Correspondence
leading to uneven liposomal tumor accumulation may affect RR to PLD. Second, PLD demonstrated RRs of 36% and 22% in other firstand second-line studies, respectively.14,15 And third, toxicity advantages of PLD vis-a`-vis doxorubicin may render PLD more suitable for drug combinations, particularly in older patients. In fact, the carboplatin plus PLD regimen has been assessed in three trials that collectively included 104 patients with endometrial carcinoma.16-18 Two of these studies analyzed the PFS to be 9.5 months and 12 months, respectively, whereas OS exceeded 20 months in both. Consequently, to answer our question, PLD rather than doxorubicin should be explored in phase II and phase III studies of endometrial carcinoma. Comparisons of carboplatin plus paclitaxel versus carboplatin plus PLD or carboplatin plus paclitaxel plus PLD are of interest, and may define a role for this doxorubicin formulation beyond its use after patients demonstrate a lack of response to CT. Future trial priorities in endometrial cancer should pursue leads that emerge from this cancer’s molecular characteristics, which were recently described by The Cancer Genome Atlas—for example, specific mutational alterations shared by endometrial serous, breast, and ovarian cancers can be used in so-called basket trials.19 However, these efforts should be coupled with refining the chemotherapy backbone to be used in first- and second-line metastatic as well as adjuvant settings.
Mendel Goldfinger Montefiore/Albert Einstein School of Medicine, Bronx, NY
Isabela Diaz Galdakao-Usa´nsolo Hospital, Galdakao, Spain
Franco Muggia New York University Cancer Institute, New York, NY
AUTHORS’ DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST
The author(s) indicated no potential conflicts of interest. REFERENCES 1. Randall ME, Filiaci VL, Muss H, et al: Randomized phase III trial of whole-abdominal irradiation versus doxorubicin and cisplatin chemotherapy in advanced endometrial carcinoma: A Gynecologic Oncology Group Study. J Clin Oncol 24:36-44, 2006 2. Thigpen JT, Buchsbaum HJ, Mangan C, et al: Phase II trial of adriamycin in the treatment of advanced or recurrent endometrial carcinoma: A Gynecologic Oncology Group study. Cancer Treat Rep 63:21-27, 1979 3. Ball HG, Blessing JA, Lentz SS, et al: A phase II trial of paclitaxel in patients with advanced or recurrent adenocarcinoma of the endometrium: A Gynecologic Oncology Group study. Gynecol Oncol 62:278-281, 1996 4. Fleming GF, Brunetto VL, Cella D, et al: Phase III trial of doxorubicin plus cisplatin with or without paclitaxel plus filgrastim in advanced endometrial
carcinoma: A Gynecologic Oncology Group Study. J Clin Oncol 22:2159-2166, 2004 5. Miller D, Fillaci V, Fleming G, et al: Randomized phase III noninferiority trial of first line chemotherapy for metastatic or recurrent endometrial carcinoma: A Gynecologic Oncology Group study. Gynecol Oncol 125:771-773, 2012 6. Thigpen JT, Blessing JA, DiSaia PJ, et al: A randomized comparison of doxorubicin alone versus doxorubicin plus cyclophosphamide in the management of advanced or recurrent endometrial carcinoma: A Gynecologic Oncology Group study. J Clin Oncol 12:1408-1414, 1994 7. Thigpen JT, Brady MF, Homesley HD, et al: Phase III trial of doxorubicin with or without cisplatin in advanced endometrial carcinoma: A Gynecologic Oncology Group study. J Clin Oncol 22:3902-3908, 2004 8. Gallion HH, Brunetto VL, Cibull M, et al: Randomized phase III trial of standard timed doxorubicin plus cisplatin versus circadian timed doxorubicin plus cisplatin in stage III and IV or recurrent endometrial carcinoma: A Gynecologic Oncology Group Study. J Clin Oncol 21:3808-3813, 2003 9. Fleming GF, Filiaci VL, Bentley RC, et al: Phase III randomized trial of doxorubicin ⫹ cisplatin versus doxorubicin ⫹ 24-h paclitaxel ⫹ filgrastim in endometrial carcinoma: A Gynecologic Oncology Group study. Ann Oncol 15: 1173-1178, 2004 10. DiSaia PJ (ed): Gynecologic Oncology Group: 43 Years of Success. Philadelphia, PA, GOG Publications, 2013 11. [No authors listed]: FIGO News: News from the secretariat. Int J Gynecol Obstet 28:189-193, 198 12. Muggia FM, Blessing JA, Sorosky J, et al: Phase II