Some of the cancers that most often affect
women are breast, colorectal, endometrial, lung, cervical, skin, and ovarian
cancers. Lesbian and bisexual women may be at increased risk for breast,
cervical, and ovarian cancer compared to heterosexual women. Knowing about
these cancers and what you can do to help prevent them or finding them early
(when the cancer is small and might be easier to treat) may help save your
life.
Recognizing barriers
Studies suggest that some lesbian and bisexual
women get less routine health care than other women, including breast,
colorectal, and cervical cancer screening tests. Some of the
reasons for this include:
·
Fear
of discrimination: Some women don’t
tell their health care providers about their sexual orientation, because they
don’t want discrimination to affect the quality of health care they receive.
This can make it harder to have a comfortable relationship with a provider.
·
Low
rates of health insurance: Some
health insurance policies don’t cover unmarried partners. This makes it harder
for many lesbian and bisexual women to get quality health care.
·
Negative
experiences with health care providers: Fear of having a negative experience with a health care
provider can lead some women to delay or avoid medical care, especially routine
care such as early detection tests. Missing routine cancer screening tests can
lead to cancer being diagnosed at a later stage, when it’s
sometimes harder to treat.
The American Cancer Society can help you learn
more about the cancers that women are most at risk for, as well as how to find
these cancers early. Women can do things to help reduce their cancer risk and
be healthy.
Breast cancer
Who is at risk?
Some risk factors for breast cancer include
being a woman and getting older. A woman whose mother, sister, or daughter has
or had breast cancer is at higher risk. Being overweight, especially after
menopause, not being physically active, drinking alcohol, or taking birth
control may add to the risk. Additionally, there may be a higher breast
cancer risk for women who have used some hormone therapy after menopause. Women
who haven’t had children or haven’t breast-fed, and are older when they first
give birth, are also at a slightly higher risk. These factors may be more
likely to affect lesbian and bisexual women.
What you can do
The American Cancer Society recommends the
following guidelines for breast cancer early detection for women at average
risk:
Women ages 40 to 44 have the choice to start annual breast
cancer screening with a mammogram if they wish to do so.
Women age 45 to 54 should get a mammogram every year.
Women 55 and older can switch to a mammogram every 2
years, or can continue to get a yearly mammogram.
Screening is recommended to continue as long
as a woman is in good health and is expected to live at least 10 more years.
All women should talk to their health care team, they are familiar
with the known benefits, limitations, and potential harms linked to breast
cancer screening.
Women should also be familiar with how their
breasts normally look and feel, and they should report any changes to a health
care provider right away.
Some women at high risk for breast cancer – because of their family history, a
genetic tendency, or certain other factors – should be screened with an MRI
along with a mammogram every year, typically starting at age 30. Talk with a
health care provider about your breast cancer risk and the best screening plan
for you.
Colorectal cancer
Who is at risk?
Being older and having a personal history of
colorectal polyps, or a personal or family history of colorectal cancer (sometimes
called either colon cancer or rectal cancer) are risk factors for developing
colorectal cancer. Being overweight, eating a diet high in red and processed
meats, heavy alcohol use, smoking, and being inactive also increase risk.
Studies also show having type 2 diabetes, irritable bowel syndrome, or certain
hereditary syndromes can also increase a person's risk for colorectal cancer.
What you can do
Know your risk. Talk to your health care team
about your risk factors.
Staying at a healthy weight, eating well,
being active, not smoking, and limiting alcohol use might help lower your risk
of colorectal cancer.
Get screened, even if you have no symptoms.
Colorectal cancer often starts with a polyp – a small growth on the lining of
the colon or rectum. Screening tests can often help find polyps before
they become cancer. If pre-cancerous polyps are removed, and regular screening
for other problems is done, colorectal cancer can be prevented. If
colorectal cancer is found during regular screening, it is often at an
early stage when it might be easier to treat.
For all people at average risk of colorectal
cancer, the American Cancer Society recommends starting regular screening at
age 45.
People who are in good health should continue
regular colorectal cancer screening through the age of 75.
