Application of the Rosner-Wei risk-prediction model to estimate sexual orientation patterns in colon cancer risk in a prospective cohort of US women

Cancer Causes Control (2014) 25:9991006

DOI 10.1007/s10552-014-0399-x

ORIGINAL PAPER

Application of the RosnerWei risk-prediction model to estimate sexual orientation patterns in colon cancer risk in a prospective cohort of US women

S. Bryn Austin Mathew J. Pazaris

Esther K. Wei Bernard Rosner Grace A. Kennedy

Deborah Bowen Donna Spiegelman

Received: 22 October 2013 / Accepted: 13 May 2014 / Published online: 23 May 2014 Springer International Publishing Switzerland 2014

AbstractPurpose We examined whether lesbian and bisexual women may be at greater risk of colon cancer (CC) than heterosexual women.

Methods Working with a large cohort of US women ages 2564 years, we analyzed 20 years of prospective data to estimate CC incidence, based on known risk factors by applying the RosnerWei CC risk-prediction model. Comparing to heterosexual women, we calculated for lesbian and bisexual women the predicted 1-year incidence rate (IR) per 100,000 person-years and estimated incidence rate ratios (IRR) and 95 % condence intervals (CI), based on each womans comprehensive risk factor prole. Results Analyses included 1,373,817 person-years of data from 66,257 women. For each sexual orientation group, mean predicted 1-year CC IR per 100,000 person-years was slightly over 12 cases for each of the sexual orientation groups. After controlling for confounders in fully adjusted models and compared with heterosexuals, no signicant

differences in IRR were observed for lesbians (IRR 1.01; 95 % CI 0.99, 1.04) or bisexuals (IRR 1.01; 95 % CI 0.98,1.04).

Conclusions CC risk is similar across all sexual orientation subgroups, with all groups comparably affected. Health professionals must ensure that prevention, screening, and treatment programs are adequately reaching each of these communities.

Keywords Colon cancer Risk model Sexual

orientation Bisexual Lesbian

Introduction

Colon cancer (CC) is the third most commonly diagnosed cancer in US women [1]. In 2013, an estimated 69,140 women will be diagnosed with CC and another 24,530 will die of the disease [1]. Prior epidemiologic research

S. B. Austin B. Rosner D. Spiegelman

Channing Division of Network Medicine, Brigham and Womens Hospital and Harvard Medical School, Boston, MA, USA

S. B. Austin (&) G. A. Kennedy

Division of Adolescent and Young Adult Medicine, Boston Childrens Hospital, 333 Longwood Ave., Room #634, Boston, MA 02115, USAe-mail: [email protected]

S. B. AustinDepartment of Social and Behavioral Sciences, Harvard School of...