trial of the pegylated liposomal doxorubicin in previously treated metastatic endometrial cancer: A Gynecologic Oncology Group study. J Clin Oncol 20:2360-2364, 2002 13. Homesley HD, Blessing JA, Sorosky J, et al: Phase II trial of liposomal doxorubicin at 40 mg/m(2) every 4 weeks in endometrial carcinoma: A Gynecologic Oncology Group Study. Gynecol Oncol 98:294-298, 2005 14. Escobar PF, Markman M, Zanotti K, et al: Phase 2 trial of pegylated liposomal doxorubicin in advanced endometrial cancer. J Cancer Res Clin Oncol 129:651-654, 2003 15. Balbi G, Visconti S, Monteverde A, et al: Liposomal doxorubicin: A phase II trial. Acta Biomed 78:210-213, 2007 16. Pignata S, Scambia G, Pisano C, et al: A multicentre phase II study of carboplatin plus pegylated liposomal doxorubicin as first-line chemotherapy for patients with advanced or recurrent endometrial carcinoma: The END-1 study of the MITO (Multicentre Italian Trials in Ovarian Cancer and Gynecologic Malignancies) group. Br J Cancer 96:1639-1643, 2007 17. du Bois A, Pfisterer J, Burchardi N, et al: Combination therapy with pegylated liposomal doxorubicin and carboplatin in gynecologic malignancies: A prospective phase II study of the Arbeitsgemeinschaft Gyna¨ekologische Onkologie Studiengruppe Ovarialkarzinom (AGO-OVAR) and Kommission Uterus (AGOK-Ut). Gynecol Oncol 107:518-525, 2007 18. Leˆ LH, Swenerton KD, Elit L, et al: Phase II multicenter open-label study of carboplatin and pegylated liposomal doxorubicin in uterine and cervical malignancies. Int J Gynecol Cancer 15:799-806, 2005 19. Cancer Genome Atlas Research Network, Kandoth C, Schultz N, et al: Integrated genomic characterization of endometrial carcinoma. Nature 497:6773, 2013
DOI: 10.1200/JCO.2014.55.7454; published online ahead of print at www.jco.org on June 2, 2014
■ ■ ■
Omission of Sexual and Gender Minority Patients TO THE EDITOR: We have great concerns about the article “Marital Status and Survival in Patients With Cancer” by Aizer et al1 and the associated editorial by Kissane,2 which further discusses the finding that marriage has a protective effect, whereas the unmarried have a significantly higher risk of late cancer diagnosis, undertreatment, and cancer death. We believe that omitting a discussion of lesbian, gay, bisexual, and transgender (LGBT) populations from both the article 2182
© 2014 by American Society of Clinical Oncology
and editorial is an oversight that is troubling for a host of reasons. Despite a failure to dedicate resources and funding, at least federal and nonfederal agencies, including the National Cancer Institute and the American Cancer Society, acknowledge the existence of cancer disparities as a result of sexual orientation. More importantly, despite the lack of dedicated resources to examine these disparities, populationbased research shows that gay men have a higher prevalence of cancer histories, lesbian and bisexual women with cancer report worse quality of life compared with their heterosexual peers,3 and women in same-sex relationships have greater risk for breast cancer–related mortality than women in opposite-sex relationships.4 Therefore, at a JOURNAL OF CLINICAL ONCOLOGY
Information downloaded from jco.ascopubs.org and provided by at Buddhist Dalin Hospital on March 20, 2015 from Copyright © 2014 American Society of Clinical Oncology. All rights reserved. 203.64.11.45
Correspondence
minimum, the article and the editorial should have discussed the fact that LGBT populations are likely overrepresented in their study, carrying a greater cancer burden. On the basis of conservative national estimates, there are approximately 9 million LGBT individuals, that is, 3.8% of US adults.5 However, the prevalence of LGBT individuals varies greatly by geographic location, and the SEER data used by the study authors include several locations in which LGBT populations are clustered above and beyond the 3.8% average, for example, in San Francisco–Oakland, Seattle– Puget Sound, and Hawaii.6,7 Twenty percent of LGBT individuals are married,7 significantly fewer than the 51% who are married among the general population.1 Therefore, the authors’ findings of late cancer diagnosis, undertreatment, and cancer