For people ages 76 through 85, the decision to
be screened should be based on a person's preferences, life expectancy, overall
health, and prior screening history. People over 85 should no longer get
colorectal cancer screening.
Screening can be done either with a sensitive
test that looks for signs of cancer in a person’s stool (a stool-based test),
or with an exam that looks at the colon and rectum (a visual exam).
Stool-based tests
·
Yearly fecal
immunochemical test (FIT) *, or
·
Yearly guaiac-based
fecal occult blood test (gFOBT) *, or
·
Multi-targeted stool
DNA test (MT-sDNA) every 3 years*
Visual (structural) exams of the colon and rectum
·
Colonoscopy every 10
years, or
·
CT colonography
(virtual colonoscopy) every 5 years*, or
·
Flexible sigmoidoscopy
every 5 years*
*If you choose to be screened with a test
other than colonoscopy, any abnormal test result should be followed up with
colonoscopy.
If you are at high risk of colorectal cancer
based on family history or other factors, you may need to start testing before
age 45. Talk to a health care provider about your risk for colorectal cancer to
know when you should start screening.
Lung cancer
Who is at risk?
Lung cancer is
the second most common cancer and a leading cause of cancer death in the US and
around the world. It's important to know that anyone can get lung cancer,
including people who have never smoked and don't currently use tobacco
products. Still, smoking is by far the leading cause of lung cancer, and is
known to be linked to 12 other types of cancer. Some evidence suggests that
lesbian and bisexual women are about twice as likely to smoke compared to
heterosexual women . Smoking is also linked to heart disease, bronchitis,
stroke, and emphysema.
Exposure to radon, asbestos, or air pollution
can put a person at higher risk for lung cancer, too. Having a personal or
family history of lung cancer or previous radiation to the chest or lungs can
also increase a person's risk for lung cancer.
What you can do
Avoid exposure to tobacco smoke and other
harmful chemicals. If you don’t smoke, don’t start. It’s also important to
reduce your exposure to secondhand smoke . If needed, talk to a health care
provider about quitting, or call 1-800-227-2345 to find out how we can help increase
the chances of quitting for good.
Think about getting screened. The American
Cancer Society recommends screening for certain people at higher risk for lung
cancer. If you are a current or former smoker aged 55 to 74 years and in fairly
good health, you might benefit from screening for lung cancer with a yearly
low-dose CT scan (LDCT). Talk to a health care provider about your risk of lung
cancer, and about the possible benefits, limitations, and harms of getting
tested for early lung cancer.
Gynecological cancers
Who is at risk?
Some common types of cancer of the female
reproductive organs (gynecological cancers) are cervical, endometrial
(uterine), and ovarian cancer.
Cervical cancer can affect any woman. It most often
occurs in women who have been exposed to certain types of a virus called human
papillomavirus, or HPV. HPV can be passed from one person to another by
skin-to-skin contact, such as through sexual activity. There are both low-risk
and high-risk types of HPV. Low-risk HPV infections don’t develop into cancer,
and the body is usually able to clear most of them by itself. But, high-risk
types of HPV can stay in the body and may eventually develop into cancer.
Besides infection with certain types of HPV, risk
factors for cervical cancer include not getting regular cervical cancer
screening, smoking, having a suppressed immune system, having a chlamydia
infection, eating a diet low in fruits and vegetables, and being overweight.
Some other risk factors include long-term use of oral contraceptives,
intrauterine device use, being younger than 17 at first pregnancy, or having a
family history of cervical cancer.
Endometrial cancer starts in the lining of the uterus.
Hormone balance plays a part in the development of most endometrial cancers.
This cancer is more likely in women who have taken estrogen therapy without
progesterone, and those who are obese, have a diet high in fat, or have a history
of diabetes. A personal history of ovarian cancer or breast cancer, taking
or have taken tamoxifen, or having pelvic radiation can also increase risk.
Women who have never been pregnant, have never taken oral contraceptives, have
polycystic ovarian syndrome (PCOS), or have certain inherited cancer syndromes
or family history of endometrial cancer may have an increased risk, too.
