Lesbians/Bisexuals have more Ca risk factors. (Less Likely to have Pelvic Exams).

SAN FRANCISCO -- Lesbian and bisexual women have more risk factors for cancer and are less likely to have health insurance, pelvic examinations, or mammograms.

The findings were seen in a study that compared national estimates for all women with data on 11,876 lesbian/bisexual women.

Women who have sex with women reported higher rates of obesity; alcohol use, and tobacco use, and lower rates of childbirth and birth control use, compared with population estimates for women with similar demographic characteristics, Susan D. Cochran, Ph.D., said at a conference sponsored by the Gay and Lesbian Medical Association.

The results confirm earlier findings from small studies that behavior risk factors for breast or gynecologic cancers are more common in lesbians. A 1999 Institute of Medicine report calculated that lesbians might have two to three times the risk of breast cancer, compared with other women.

However, the study reported by Dr. Cochran found no differences in self-reported histories of breast cancer between lesbians and other women after the results were adjusted for demographic cofounders. The lesbian sample was relatively young (mean age 36 years), and breast cancer is a disease of older women. Longitudinal data or further studies of older women will be needed to document any increase in cancer rates.

The breast cancer prevalence rate was approximately 1% for lesbians and all women with similar demographics. The results should be somewhat reassuring that, if there is an increased risk for breast cancer in lesbians, it is not the rumored epidemic of undetected cancer, said Dr. Cochran, professor of epidemiology and statistics at the University of California, Los Angeles.

Investigators pooled data from nearly 12,000 lesbians and bisexual women in seven independently conducted surveys between 1987 and 1994. The anonymous, self-administered questionnaires were distributed through social networks, mass mailings on community lists, lesbian and gay public events, organizational meetings, commercial establishments, and other convenience-based methods.