deaths is of the utmost importance for the majority of unmarried LGBT individuals. Although we recognize that SEER does not collect sexual orientation and gender identity data and LGBT individuals could not be separated into the married and unmarried categories for analysis, the implications of this study’s findings for LGBT individuals should have been discussed. After all, the authors used SEER data from 2004 to 2008, a time when the legalization of same-sex marriages emerged; the American Community Survey and other data sources counted same-sex marriages alongside opposite-sex marriages; and research established the protective health effects of same-sex marriage for LGBT individuals.8 In addition to calling on the authors,1,2 we recognize that it is foremost the obligation of federal and nonfederal agencies to facilitate researchers’ ability to perform data analyses that consider LGBT individuals by systematically collecting sexual orientation and gender identity data in all data sources, including SEER. Moreover, we must call on Journal of Clinical Oncology to hold study authors accountable for excluding LGBT populations without explanation in their methodology or limitations sections. In addition, we hope that in the future, Journal of Clinical Oncology will accept and publish more research on LGBT communities along the cancer continuum, from prevention to
end of life, to facilitate awareness about the increasing recognition of cancer disparities that affect LGBT populations. The crucial question to be asked and answered must be: how many lives would be improved and saved if LGBT individuals had the social and cultural conditions that heterosexuals enjoy?
Michael G. Bare and Liz Margolies National Lesbian, Gay, Bisexual, and Transgender Cancer Network, New York, NY
Ulrike Boehmer Boston University, Boston, MA
AUTHORS’ DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST
The author(s) indicated no potential conflicts of interest. REFERENCES 1. Aizer AA, Chen MH, McCarthy EP, et al: Marital status and survival in patients with cancer. J Clin Oncol 31:3869-3876, 2013 2. Kissane DW: Marriage is as protective as chemotherapy in cancer care. J Clin Oncol 31:3852-3853, 2013 3. Boehmer U, Miao X, Ozonoff A: Cancer survivorship and sexual orientation. Cancer 117:3796-3804, 2011 4. Cochran SD, Mays VM: Risk of breast cancer mortality among women cohabiting with same sex partners: Findings from the National Health Interview Survey, 1997-2003. J Womens Health (Larchmt) 21:528-533, 2012 5. Gates GJ: How many people are lesbian, gay, bisexual, and transgender? Los Angeles, CA, The Williams Institute, 2011. http://williamsinstitute.law.ucla.edu/wpcontent/uploads/Gates-How-Many-People-LGBT-Apr-2011.pdf 6. Gates GJ, Cooke AM: United States census snapshot 2010. Los Angeles, CA, The Williams Institute, 2011 7. Gates GJ, Newport F: LGBT percentage highest in DC, lowest in North Dakota. Gallup, February 15, 2013. http://www.gallup.com/poll/160517/lgbtpercentage-highest-lowest-north-dakota.aspx 8. Wight RG, LeBlanc AJ, Lee Badgett MV: Same-sex legal marriage and psychological well-being: Findings from the California Health Interview Survey. Am J Public Health 103:339-346, 2013
DOI: 10.1200/JCO.2014.55.6126; published online ahead of print at www.jco.org on June 2, 2014
■ ■ ■
Reply to M.G. Bare et al
REFERENCES
TO THE EDITOR: The editors thank Bare et al1 for drawing attention to the oversight of lesbian, gay, bisexual, and transgender populations in the recent discussion of the impact of marital status on survival in patients with cancer2 and the related editorial.3 Their call to the National Cancer Institute for the systematic collection of sexual orientation and gender identity information in data such as the SEER program is supported.4 Clear evidence is accumulating about the presence of cancer outcome disparities in the lesbian, gay, bisexual, and transgender populations.5-7
David W. Kissane Monash University, Melbourne, Victoria, Australia; Memorial Sloan-Kettering Cancer Center and Weill Cornell Medical College, New York, NY
AUTHOR’S DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST
The author(s) indicated no potential conflicts of interest.