Ovarian cancer is more likely to occur in women as they
get older. Risk factors include never being pregnant; being obese; having
breast cancer or a family history of breast, ovarian, or colorectal cancer; or
use of estrogen therapy without progesterone.
What you can do
While routine HPV vaccination is recommended for
the prevention of cervical and other cancers, it should be started at age 11 or
12. However, HPV vaccination is also recommended for females 13 to 26 years old
who have not started the vaccines, or who have started but not completed the
series. For women 22 to 26 years old who have not started the vaccines, or who
have started but not completed the series, it’s important to know that
vaccination at older ages is less effective in lowering cancer risk. The
vaccine is approved for use in people up to age 45, though not recommended
after age 26. While the vaccine is safe, it is unlikely to provide much, if
any, benefit as people get older. Talk to your health care provider for more
information.
There are currently no recommended screening
tests for endometrial or ovarian cancer. But, there are screening tests for
cervical cancer.
The Pap test is used to help find cervical
cancer or pre-cancers; it does not find endometrial or ovarian
cancer. The Pap test can help find pre-cancers by looking for changes in the
cervix before they become cancer. The American Cancer Society recommends all
women start getting cervical cancer screening at age 21 by getting a Pap test
every 3 years. Starting at age 30, the preferred way to screen is with a Pap
test combined with an HPV test every 5 years (co-testing). This should be done
until age 65. Another reasonable option for these women ages 30-65 ages 30 to
65 is to continue to get tested every 3 years with just the Pap test.
It's important to know that screening is done
on people who do not have symptoms. If you have symptoms, your
testing may be different. Symptoms may include unusual vaginal discharge,
spotting, or bleeding. Ovarian cancers tend to cause other more vague symptoms,
such as swelling in the belly, unusual vaginal bleeding, pelvic pressure, back
pain, leg pain, or digestive problems. See a health care provider if you have
any of these symptoms.
Skin cancer
Who is at risk?
Anyone can get skin cancer. But
people who spend a lot of time in the sun or use tanning beds have a
higher risk for skin cancer. People with fair skin, especially those with blond
or red hair, are at greater risk than people with darker coloring. Those who
have weakened immune systems or close family members with skin cancer are also
at a higher risk for skin cancer.
What you can do
Here are some things you can do to help prevent skin cancer:
·
Limit the time spent
in the sun, especially from 10 a.m. to 4 p.m., when its rays are strongest.
·
Protect your skin by
wearing hats with wide brims, long-sleeved shirts, and wrap-around sunglasses
when you are outside.
·
Use broad-spectrum
sunscreen with an SPF of at least 30 on all exposed skin. Always follow the
label directions when applying, and be sure to reapply it. You should even wear
sunscreen on cloudy or overcast days, too, because UV rays travel through
clouds.
·
Avoid other sources of
UV light, like tanning beds and sun lamps. These can damage your skin just like
the sun.
·
Know your skin, and
report any skin changes to a health care provider. Talk about your risk with
them and think about asking for a skin exam done during your regular health
check-ups.
What else you can
do to help reduce your cancer risk
·
Stay away from tobacco.
·
Get to and stay at a
healthy weight.
·
Get moving with
regular physical activity.
·
Follow a healthy
eating pattern that includes plenty of fruits, vegetables, and whole grains,
and that limits or avoids red/processed meats, and highly processed foods.
·
It’s best not to drink
alcohol. If you do drink, have no more than 1 drink per day for women.
·
Protect your skin from
the sun.
·
Know yourself, your
family history, and your risks.
·
Get regular check-ups
and cancer screening tests.
The most common types of cancer among women
are skin, breast, lung, colorectal, endometrial (uterine), and cervical cancer.
Lesbian and bisexual women may be at increased risk for some cancers, including
breast, cervical, and ovarian cancer compared with heterosexual women.
Knowing about these cancers and what you can
do to help reduce your risk for cancer or finding it early may help save your
life or the life of someone you love.
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