Survivors’ Perceptions of Quality of Colorectal Cancer Care by Sexual Orientation

Abstract

Objective: 

The objective of this study was to assess sexual minority and heterosexual survivors’ perceived quality of cancer care and identify demographic, clinical, and psychosocial characteristics associated with patient-centered quality of care.

Materials and Methods: 

Four cancer registries provided data on 17,849 individuals who were diagnosed with stage I, II, or III colorectal cancer an average of 3 years prior and resided in predetermined diverse geographic areas. A questionnaire, which queried about sexual orientation and other eligibility criteria was mailed to all cancer survivors. Of these, 480 eligible survivors participated in a telephone survey. Quality of cancer care was defined by 3 measures of interpersonal care (physician communication, nursing care, and coordination of care) and by rating cancer care as excellent. We used generalized linear models and logistic regression with forward selection to obtain models that best explained each quality of care measure.

Results: 

Sexual minority survivors rated physician communication, nursing care, and coordination of care similarly to heterosexual survivors, yet a significantly higher percentage of sexual minority survivors rated the overall quality of their cancer care as excellent (59% vs. 49%). Sexual minority survivors’ greater likelihood of reporting excellent care remained unchanged after adjusting for demographic, clinical, and psychosocial characteristics.

Conclusions: 

Sexual minority survivors’ ratings of quality of colorectal cancer care were comparable or even higher than heterosexual survivors. Sexual minority survivors’ reports of excellent care were not explained by their interpersonal care experiences.