More LGBTQ+ individuals report, have increased odds for COPD
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Key takeaways:
- A small number of studies have reported on COPD prevalence in individuals who identify as LGBTQ+.
- A proposed call to action involves COPD education, prevention efforts and research in this population.
COPD appeared more frequently and was more likely in an LGBTQ+ population vs. a heterosexual and/or cisgender population, according to research published in Chronic Obstructive Pulmonary Diseases: Journal of the COPD Foundation.
“The current studies all point to a higher prevalence of COPD in the LGBTQ+ population, which stands to reason since it has been established that exposure to commercial tobacco is higher in this group as well,” Ninad T. Maniar, MD, attending physician in surgical critical care and pulmonary medicine at MedStar Washington Hospital Center and assistant professor of medicine at Georgetown University Medical Center, told Healio.
In a literature review with a time span of 1966 to 2023, Maniar and M. Bradley Drummond, MD, MHS, associate professor of medicine in the division of pulmonary diseases and critical care medicine at the University of North Carolina at Chapel Hill School of Medicine, found eight studies (seven through PubMed) with a focus on identifying LGBTQ+ vs. straight patients with COPD to determine the prevalence of the disease in this population.
Across these various studies, COPD was more often reported/likely among individuals who identified as LGBTQ+ vs. heterosexual and/or cisgender.
Between 24,582 sexual minority individuals and 619,347 heterosexual individuals, all of whom completed the 2017 to 2019 Behavioral Risk Factor Surveillance System survey, a higher prevalence of self-reported COPD was observed in the sexual minority group (10.3% vs. 6.9%; adjusted prevalence ratio = 1.49; 95% CI, 1.37-1.61).
Another study of individuals who took the Behavioral Risk Factor Surveillance System survey focused on 2014 to 2020 data and reported that the odds for self-reported COPD or chronic bronchitis increased by 30% for adults of a sexual and gender minority (n = 64,696) vs. non-sexual and non-gender minority (n = 1,369,681).
Looking specifically at smokers, researchers noted a similar finding in a study including Puerto Rican individuals. Compared with the general population, individuals who identified as lesbian, gay, bisexual, transgender and transsexual were significantly more likely to have COPD (OR = 4.81).
Researchers continued to observe this pattern in two studies of the National Health Interview Survey. One reported a greater prevalence of self-reported COPD among bisexual vs. gay/lesbian or straight adults (12.7% vs. 4.6% vs. 5.7%), and the other found an elevated likelihood for COPD among lesbian vs. heterosexual women (OR = 1.98; 95% CI, 1.09-3.56).
Among veterans, a COPD diagnosis was observed more often in the sexual minority cohort (n = 108,401; 36.3%) vs. the non-sexual minority cohort (n = 6,511,698; 22.7%).
A separate study of 7,454 transgender Medicare beneficiaries (mean age, 53.1 years) and 39,136,229 cisgender Medicare beneficiaries (mean age, 70.9 years) revealed a greater proportion of patients with a COPD diagnosis in the transgender cohort (27% vs. 20.8%).
Researchers also observed this outcome in a smaller study comparing COPD prevalence in transgender vs. cisgender individuals (2.4% vs. 1.5%).
When interpreting the findings from this literature review, some limitations should be kept in mind, Maniar said.
“While we identified studies that do show an increased prevalence of COPD in LGBTQ+ cohorts, the studies were heterogenous and had no data from low- and middle-income countries,” he told Healio. “We need better data, not just on prevalence but also on outcomes.”
Moving forward, Maniar outlined a three-pronged call to action aimed at helping individuals who identify as LGBTQ+.
“The first point is to increase awareness and education about COPD as a harmful consequence of smoking by leveraging national level resources and unique knowledge dissemination methods,” Maniar said.
Along with COPD education, disease prevention resources specific to the LGBTQ+ community are important.
“The second is prevention and treatment which can be achieved through the development of sensitive resources targeted at tobacco cessation and providing inclusive care to this population,” Maniar said.
Lastly, Maniar told Healio the last prong focuses on research “so we can better understand the burden of this disease in the LGBTQ+ population.”
Reference:
- Increased education, research needed to address risk of COPD among sexual and gender minorities. https://www.copdfoundation.org/About-Us/Press-Room/Press-Releases/Article/1973/Increased-Education-Research-Needed-to-Address-Risk-of-COPD-Among-Sexual-and-Ge.aspx. Published June 20, 2024. Accessed June 20, 2024.