ArticleCancer causes & control : CCC2026
Person-level health factors partially mediate the association between lesbian, gay, or bisexual (LGB) identity, allostatic load, and cancer mortality in NHANES.
Article in Cancer causes & control : CCC, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeIndividuals identifying as Lesbian, Gay, or Bisexual (LGB) with high allostatic load have more than double the cancer mortality risk of heterosexual individuals with high allostatic load. This study explored how person-level health factors mediate the relationship between individuals identifying as LGB with high allostatic load and subsequent risk of cancer mortality.
methodsWe conducted a retrospective analysis of 12,470 participants in the National Health and Nutrition Examination Survey (2001-2010) linked to the National Death Index through 31 December 2019. Survey-weighted Cox regression assessed associations of individuals identifying as LGB and allostatic load with cancer mortality. Person-level health factors examined as mediators included household income, general health condition, routine health access, location of healthcare providers, prior health condition, mental health professional visits, and the number of health visits within the past year.
resultsAdults reporting as LGB with high allostatic load had a threefold higher cancer mortality risk than heterosexual adults with low allostatic load (adjusted hazard ratio: 2.96, 95% confidence interval: 1.62-5.41). Mediation analysis showed household income (4.9%), seeing a mental health provider within the past year (8.53%), frequent healthcare visits (9.65%), poor self-reported health (9.9%), and worse health now than past year (5.41%) partially influence this relationship.
conclusionIn a nationally representative sample, person-level health factors significantly mediated the link between adults reporting as LGB, high allostatic load, and cancer mortality. These findings highlight that potential efforts focused on financial support, culturally competent care, and mental health access may reduce cancer health disparities.
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