SGM-serving primary care clinicians outside of cancer care settings on the care needs of survivors, and by piloting SGM-tailored interventions to address fatigue.

Ask AI

Helpful

Bookmark

View Full Paper