1. Bare MG, Margolies L, Boehmer U: Omission of sexual and gender minority patients. J Clin Oncol 32:2182-2183, 2014 2. Aizer AA, Chen MH, McCarthy EP, et al: Marital status and survival in patients with cancer. J Clin Oncol 31:3869-3876, 2013 3. Kissane DW: Marriage is as protective as chemotherapy in cancer care. J Clin Oncol 31:3852-3853, 2013 4. National Cancer Institute, Division of Cancer Control and Population Sciences, Surveillance Research Program, Surveillance Systems Branch: Surveillance, Epidemiology, and End Results (SEER) Program Research Data (19732009). http://www.seer.cancer.gov 5. Boehmer U, Miao X, Ozonoff A: Cancer survivorship and sexual orientation. Cancer 117:3796-3804, 2011 6. Cochran SD, Mays VM: Risk of breast cancer mortality among women cohabiting with same sex partners: Findings from the National Health Interview Survey, 1997-2003. J Womens Health (Larchmt) 21:528-533, 2012 7. Meads C, Moore D: Breast cancer in lesbians and bisexual women: Systematic review of incidence, prevalence and risk studies. BMC Public Health 13:1127, 2013
DOI: 10.1200/JCO.2014.55.6696; published online ahead of print at www.jco.org on June 2, 2014 ■ ■ ■
www.jco.org
© 2014 by American Society of Clinical Oncology
Information downloaded from jco.ascopubs.org and provided by at Buddhist Dalin Hospital on March 20, 2015 from Copyright © 2014 American Society of Clinical Oncology. All rights reserved. 203.64.11.45
2183
leading to uneven liposomal tumor accumulation may affect RR to PLD. Second, PLD demonstrated RRs of 36% and 22% in other firstand second-line studies, respectively.14,15 And third, toxicity advantages of PLD vis-a`-vis doxorubicin may render PLD more suitable for drug combinations, particularly in older patients. In fact, the carboplatin plus PLD regimen has been assessed in three trials that collectively included 104 patients with endometrial carcinoma.16-18 Two of these studies analyzed the PFS to be 9.5 months and 12 months, respectively, whereas OS exceeded 20 months in both. Consequently, to answer our question, PLD rather than doxorubicin should be explored in phase II and phase III studies of endometrial carcinoma. Comparisons of carboplatin plus paclitaxel versus carboplatin plus PLD or carboplatin plus paclitaxel plus PLD are of interest, and may define a role for this doxorubicin formulation beyond its use after patients demonstrate a lack of response to CT. Future trial priorities in endometrial cancer should pursue leads that emerge from this cancer’s molecular characteristics, which were recently described by The Cancer Genome Atlas—for example, specific mutational alterations shared by endometrial serous, breast, and ovarian cancers can be used in so-called basket trials.19 However, these efforts should be coupled with refining the chemotherapy backbone to be used in first- and second-line metastatic as well as adjuvant settings.
Mendel Goldfinger Montefiore/Albert Einstein School of Medicine, Bronx, NY
Isabela Diaz Galdakao-Usa´nsolo Hospital, Galdakao, Spain
Franco Muggia New York University Cancer Institute, New York, NY
AUTHORS’ DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST
The author(s) indicated no potential conflicts of interest. REFERENCES 1. Randall ME, Filiaci VL, Muss H, et al: Randomized phase III trial of whole-abdominal irradiation versus doxorubicin and cisplatin chemotherapy in advanced endometrial carcinoma: A Gynecologic Oncology Group Study. J Clin Oncol 24:36-44, 2006 2. Thigpen JT, Buchsbaum HJ, Mangan C, et al: Phase II trial of adriamycin in the treatment of advanced or recurrent endometrial carcinoma: A Gynecologic Oncology Group study. Cancer Treat Rep 63:21-27, 1979 3. Ball HG, Blessing JA, Lentz SS, et al: A phase II trial of paclitaxel in patients with advanced or recurrent adenocarcinoma of the endometrium: A Gynecologic Oncology Group study. Gynecol Oncol 62:278-281, 1996 4. Fleming GF, Brunetto VL, Cella D, et al: Phase III trial of doxorubicin plus cisplatin with or without paclitaxel plus filgrastim in advanced endometrial
carcinoma: A Gynecologic Oncology Group Study. J Clin Oncol 22:2159-2166, 2004 5. Miller D, Fillaci V, Fleming G, et al: Randomized phase III noninferiority trial of first line chemotherapy for metastatic or recurrent endometrial carcinoma: A Gynecologic Oncology Group study. Gynecol Oncol 125:771-773, 2012 6. Thigpen JT, Blessing JA, DiSaia PJ, et al: A randomized comparison of doxorubicin alone versus doxorubicin plus cyclophosphamide in the management of advanced or recurrent endometrial carcinoma: A Gynecologic Oncology Group study. J Clin Oncol 12:1408-1414, 1994 7. Thigpen JT, Brady MF, Homesley HD, et al: Phase III trial of doxorubicin with or without cisplatin in advanced endometrial carcinoma: A Gynecologic Oncology Group study. J Clin Oncol 22:3902-3908, 2004 8. Gallion HH, Brunetto VL, Cibull M, et al: Randomized phase III trial of standard timed doxorubicin plus cisplatin versus circadian timed doxorubicin plus cisplatin in stage III and IV or recurrent endometrial carcinoma: A Gynecologic Oncology Group Study. J Clin Oncol 21:3808-3813, 2003 9. Fleming GF, Filiaci VL, Bentley RC, et al: Phase III randomized trial of doxorubicin ⫹ cisplatin versus doxorubicin ⫹ 24-h paclitaxel ⫹ filgrastim in endometrial carcinoma: A Gynecologic Oncology Group study. Ann Oncol 15: 1173-1178, 2004 10. DiSaia PJ (ed): Gynecologic Oncology Group: 43 Years of Success. Philadelphia, PA, GOG Publications, 2013 11. [No authors listed]: FIGO News: News from the secretariat. Int J Gynecol Obstet 28:189-193, 198 12. Muggia FM, Blessing JA, Sorosky J, et al: Phase II trial of the pegylated liposomal doxorubicin in previously treated metastatic endometrial cancer: A Gynecologic Oncology Group study. J Clin Oncol 20:2360-2364, 2002 13. Homesley HD, Blessing JA, Sorosky J, et al: Phase II trial of liposomal doxorubicin at 40 mg/m(2) every 4 weeks in endometrial carcinoma: A Gynecologic Oncology Group Study. Gynecol Oncol 98:294-298, 2005 14. Escobar PF, Markman M, Zanotti K, et al: Phase 2 trial of pegylated liposomal doxorubicin in advanced endometrial cancer. J Cancer Res Clin Oncol 129:651-654, 2003 15. Balbi G, Visconti S, Monteverde A, et al: Liposomal doxorubicin: A phase II trial. Acta Biomed 78:210-213, 2007 16. Pignata S, Scambia G, Pisano C, et al: A multicentre phase II study of carboplatin plus pegylated liposomal doxorubicin as first-line chemotherapy for patients with advanced or recurrent endometrial carcinoma: The END-1 study of the MITO (Multicentre Italian Trials in Ovarian Cancer and Gynecologic Malignancies) group. Br J Cancer 96:1639-1643, 2007 17. du Bois A, Pfisterer J, Burchardi N, et al: Combination therapy with pegylated liposomal doxorubicin and carboplatin in gynecologic malignancies: A prospective phase II study of the Arbeitsgemeinschaft Gyna¨ekologische Onkologie Studiengruppe Ovarialkarzinom (AGO-OVAR) and Kommission Uterus (AGOK-Ut). Gynecol Oncol 107:518-525, 2007 18. Leˆ LH, Swenerton KD, Elit L, et al: Phase II multicenter open-label study of carboplatin and pegylated liposomal doxorubicin in uterine and cervical malignancies. Int J Gynecol Cancer 15:799-806, 2005 19. Cancer Genome Atlas Research Network, Kandoth C, Schultz N, et al: Integrated genomic characterization of endometrial carcinoma. Nature 497:6773, 2013
DOI: 10.1200/JCO.2014.55.7454; published online ahead of print at www.jco.org on June 2, 2014
■ ■ ■
Omission of Sexual and Gender Minority Patients TO THE EDITOR: We have great concerns about the article “Marital Status and Survival in Patients With Cancer” by Aizer et al1 and the associated editorial by Kissane,2 which further discusses the finding that marriage has a protective effect, whereas the unmarried have a significantly higher risk of late cancer diagnosis, undertreatment, and cancer death. We believe that omitting a discussion of lesbian, gay, bisexual, and transgender (LGBT) populations from both the article 2182
© 2014 by American Society of Clinical Oncology
and editorial is an oversight that is troubling for a host of reasons. Despite a failure to dedicate resources and funding, at least federal and nonfederal agencies, including the National Cancer Institute and the American Cancer Society, acknowledge the existence of cancer disparities as a result of sexual orientation. More importantly, despite the lack of dedicated resources to examine these disparities, populationbased research shows that gay men have a higher prevalence of cancer histories, lesbian and bisexual women with cancer report worse quality of life compared with their heterosexual peers,3 and women in same-sex relationships have greater risk for breast cancer–related mortality than women in opposite-sex relationships.4 Therefore, at a JOURNAL OF CLINICAL ONCOLOGY
Information downloaded from jco.ascopubs.org and provided by at Buddhist Dalin Hospital on March 20, 2015 from Copyright © 2014 American Society of Clinical Oncology. All rights reserved. 203.64.11.45
Correspondence
minimum, the article and the editorial should have discussed the fact that LGBT populations are likely overrepresented in their study, carrying a greater cancer burden. On the basis of conservative national estimates, there are approximately 9 million LGBT individuals, that is, 3.8% of US adults.5 However, the prevalence of LGBT individuals varies greatly by geographic location, and the SEER data used by the study authors include several locations in which LGBT populations are clustered above and beyond the 3.8% average, for example, in San Francisco–Oakland, Seattle– Puget Sound, and Hawaii.6,7 Twenty percent of LGBT individuals are married,7 significantly fewer than the 51% who are married among the general population.1 Therefore, the authors’ findings of late cancer diagnosis, undertreatment, and cancer deaths is of the utmost importance for the majority of unmarried LGBT individuals. Although we recognize that SEER does not collect sexual orientation and gender identity data and LGBT individuals could not be separated into the married and unmarried categories for analysis, the implications of this study’s findings for LGBT individuals should have been discussed. After all, the authors used SEER data from 2004 to 2008, a time when the legalization of same-sex marriages emerged; the American Community Survey and other data sources counted same-sex marriages alongside opposite-sex marriages; and research established the protective health effects of same-sex marriage for LGBT individuals.8 In addition to calling on the authors,1,2 we recognize that it is foremost the obligation of federal and nonfederal agencies to facilitate researchers’ ability to perform data analyses that consider LGBT individuals by systematically collecting sexual orientation and gender identity data in all data sources, including SEER. Moreover, we must call on Journal of Clinical Oncology to hold study authors accountable for excluding LGBT populations without explanation in their methodology or limitations sections. In addition, we hope that in the future, Journal of Clinical Oncology will accept and publish more research on LGBT communities along the cancer continuum, from prevention to
end of life, to facilitate awareness about the increasing recognition of cancer disparities that affect LGBT populations. The crucial question to be asked and answered must be: how many lives would be improved and saved if LGBT individuals had the social and cultural conditions that heterosexuals enjoy?
Michael G. Bare and Liz Margolies National Lesbian, Gay, Bisexual, and Transgender Cancer Network, New York, NY
Ulrike Boehmer Boston University, Boston, MA
AUTHORS’ DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST
The author(s) indicated no potential conflicts of interest. REFERENCES 1. Aizer AA, Chen MH, McCarthy EP, et al: Marital status and survival in patients with cancer. J Clin Oncol 31:3869-3876, 2013 2. Kissane DW: Marriage is as protective as chemotherapy in cancer care. J Clin Oncol 31:3852-3853, 2013 3. Boehmer U, Miao X, Ozonoff A: Cancer survivorship and sexual orientation. Cancer 117:3796-3804, 2011 4. Cochran SD, Mays VM: Risk of breast cancer mortality among women cohabiting with same sex partners: Findings from the National Health Interview Survey, 1997-2003. J Womens Health (Larchmt) 21:528-533, 2012 5. Gates GJ: How many people are lesbian, gay, bisexual, and transgender? Los Angeles, CA, The Williams Institute, 2011. http://williamsinstitute.law.ucla.edu/wpcontent/uploads/Gates-How-Many-People-LGBT-Apr-2011.pdf 6. Gates GJ, Cooke AM: United States census snapshot 2010. Los Angeles, CA, The Williams Institute, 2011 7. Gates GJ, Newport F: LGBT percentage highest in DC, lowest in North Dakota. Gallup, February 15, 2013. http://www.gallup.com/poll/160517/lgbtpercentage-highest-lowest-north-dakota.aspx 8. Wight RG, LeBlanc AJ, Lee Badgett MV: Same-sex legal marriage and psychological well-being: Findings from the California Health Interview Survey. Am J Public Health 103:339-346, 2013
DOI: 10.1200/JCO.2014.55.6126; published online ahead of print at www.jco.org on June 2, 2014
■ ■ ■
Reply to M.G. Bare et al
REFERENCES
TO THE EDITOR: The editors thank Bare et al1 for drawing attention to the oversight of lesbian, gay, bisexual, and transgender populations in the recent discussion of the impact of marital status on survival in patients with cancer2 and the related editorial.3 Their call to the National Cancer Institute for the systematic collection of sexual orientation and gender identity information in data such as the SEER program is supported.4 Clear evidence is accumulating about the presence of cancer outcome disparities in the lesbian, gay, bisexual, and transgender populations.5-7
David W. Kissane Monash University, Melbourne, Victoria, Australia; Memorial Sloan-Kettering Cancer Center and Weill Cornell Medical College, New York, NY
AUTHOR’S DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST
The author(s) indicated no potential conflicts of interest.
1. Bare MG, Margolies L, Boehmer U: Omission of sexual and gender minority patients. J Clin Oncol 32:2182-2183, 2014 2. Aizer AA, Chen MH, McCarthy EP, et al: Marital status and survival in patients with cancer. J Clin Oncol 31:3869-3876, 2013 3. Kissane DW: Marriage is as protective as chemotherapy in cancer care. J Clin Oncol 31:3852-3853, 2013 4. National Cancer Institute, Division of Cancer Control and Population Sciences, Surveillance Research Program, Surveillance Systems Branch: Surveillance, Epidemiology, and End Results (SEER) Program Research Data (19732009). http://www.seer.cancer.gov 5. Boehmer U, Miao X, Ozonoff A: Cancer survivorship and sexual orientation. Cancer 117:3796-3804, 2011 6. Cochran SD, Mays VM: Risk of breast cancer mortality among women cohabiting with same sex partners: Findings from the National Health Interview Survey, 1997-2003. J Womens Health (Larchmt) 21:528-533, 2012 7. Meads C, Moore D: Breast cancer in lesbians and bisexual women: Systematic review of incidence, prevalence and risk studies. BMC Public Health 13:1127, 2013
DOI: 10.1200/JCO.2014.55.6696; published online ahead of print at www.jco.org on June 2, 2014 ■ ■ ■
www.jco.org
© 2014 by American Society of Clinical Oncology
Information downloaded from jco.ascopubs.org and provided by at Buddhist Dalin Hospital on March 20, 2015 from Copyright © 2014 American Society of Clinical Oncology. All rights reserved. 203.64.11.45
2183
